1. A client is taking a drug that blocks a hormone’s receptor site. What is the effect on the client’s hormone response?

a.            Greater hormone metabolism

b.            Decreased hormone activity

c.             Increased hormone activity

d.            Unchanged hormone response

ANS: B

Hormones cause activity in the target tissues by binding with their specific cellular receptor sites, thereby changing the activity of the cell. When receptor sites are occupied by other substances that block hormone binding, the cell’s response is the same as when the level of the hormone is decreased.

DIF: Cognitive Level: Comprehension/Understanding REF: p. 1359

TOP: Client Needs Category: Physiological Integrity (Pharmacological and Parenteral Therapies—Expected Actions/Outcomes) MSC: Integrated Process: Nursing Process (Evaluation)

2. How does a tropic hormone differ from other hormones?

a.            Tropic hormones are given to clients who have a hormone deficiency.

b.            Tropic hormones are exclusively involved in the production of sex hormones.

c.             Tropic hormones stimulate other endocrine glands to secrete hormones.

d.            Tropic hormones are not under negative feedback control.

ANS: C

The target tissues for tropic hormones are other endocrine glands. The effect of these agents is to stimulate another endocrine gland to secrete its hormone. The other statements are inaccurate.

DIF: Cognitive Level: Knowledge/Remembering REF: p. 1361

TOP: Client Needs Category: Physiological Integrity (Physiological Adaptation—Pathophysiology)

MSC: Integrated Process: Nursing Process (Evaluation)

3. A client has a deficiency of aldosterone. Which assessment finding does the nurse correlate with this condition?

a.            Increased urine output

b.            Vasoconstriction

c.             Blood glucose, 98 mg/dL

d.            Serum sodium, 144 mEq/L

ANS: A

Aldosterone, the major mineralocorticoid, maintains extracellular fluid volume. It promotes sodium and water reabsorption and potassium excretion in the kidney tubules. A client with an aldosterone deficiency will have increased urine output. Sodium and potassium levels are normal; in aldosterone deficiency, the client would have hyponatremia and hyperkalemia. Vasoconstriction is not related.

DIF: Cognitive Level: Application/Applying or higher REF: N/A

TOP: Client Needs Category: Physiological Integrity (Physiological Adaptation—Pathophysiology)

MSC: Integrated Process: Nursing Process (Assessment)

4. A male client reports fluid secretion from his breasts. What does the nurse assess next in this client?

a.            Posterior pituitary hormones

b.            Adrenal medulla functioning

c.             Anterior pituitary hormones

d.            Parathyroid functioning

ANS: C

Breast fluid and milk production are induced by the presence of prolactin, secreted from the anterior pituitary gland. The other hormones do not influence this process.

DIF: Cognitive Level: Application/Applying or higher REF: N/A

TOP: Client Needs Category: Physiological Integrity (Physiological Adaptation—Pathophysiology)

MSC: Integrated Process: Nursing Process (Assessment)

5. A client has a condition of excessive catecholamine release. Which assessment finding does the nurse correlate with this condition?

a.            Decreased blood pressure

b.            Increased pulse

c.             Decreased respiratory rate

d.            No change in vital signs

ANS: B

Catecholamines are responsible for the “fight-or-flight” stress response. Activation of the sympathetic nervous system can be correlated with tachycardia. The other options are not correlated with excessive catecholamine release.

DIF: Cognitive Level: Application/Applying or higher REF: N/A

TOP: Client Needs Category: Physiological Integrity (Physiological Adaptation—Pathophysiology)

MSC: Integrated Process: Nursing Process (Evaluation)

6. A client is admitted to the hospital with exacerbation of heart failure, which had been stable for several years. Which finding does the nurse associate with the client’s current condition?

a.            Recent prescription for thyroid hormone replacement medication

b.            Recent onset of menopause

c.             Patchy areas of depigmentation on the face

d.            Absence of fish in the diet, but inclusion of the iodized form of table salt

ANS: A

Thyroid hormones regulate metabolism. Starting on thyroid replacement therapy can lead to an increase in heart rate and tissue oxygen use, which can lead to an exacerbation of heart failure if the client’s heart is not able to meet these increased demands. Menopause and vitiligo (depigmentation of the skin) would not be related. Thyroid function is needed to produce thyroid hormones. The client who does not eat shellfish should use iodized table salt.

DIF: Cognitive Level: Application/Applying or higher REF: N/A

TOP: Client Needs Category: Physiological Integrity (Reduction of Risk Potential—Potential for Complications from Surgical Procedures and Health Alterations)

MSC: Integrated Process: Nursing Process (Analysis)

7. A client has abnormal calcium levels. Which hormone does the nurse anticipate testing for?

a.            Thyroxine (T4)

b.            Triiodothyronine (T3)

c.             Thyrocalcitonin (calcitonin)

d.            Propylthiouracil (PTU)

ANS: C

Parafollicular cells produce thyrocalcitonin (calcitonin [TCT]), which helps regulate serum calcium levels. The other hormones are not related directly to calcium levels.

DIF: Cognitive Level: Application/Applying or higher REF: N/A

TOP: Client Needs Category: Physiological Integrity (Physiological Adaptation—Pathophysiology)

MSC: Integrated Process: Nursing Process (Assessment)

8. Which is the expected clinical manifestation for a client who has excessive production of melanocyte-stimulating hormone?

a.            Hypoglycemia and hyperkalemia

b.            Irritability and insomnia

c.             Increased urine output

d.            Darkening of the skin

ANS: D

Melanocyte-stimulating hormone increases the size of melanocytes in the skin and increases the amount of pigment (melanin) that they produce. The other actions do not occur as the result of excessive melanocyte-stimulating hormone function.

DIF: Cognitive Level: Comprehension/Understanding REF: p. 1367

TOP: Client Needs Category: Physiological Integrity (Physiological Adaptation—Pathophysiology)

MSC: Integrated Process: Nursing Process (Assessment)