1. Besides hyposecretion and hypersecretion, endocrine system

1. Besides hyposecretion and hypersecretion, endocrine system dysfunction can result from: a. abnormal receptor activity. b. extracellular electrolyte alterations. c. abnormal hormone levels. d. increased synthesis of second messengers. 2 What is the most common cause of elevated levels of antidiuretic hormone (ADH) secretion? a. Pregnancy b. Autoimmune disease c. Cancer d. Heart failure 3 A 54-year-old patient with pulmonary tuberculosis is evaluated for syndrome of inappropriate ADH secretion (SIADH). Which electrolyte imbalance would be expected in this patient? a. Hypokalemia b. Hyponatremia c. Hypernatremia d. Hyperkalemia 4 A 44-year-old patient with pulmonary tuberculosis is evaluated for SIADH. Which assessment finding would support this diagnosis? a. Peripheral edema b. Low blood pressure c. Tachycardia d. Concentrated urine 5 A nurse is caring for a patient diagnosed with SIADH. What severe complication should the nurse assess for? a. Diabetes insipidus b. Neurologic damage c. Stroke d. Renal failure 6 A patient is admitted to the intensive care unit with a closed head injury sustained in a motorcycle accident. The injury has caused severe damage to the posterior pituitary. Which of the following complications should the nurse anticipate? a. Dilutional hyponatremia b. Cardiac arrest from hyperkalemia c. Dehydration from polyuria d. Metabolic acidosis 7. While planning care for a patient from general anesthesia, which principle should the nurse remember? A side effect of some general anesthetic agents is _____ diabetes insipidus. a. nephrogenic b. neurogenic c. allogenic d. psychogenic 8 Diabetes insipidus, diabetes mellitus (DM), and SIADH share which of the following assessment manifestations? a. Edema b. Polyuria c. Thirst d. Vomiting 9 A patient presents with polyuria and extreme thirst and is given exogenous ADH. For which of the following conditions would this treatment be effective? a. Psychogenic diabetes insipidus b. SIADH c. Nephrogenic diabetes insipidus d. Neurogenic diabetes insipidus 10 A patient presents with breast discharge, dysmenorrhea, and excessive excitability. Tests reveal that all pituitary hormones are elevated. What does the nurse suspect as the most likely cause for these assessment findings? a. A pituitary adenoma b. Pheochromocytoma c. Hypothalamic inflammation d. Hypothalamic hyposecretion 11 What common neurologic disturbances should the nurse assess for in a patient with a pituitary adenoma? a. Confused states b. Coma c. Visual disturbances d. Breathing abnormalities 12. Which assessment result would the nurse expect to find associated with a patient diagnosed with Graves disease? a. High levels of circulating thyroid-stimulating autoantibodies b. Ectopic secretion of thyroid-stimulating hormone (TSH) c. Increased circulation of iodine d. Low circulating levels of thyroid hormones 13 While checking the lab results for a patient diagnosed with Graves disease, the nurse would expect the T3 level to be abnormally: a. high. b. absent. c. low. d. variable. 14 A patient diagnosed with Graves disease is admitted to a medical-surgical unit. Which of the following symptoms would the nurse expect to find before treatment? a. Slow heart rate, rash b. Weight gain, cold intolerance c. Skin hot and moist, rapid heart rate d. Constipation, confusion 15 Visual disturbances are a common occurrence in patients with untreated Graves disease. The endocrinologist explains to the patient that the main cause of these complications is: a. orbital edema and protrusion of the eyeball. b. decreased blood flow to the eye. c. TSH neurotoxicity to retinal cells. d. local lactic acidosis. 16 Palpation of the neck of a patient diagnosed with Graves disease would most likely reveal: a. a small discrete thyroid nodule. b. a normal-sized thyroid. c. multiple discrete thyroid nodules. d. diffuse thyroid enlargement. 17 Which hypothyroid diagnosis is supported by low levels of TSH? a. Atypical b. Secondary c. Primary d. Autoimmune 18 When considering hypothyroidism, the basal metabolic rate is unusually: a. low. b. high. c. steady. d. variable. 19. A patient diagnosed with thyroid carcinoma would be expected to have T3 and T4 levels that are: a. normal. b. high. c. variable. d. low. 20. A 45-year-old diagnosed with Graves disease underwent surgical removal of the thyroid gland. During the postoperative period, the patient’s serum calcium is low. The most probable reason for her low serum calcium is: a. hyperparathyroidism secondary to Graves disease. b. hypoparathyroidism caused by surgical injury to the parathyroid glands. c. myxedema secondary to surgery. d. hypothyroidism resulting from lack of thyroid replacement. 21 A 30-year-old diagnosed with Graves disease is admitted to a hospital unit for the surgical removal of the thyroid gland. During the postoperative period, the nurse notes that the patient’s serum calcium is low. The nurse should observe the patient for which of the following signs/symptoms? a. Anorexia, nausea, and vomiting b. Muscle weakness and constipation c. Laryngeal spasms and hyperreflexia d. Abdominal pain and fever 22 What is the most common cause of hypoparathyroidism? a. Parathyroid adenoma b. Pituitary hyposecretion c. Hypothalamic inactivity d. Parathyroid gland injury 23 A 25-year-old male presents to his primary care provider reporting changes in facial features. CT scan reveals a mass on the anterior pituitary, and lab tests reveal severely elevated growth hormone (GH). Which of the following would the nurse also expect to find? a. Decreased IGF-1 b. Height increases c. Hypotension d. Muscular atrophy 24 A patient presents reporting visual disturbances. When CT reveals a pituitary tumor and lab tests reveal elevated prolactin, the diagnosis of prolactinoma is made. Which intervention is the treatment of choice for this condition? a. Dopaminergic agonists b. Calcium c. Radiation d. Insulin 25 What is the cause of type 1 diabetes mellitus (DM)? a. Obesity and lack of exercise b. Hyperglycemia from eating too many sweets c. Immune destruction of the pancreas d. A familial, autosomal dominant gene defect 26 What is the purpose of the glycosylated hemoglobin (hemoglobin A1c) test? a. Detecting acute complications of diabetes. b. Monitoring long-term serum glucose control. c. Checking for hyperlipidemia. d. Measuring fasting glucose levels. 27 An 11-year-old is newly diagnosed with type 1 DM. Which classic symptoms should the nurse assess the patient for? a. Weakness, vomiting, hypotension, and mental confusion b. Vomiting, abdominal pain, sweet, fruity breath, dehydration, and Kussmaul breathing c. Polydipsia, polyuria, polyphagia, and weight loss d. Recurrent infections, visual changes, fatigue, and paresthesia 28 A 19-year-old female with type 1 DM was admitted to the hospital with the following lab values: serum glucose 500 milligrams per deciliter (high), urine glucose and ketones 4+ (high), and arterial pH 7.20 (low). Her parents state that she has been sick with the “flu” for a week. Which of the following statements best explains her acidotic state? a. Her uncontrolled diabetes has led to renal failure. b. Low serum insulin promotes lipid storage and a corresponding release of ketones. c. Increased insulin levels promote protein breakdown and ketone formation. d. Insulin deficiency promotes lipid metabolism and ketone formation. 29 What causes the chronic microvascular and macrovascular complications of DM? a. Ketone toxicity b. Hyperglycemia c. Hyperinsulinemia d. Pancreatic changes 30 Which condition is considered the ultimate cause of death in the patient with diabetes? a. Stroke b. Cardiovascular disease c. Renal disease d. Cancer 31 What is the earliest manifestation of diabetes-induced kidney dysfunction? a. Microalbuminuria b. Polyuria c. Glycosuria d. Decreased glomerular filtration 32 A patient is admitted to the medical unit for complications of long-term, poorly controlled type 2 DM. Which of the following would the nurse expect to find in addition to elevated glucose? a. Elevated liver enzymes b. Atherosclerosis c. Anemia d. Metabolic alkalosis 33 A nurse checks lab results as both Cushing disease and Addison disease can manifest with elevated levels of: a. ADH. b. estrogen. c. aldosterone. d. adrenocorticotropic hormone (ACTH). 34 Which of the following alterations would the nurse expect to find in a patient with untreated Cushing disease or syndrome? a. Bradycardia b. Hypertension c. Hyperkalemia d. Tachypnea 35 Which physical feature supports the diagnosis of Cushing syndrome? a. Pallor and swollen tongue b. Depigmented skin and eyelid lag c. Truncal obesity and moon face d. Weight loss and muscle wasting 36 A 35-year-old female took corticosteroid therapy for several months. Which of the following would the nurse expect to find? a. Episodes of hypoglycemia b. Renal toxicity c. Type 2 DM d. Hypotension 37 What is the most common cause of Addison disease? a. An autoimmune reaction b. Dietary deficiency of sodium and potassium c. Cancer d. Viral infection of the pituitary gland 38 Which symptom would the nurse expect in a patient diagnosed with hyperaldosteronism? a. Hyponatremia b. Hypotension c. Hypokalemia d. Hypovolemia 39 The body’s inability to conserve water and sodium when affected by Addison disease is explained by which of the following conditions? a. Aldosterone deficiency b. Decreased levels of ACTH c. Hypersecretion of ADH d. Elevated levels of cortisol 40 A patient diagnosed with Addison disease reports weakness and is easily fatigued. What is the root of these symptoms? a. Hypocortisolism b. Metabolic acidosis c. Hypoglycemia d. Hyperkalemia 41 What is the cause of the hyperpigmentation seen in people with Cushing syndrome? a. Abnormal levels of cortisol b. Hypersensitivity of melanocytes with sun exposure c. Elevated levels of ACTH d. Permissive effects of aldosterone when cortisol levels are altered 42 A 30-year-old presents with hypertension, headache, tachycardia, impaired glucose tolerance, and weight loss. Which of the following diagnoses is supported by this symptomology? a. Pheochromocytoma b. Conn disease c. Addison disease d. Cushing disease 43 A nurse is assessing a patient with hypoparathyroidism. Clinical manifestations of hypoparathyroidism include: (select all that apply) a. Trousseau sign. b. tetany. c. oily skin. d. hair loss. e. Chvostek sign.

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