C HAPTER 31: E NDOCRINE C LINICAL
A SSESSMENT AND D IAGNOSTIC
P ROCEDURES
Urden: Critical Care Nursing, 9th Edition
MULTIPLE CHOICE
1. A patient is admitted with hypernatremia secondary to di abetes insipidus
(DI). Which test would help the practitioner differentiate between central
and nephrogenic DI?
a. Water deprivation test
b. Serum osmolalit y
c. Serum antidiuretic hormone level
d. Antidiuretic hormone (ADH) test
ANS: D
The antidiuretic hormone test is used to differentiate between
neurogenic diabetes insipidus (DI) (central) and nephrogenic (kidney)
DI. In severe central DI, in which the pituitary is affected, the urine
osmolalit y shows a significant increase (becomes more concentrated),
which indicates that the cell receptor sites on the kidney tubules are
responsive to vasopressin. Test results in which urine osmolalit y
remains unchanged indicate nephrogenic DI, suggesting kidney
dysfunction because the kidneys are no longer responsive to
antidiuretic hormone.
, PTS: 1 DIF: Cognitive Level: Appl ying REF: p. 719
OBJ: Nursing Process Step: Diagnosis TOP:
Endocrine MSC: NC LEX: Physiologic Integrit y
2. A patient is admitted with hypernatremia secondary to diabetes insipidus
(DI). The practitioner susp ects the patient has neurogenic DI. Which
finding would confirm that diagnosis?
a. A slight increase in urine osmolalit y
b. A decrease in urine output
c. A decrease in serum osmolalit y
d. No change in urine osmolalit y
ANS: D
In cases of severe central diabetes insi pidus (DI), the urine osmolalit y
shows a significant increase (becomes more concentrated). Test results
in which urine osmolalit y remains unchanged indicate nephrogenic DI.
PTS: 1 DIF: Cognitive Level: Appl ying REF: p. 719
OBJ: Nursing Process Step: Evaluation TOP:
Endocrine MSC: NC LEX: Physiologic Integrit y
3. A patient has been admitted with a brain mass. The practitioner suspects it
might be a pituitary tumor and orders a computed tomography (CT) scan.
What area of brain should be scanned to confirm this diagnosis?
a. Frontal lobe
b. Base of the skull
c. Temporal lobe
d. Anterior fossa
, ANS: B
Computed tomography (CT) of the base of the skull identifies pituitary
tumors, blood clots, cysts, nodules, or other soft tissue masses.
PTS: 1 DIF: Cognitive Level: U nderstanding REF: p.
719 OBJ: Nursing Process Step: Diagnosis TOP:
Endocrine MSC: NC LEX: Physiologic Integrit y
4. A patient reports losing weight even though she eats “everything in sight.”
She also reports tremors and diarrhea. The nurse suspects the p atient may
have what problem?
a. Hypothyroidism
b. Diabetes mellitus
c. Hyperthyroidism
d. Pituitary tumor
ANS: C
Weight loss, increased appetite, tremors, insomnia, and diarrhea are
s ymptoms of hyperthyroidism.
PTS: 1 DIF: Cognitive Level: Understanding REF: p.
720 | Box 31-2 OBJ: Nursing Process Step: Diagnosis
TOP: Endocrine MSC: NC LEX: Physiologic Integrit y
5. A patient has been admitted with uncontrolled atrial fibrillation and
muscle wasting. The practitioner suspects the patient may have a thyroid
A SSESSMENT AND D IAGNOSTIC
P ROCEDURES
Urden: Critical Care Nursing, 9th Edition
MULTIPLE CHOICE
1. A patient is admitted with hypernatremia secondary to di abetes insipidus
(DI). Which test would help the practitioner differentiate between central
and nephrogenic DI?
a. Water deprivation test
b. Serum osmolalit y
c. Serum antidiuretic hormone level
d. Antidiuretic hormone (ADH) test
ANS: D
The antidiuretic hormone test is used to differentiate between
neurogenic diabetes insipidus (DI) (central) and nephrogenic (kidney)
DI. In severe central DI, in which the pituitary is affected, the urine
osmolalit y shows a significant increase (becomes more concentrated),
which indicates that the cell receptor sites on the kidney tubules are
responsive to vasopressin. Test results in which urine osmolalit y
remains unchanged indicate nephrogenic DI, suggesting kidney
dysfunction because the kidneys are no longer responsive to
antidiuretic hormone.
, PTS: 1 DIF: Cognitive Level: Appl ying REF: p. 719
OBJ: Nursing Process Step: Diagnosis TOP:
Endocrine MSC: NC LEX: Physiologic Integrit y
2. A patient is admitted with hypernatremia secondary to diabetes insipidus
(DI). The practitioner susp ects the patient has neurogenic DI. Which
finding would confirm that diagnosis?
a. A slight increase in urine osmolalit y
b. A decrease in urine output
c. A decrease in serum osmolalit y
d. No change in urine osmolalit y
ANS: D
In cases of severe central diabetes insi pidus (DI), the urine osmolalit y
shows a significant increase (becomes more concentrated). Test results
in which urine osmolalit y remains unchanged indicate nephrogenic DI.
PTS: 1 DIF: Cognitive Level: Appl ying REF: p. 719
OBJ: Nursing Process Step: Evaluation TOP:
Endocrine MSC: NC LEX: Physiologic Integrit y
3. A patient has been admitted with a brain mass. The practitioner suspects it
might be a pituitary tumor and orders a computed tomography (CT) scan.
What area of brain should be scanned to confirm this diagnosis?
a. Frontal lobe
b. Base of the skull
c. Temporal lobe
d. Anterior fossa
, ANS: B
Computed tomography (CT) of the base of the skull identifies pituitary
tumors, blood clots, cysts, nodules, or other soft tissue masses.
PTS: 1 DIF: Cognitive Level: U nderstanding REF: p.
719 OBJ: Nursing Process Step: Diagnosis TOP:
Endocrine MSC: NC LEX: Physiologic Integrit y
4. A patient reports losing weight even though she eats “everything in sight.”
She also reports tremors and diarrhea. The nurse suspects the p atient may
have what problem?
a. Hypothyroidism
b. Diabetes mellitus
c. Hyperthyroidism
d. Pituitary tumor
ANS: C
Weight loss, increased appetite, tremors, insomnia, and diarrhea are
s ymptoms of hyperthyroidism.
PTS: 1 DIF: Cognitive Level: Understanding REF: p.
720 | Box 31-2 OBJ: Nursing Process Step: Diagnosis
TOP: Endocrine MSC: NC LEX: Physiologic Integrit y
5. A patient has been admitted with uncontrolled atrial fibrillation and
muscle wasting. The practitioner suspects the patient may have a thyroid
