NUR 265 Exam 3 Advanced Concepts in
Medical-Surgical Nursing Questions and
Answers Rated A+ update Test Bank
A young adult patient who is being seen in the clinic has excessive secretion of the anterior
pituitary hormones. Which laboratory test result would the nurse expect?
a. Increased urinary cortisol
b. Decreased serum thyroxine
c. Elevated serum aldosterone
d. Low urinary catecholamines -ANSWER : A
Increased secretion of adrenocorticotropic hormone (ACTH) by the anterior pituitary gland will
lead to an increase in serum and urinary cortisol levels. An increase, rather than a decrease, in
thyroxine level would be expected with increased secretion of thyroid-stimulating hormone
(TSH) by the anterior pituitary. The anterior pituitary does not control aldosterone and
catecholamine levels.
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,Which statement made by a 50-yr-old female patient indicates to the nurse that further
assessment of thyroid function may be needed?
a. "I am so thirsty that I drink all day long."
b. "I get up several times at night to urinate."
c. "I feel a lump in my throat when I swallow."
d. "I notice my breasts are always tender lately." -ANSWER : C
An enlarged thyroid gland can cause problems swallowing or a change in neck size. Nocturia
is associated with diseases such as diabetes, diabetes insipidus, or chronic kidney disease.
Breast tenderness would occur with excessive gonadal hormone levels. Thirst is a sign of
disease such as diabetes.
A patient seen in the emergency department for severe headache and acute confusion has a
serum sodium level of 118 mEq/L. The nurse would anticipate the need for which diagnostic
test?
a. Urinary 17-ketosteroids
b. Antidiuretic hormone level
c. Growth hormone stimulation test
d. Adrenocorticotropic hormone level -ANSWER : B
Elevated levels of antidiuretic hormone will cause water retention and decrease serum sodium
levels. The other tests would not be helpful in determining the cause of the patient's
hyponatremia.
Which question from the nurse during a patient interview would provide focused information
about a possible thyroid disorder?
a. "What methods do you use to help cope with stress?"
b. "Have you experienced any blurring or double vision?"
c. "Have you had a recent unplanned weight gain or loss?"
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,d. "Do you have to get up at night to empty your bladder?" -ANSWER : C
Because thyroid function affects metabolic rate, changes in weight may indicate hyperfunction
or hypofunction of the thyroid gland. Nocturia, visual difficulty, and changes in stress level are
associated with other endocrine disorders.
A patient is scheduled in the outpatient clinic for blood cortisol testing. Which instruction would
the nurse provide?
a. "Avoid adding any salt to your foods for 24 hours before the test."
b. "You will need to lie down for 30 minutes before the blood is drawn."
c. "Come to the laboratory to have the blood drawn early in the morning."
d. "Do not have anything to eat or drink before the blood test is obtained." -ANSWER : C
Cortisol levels are usually drawn in the morning, when levels are highest. The other instructions
would be given to patients who were having other endocrine testing.
A patient admitted with pneumonia has a total serum calcium level of 13.3 mg/dL. Which
serum level would the nurse anticipate will be tested next?
a. Calcitonin
b. Catecholamine
c. Thyroid hormone
d. Parathyroid hormone -ANSWER : D
Parathyroid hormone (PTH) is the major controller of blood calcium levels. Although calcitonin
secretion is a counter mechanism to PTH, it does not play a major role in calcium balance.
Catecholamine and thyroid hormone levels do not affect serum calcium level.
During the physical examination, the nurse cannot feel the patient's thyroid gland. Which
action would the nurse take?
a. Palpate the patient's neck more deeply.
b. Document that the thyroid was nonpalpable.
c. Notify the health care provider immediately.
d. Teach the patient about thyroid hormone testing. -ANSWER : B
The thyroid is usually nonpalpable. The nurse would simply document the finding. Deep
palpation of the neck is not appropriate; do not press too hard or massage an enlarged
thyroid gland as this can cause a sudden release of thyroid hormone into an already
3 | Pa g e
, overloaded system. There is no need to notify the health care provider immediately about a
normal finding. There is no indication for thyroid-stimulating hormone (TSH) testing unless there
is evidence of thyroid dysfunction.
Which laboratory value would the nurse review to determine whether a patient's
hypothyroidism is caused by a problem with the anterior pituitary gland?
a. Thyroxine (T4) level
b. Triiodothyronine (T3) level
c. Thyroid-stimulating hormone (TSH) level
d. Thyrotropin-releasing hormone (TRH) level -ANSWER : C
A low TSH level indicates that the patient's hypothyroidism is caused by decreased anterior
pituitary secretion of TSH. Low T3 and T4 levels are not diagnostic of the primary cause of the
hypothyroidism. TRH levels indicate the function of the hypothalamus.
Which information will a patient's glycosylated hemoglobin (A1C) result provide to the nurse?
a. Fasting preprandial glucose levels
b. Glucose levels 2 hours after a meal
c. Glucose control over the past 90 days
d. Hypoglycemic episodes in the past 3 months -ANSWER : C
Glycosylated hemoglobin testing measures glucose control over the last 3 months. Glucose
testing before/after a meal or random testing may reveal impaired glucose tolerance and
indicate prediabetes, but it is not done on patients who already have a diagnosis of diabetes.
There is no test to evaluate for hypoglycemic episodes in the past.
A patient is taking a drug that blocks the action of aldosterone. Which additional effect of the
medication would the nurse monitor?
a. Increased serum sodium
b. Decreased urinary output
c. Elevated serum potassium
d. Evidence of fluid overload -ANSWER : C
Because aldosterone increases the excretion of potassium, a medication that blocks
aldosterone will tend to cause hyperkalemia. Aldosterone also promotes the reabsorption of
sodium and water in the renal tubules, so spironolactone will tend to cause increased urine
output, a decreased or normal serum sodium level, and signs of dehydration.
4 | Pa g e
Medical-Surgical Nursing Questions and
Answers Rated A+ update Test Bank
A young adult patient who is being seen in the clinic has excessive secretion of the anterior
pituitary hormones. Which laboratory test result would the nurse expect?
a. Increased urinary cortisol
b. Decreased serum thyroxine
c. Elevated serum aldosterone
d. Low urinary catecholamines -ANSWER : A
Increased secretion of adrenocorticotropic hormone (ACTH) by the anterior pituitary gland will
lead to an increase in serum and urinary cortisol levels. An increase, rather than a decrease, in
thyroxine level would be expected with increased secretion of thyroid-stimulating hormone
(TSH) by the anterior pituitary. The anterior pituitary does not control aldosterone and
catecholamine levels.
1 | Pa g e
,Which statement made by a 50-yr-old female patient indicates to the nurse that further
assessment of thyroid function may be needed?
a. "I am so thirsty that I drink all day long."
b. "I get up several times at night to urinate."
c. "I feel a lump in my throat when I swallow."
d. "I notice my breasts are always tender lately." -ANSWER : C
An enlarged thyroid gland can cause problems swallowing or a change in neck size. Nocturia
is associated with diseases such as diabetes, diabetes insipidus, or chronic kidney disease.
Breast tenderness would occur with excessive gonadal hormone levels. Thirst is a sign of
disease such as diabetes.
A patient seen in the emergency department for severe headache and acute confusion has a
serum sodium level of 118 mEq/L. The nurse would anticipate the need for which diagnostic
test?
a. Urinary 17-ketosteroids
b. Antidiuretic hormone level
c. Growth hormone stimulation test
d. Adrenocorticotropic hormone level -ANSWER : B
Elevated levels of antidiuretic hormone will cause water retention and decrease serum sodium
levels. The other tests would not be helpful in determining the cause of the patient's
hyponatremia.
Which question from the nurse during a patient interview would provide focused information
about a possible thyroid disorder?
a. "What methods do you use to help cope with stress?"
b. "Have you experienced any blurring or double vision?"
c. "Have you had a recent unplanned weight gain or loss?"
2 | Pa g e
,d. "Do you have to get up at night to empty your bladder?" -ANSWER : C
Because thyroid function affects metabolic rate, changes in weight may indicate hyperfunction
or hypofunction of the thyroid gland. Nocturia, visual difficulty, and changes in stress level are
associated with other endocrine disorders.
A patient is scheduled in the outpatient clinic for blood cortisol testing. Which instruction would
the nurse provide?
a. "Avoid adding any salt to your foods for 24 hours before the test."
b. "You will need to lie down for 30 minutes before the blood is drawn."
c. "Come to the laboratory to have the blood drawn early in the morning."
d. "Do not have anything to eat or drink before the blood test is obtained." -ANSWER : C
Cortisol levels are usually drawn in the morning, when levels are highest. The other instructions
would be given to patients who were having other endocrine testing.
A patient admitted with pneumonia has a total serum calcium level of 13.3 mg/dL. Which
serum level would the nurse anticipate will be tested next?
a. Calcitonin
b. Catecholamine
c. Thyroid hormone
d. Parathyroid hormone -ANSWER : D
Parathyroid hormone (PTH) is the major controller of blood calcium levels. Although calcitonin
secretion is a counter mechanism to PTH, it does not play a major role in calcium balance.
Catecholamine and thyroid hormone levels do not affect serum calcium level.
During the physical examination, the nurse cannot feel the patient's thyroid gland. Which
action would the nurse take?
a. Palpate the patient's neck more deeply.
b. Document that the thyroid was nonpalpable.
c. Notify the health care provider immediately.
d. Teach the patient about thyroid hormone testing. -ANSWER : B
The thyroid is usually nonpalpable. The nurse would simply document the finding. Deep
palpation of the neck is not appropriate; do not press too hard or massage an enlarged
thyroid gland as this can cause a sudden release of thyroid hormone into an already
3 | Pa g e
, overloaded system. There is no need to notify the health care provider immediately about a
normal finding. There is no indication for thyroid-stimulating hormone (TSH) testing unless there
is evidence of thyroid dysfunction.
Which laboratory value would the nurse review to determine whether a patient's
hypothyroidism is caused by a problem with the anterior pituitary gland?
a. Thyroxine (T4) level
b. Triiodothyronine (T3) level
c. Thyroid-stimulating hormone (TSH) level
d. Thyrotropin-releasing hormone (TRH) level -ANSWER : C
A low TSH level indicates that the patient's hypothyroidism is caused by decreased anterior
pituitary secretion of TSH. Low T3 and T4 levels are not diagnostic of the primary cause of the
hypothyroidism. TRH levels indicate the function of the hypothalamus.
Which information will a patient's glycosylated hemoglobin (A1C) result provide to the nurse?
a. Fasting preprandial glucose levels
b. Glucose levels 2 hours after a meal
c. Glucose control over the past 90 days
d. Hypoglycemic episodes in the past 3 months -ANSWER : C
Glycosylated hemoglobin testing measures glucose control over the last 3 months. Glucose
testing before/after a meal or random testing may reveal impaired glucose tolerance and
indicate prediabetes, but it is not done on patients who already have a diagnosis of diabetes.
There is no test to evaluate for hypoglycemic episodes in the past.
A patient is taking a drug that blocks the action of aldosterone. Which additional effect of the
medication would the nurse monitor?
a. Increased serum sodium
b. Decreased urinary output
c. Elevated serum potassium
d. Evidence of fluid overload -ANSWER : C
Because aldosterone increases the excretion of potassium, a medication that blocks
aldosterone will tend to cause hyperkalemia. Aldosterone also promotes the reabsorption of
sodium and water in the renal tubules, so spironolactone will tend to cause increased urine
output, a decreased or normal serum sodium level, and signs of dehydration.
4 | Pa g e
