Chapter 52: Assessment and
Management of Patients With Endocrine
Disorders
The nurse obtains a complete family history of a client with a suspected endocrine disorder
based on which rationale?
1. An allergy to iodine is inherited.
2. It helps determine the client's general status.
3. Endocrine disorders can be inherited.
4. Diet and drug histories are related to the family history. - correct answer-Correct response:
Endocrine disorders can be inherited.
Explanation:
Some endocrine disorders are inherited or have a tendency to run in families. Therefore, it is
essential to take a complete family history. A complete blood count and chemistry profile are
performed to determine the client's general status and to rule out disorders. Obtaining
information about an allergy to iodine is important because diagnostic testing may involve
the use of contrast dyes. However, an allergy to iodine is not related to endocrine disorders.
Diet and drug histories, although important information, are not associated with the family
history.
Accidental removal of one or both parathyroid glands can occur during a thyroidectomy.
Which of the following is used to treat tetany?
1. Tapazole
2. Synthroid
3. Propylthiouracil (PTU)
4. Calcium gluconate - correct answer-Correct response:
Calcium gluconate
Explanation:
Sometimes in thyroid surgery, the parathyroid glands are removed, producing a disturbance
in calcium metabolism. Tetany is usually treated with IV calcium gluconate. Synthroid is used
in the treatment of hypothyroidism. PTU and Tapazole are used in the treatment of
hyperthyroidism.
A nurse is caring for a client with a kidney disorder. What hormone released by the kidneys
initiates the production of angiotensin and aldosterone to increase blood pressure and blood
volume?
1. erythropoietin
2. cholecystokinin
3. gastrin
4. rerenin - correct answer-Correct response:
renin
, Explanation:
Renin is released from the kidneys and initiates the production of angiotensin and
aldosterone to increase blood pressure and blood volume. The kidneys secrete
erythropoietin, a substance that promotes the maturation of red blood cells. Cholecystokinin
released from cells in the small intestine stimulates contraction of the gallbladder to release
bile when dietary fat is ingested. Gastrin is released within the stomach to increase the
production of hydrochloric acid.
A client with acromegaly is admitted to the hospital with complaints of partial blindness that
began suddenly. What does the nurse suspect is occurring with this client?
1. Retinal detachment
2. Pressure on the optic nerve
3. Glaucoma
4. Corneal abrasions - correct answer-Correct response:
Pressure on the optic nerve
Explanation:
Partial blindness may result from pressure on the optic nerve. Glaucoma does not occur
suddenly, and the client did not report injury to suspect corneal abrasions or retinal
detachment.
A nurse is caring for a client with suspected hyperparathyroidism. Which condition may
contribute to hyperparathyroidism?
1. Steroid use
2. Renal failure
3. Decreased serum calcium level
4. Thyroidectomy - correct answer-Correct response:
Renal failure
Explanation:
Kidney damage can result from the precipitation of calcium phosphate in the renal pelvis and
parenchyma, which causes renal calculi (kidney stones), obstruction, pyelonephritis, and
kidney injury. Parathyroid hormone release increases, causing hyperparathyroidism. Serum
calcium level may rise as a result of hyperparathyroidism. Thyroidectomy may lead to
hypoparathyroidism if the parathyroid is also removed during surgery. Steroid use causes
calcium to leave bone, suppressing parathyroid hormone.
Which of the following hormones controls secretion of adrenal androgens?
1. Adrenocorticotropic hormone (ACTH)
2. Thyroid-stimulating hormone (TSH)
3. Calcitonin
4. Parathormone - correct answer-Correct response:
Adrenocorticotropic hormone (ACTH)
Explanation:
ACTH controls the secretion of adrenal androgens. When secreted in normal amounts, the
adrenal androgens appear to have little effect, but when secreted in excess, as in certain
inborn enzyme deficiencies, masculinization may result. The secretion of T3 and T4 by the
,thyroid gland is controlled by TSH. Parathormone regulates calcium and phosphorous
metabolism. Calcitonin reduces the plasma level of calcium by increasing its deposition in
bone.
A patient has been diagnosed with Cushing's syndrome. The nurse would expect which of
the following features to be present upon physical examination? Select all that apply.
1. Thin extremities
2. Purple striae
3. Truncal obesity
4. "Moon face"
5. "Buffalo hump" - correct answer-Correct response:
"Buffalo hump"
Thin extremities
"Moon face"
Truncal obesity
Purple striae
Explanation:
Manifestations of Cushing's syndrome (excessive adrenocortical hormones may cause
"moon face," "buffalo hump," thinning of the skin, obesity of the trunk and thinness of the
extremities, and purple striae.
A client presents with a huge lower jaw, bulging forehead, large hands and feet, and frequent
headaches. What could be causing this client's symptoms?
1. panhypopituitarism
2. panhyperpituitarism
3. hypopituitarism
4. hyperpituitarism - correct answer-Correct response:
hyperpituitarism
Explanation:
Acromegaly (hyperpituitarism) is a condition in which growth hormone is oversecreted after
the epiphyses of the long bones have sealed. A client with acromegaly has coarse features,
a huge lower jaw, thick lips, a thickened tongue, a bulging forehead, a bulbous nose, and
large hands and feet. When the overgrowth is from a tumor, headaches caused by pressure
on the sella turcica are common.
The nurse is assessing a client in the clinic who appears restless, excitable, and agitated.
The nurse observes that the client has exophthalmos and neck swelling. What diagnosis do
these clinical manifestations correlate with?
1. Hypothyroidism
2. Diabetes insipidus (DI)
3. Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
4. Hyperthyroidism - correct answer-Correct response:
Hyperthyroidism
Explanation:
, Clients with hyperthyroidism characteristically are restless despite felling fatigued and weak,
highly excitable, and constantly agitated. Fine tremors of the hand occur, causing unusual
clumsiness. The client cannot tolerate heat and has an increased appetite but loses weight.
Diarrhea also occurs. Visual changes, such as blurred or double vision, can develop.
Exophthalmos, seen in clients with severe hyperthyroidism, results from enlarged muscle
and fatty tissue surrounding the rear and sides of the eyeball. Neck swelling caused by the
enlarged thyroid gland often is visible. Hypothyroidism clinical manifestations are the
opposite of what is seen as hyperthyroidism. SIADH and DI clinical manifestations do not
correlate with the symptoms manifested by the client.
A client has been experiencing a decrease in serum calcium. After diagnostics, the physician
proposes the calcium level fluctuation is due to altered parathyroid function. What is the
typical number of parathyroid glands?
1. two
2. four
3. one
4. three - correct answer-Correct response:
four
Explanation:
The parathyroid glands are four (some people have more than four) small, bean-shaped
bodies, each surrounded by a capsule of connective tissue and embedded within the lateral
lobes of the thyroid.
What interventions can the nurse encourage the client with diabetes insipidus to do in order
to control thirst and compensate for urine loss?
1. Limit the fluid intake at night.
2. Consume adequate amounts of fluid.
3. Weigh daily.
4. Come to the clinic for IV fluid therapy daily. - correct answer-Correct response:
Consume adequate amounts of fluid.
Explanation:
The nurse teaches the client to consume sufficient fluid to control thirst and to compensate
for urine loss. The client will not be required to come in daily for IV fluid therapy. The client
should not limit fluid intake at night if thirst is present. Weighing daily will not control thirst or
compensate for urine loss.
The nurse is caring for a client with diabetes who developed hypoglycemia. What can the
nurse administer to the client to raise the blood sugar level?
1. Glucagon
2. Cortisone
3. Estrogen
4. Insulin - correct answer-Correct response:
Glucagon
Explanation:
Management of Patients With Endocrine
Disorders
The nurse obtains a complete family history of a client with a suspected endocrine disorder
based on which rationale?
1. An allergy to iodine is inherited.
2. It helps determine the client's general status.
3. Endocrine disorders can be inherited.
4. Diet and drug histories are related to the family history. - correct answer-Correct response:
Endocrine disorders can be inherited.
Explanation:
Some endocrine disorders are inherited or have a tendency to run in families. Therefore, it is
essential to take a complete family history. A complete blood count and chemistry profile are
performed to determine the client's general status and to rule out disorders. Obtaining
information about an allergy to iodine is important because diagnostic testing may involve
the use of contrast dyes. However, an allergy to iodine is not related to endocrine disorders.
Diet and drug histories, although important information, are not associated with the family
history.
Accidental removal of one or both parathyroid glands can occur during a thyroidectomy.
Which of the following is used to treat tetany?
1. Tapazole
2. Synthroid
3. Propylthiouracil (PTU)
4. Calcium gluconate - correct answer-Correct response:
Calcium gluconate
Explanation:
Sometimes in thyroid surgery, the parathyroid glands are removed, producing a disturbance
in calcium metabolism. Tetany is usually treated with IV calcium gluconate. Synthroid is used
in the treatment of hypothyroidism. PTU and Tapazole are used in the treatment of
hyperthyroidism.
A nurse is caring for a client with a kidney disorder. What hormone released by the kidneys
initiates the production of angiotensin and aldosterone to increase blood pressure and blood
volume?
1. erythropoietin
2. cholecystokinin
3. gastrin
4. rerenin - correct answer-Correct response:
renin
, Explanation:
Renin is released from the kidneys and initiates the production of angiotensin and
aldosterone to increase blood pressure and blood volume. The kidneys secrete
erythropoietin, a substance that promotes the maturation of red blood cells. Cholecystokinin
released from cells in the small intestine stimulates contraction of the gallbladder to release
bile when dietary fat is ingested. Gastrin is released within the stomach to increase the
production of hydrochloric acid.
A client with acromegaly is admitted to the hospital with complaints of partial blindness that
began suddenly. What does the nurse suspect is occurring with this client?
1. Retinal detachment
2. Pressure on the optic nerve
3. Glaucoma
4. Corneal abrasions - correct answer-Correct response:
Pressure on the optic nerve
Explanation:
Partial blindness may result from pressure on the optic nerve. Glaucoma does not occur
suddenly, and the client did not report injury to suspect corneal abrasions or retinal
detachment.
A nurse is caring for a client with suspected hyperparathyroidism. Which condition may
contribute to hyperparathyroidism?
1. Steroid use
2. Renal failure
3. Decreased serum calcium level
4. Thyroidectomy - correct answer-Correct response:
Renal failure
Explanation:
Kidney damage can result from the precipitation of calcium phosphate in the renal pelvis and
parenchyma, which causes renal calculi (kidney stones), obstruction, pyelonephritis, and
kidney injury. Parathyroid hormone release increases, causing hyperparathyroidism. Serum
calcium level may rise as a result of hyperparathyroidism. Thyroidectomy may lead to
hypoparathyroidism if the parathyroid is also removed during surgery. Steroid use causes
calcium to leave bone, suppressing parathyroid hormone.
Which of the following hormones controls secretion of adrenal androgens?
1. Adrenocorticotropic hormone (ACTH)
2. Thyroid-stimulating hormone (TSH)
3. Calcitonin
4. Parathormone - correct answer-Correct response:
Adrenocorticotropic hormone (ACTH)
Explanation:
ACTH controls the secretion of adrenal androgens. When secreted in normal amounts, the
adrenal androgens appear to have little effect, but when secreted in excess, as in certain
inborn enzyme deficiencies, masculinization may result. The secretion of T3 and T4 by the
,thyroid gland is controlled by TSH. Parathormone regulates calcium and phosphorous
metabolism. Calcitonin reduces the plasma level of calcium by increasing its deposition in
bone.
A patient has been diagnosed with Cushing's syndrome. The nurse would expect which of
the following features to be present upon physical examination? Select all that apply.
1. Thin extremities
2. Purple striae
3. Truncal obesity
4. "Moon face"
5. "Buffalo hump" - correct answer-Correct response:
"Buffalo hump"
Thin extremities
"Moon face"
Truncal obesity
Purple striae
Explanation:
Manifestations of Cushing's syndrome (excessive adrenocortical hormones may cause
"moon face," "buffalo hump," thinning of the skin, obesity of the trunk and thinness of the
extremities, and purple striae.
A client presents with a huge lower jaw, bulging forehead, large hands and feet, and frequent
headaches. What could be causing this client's symptoms?
1. panhypopituitarism
2. panhyperpituitarism
3. hypopituitarism
4. hyperpituitarism - correct answer-Correct response:
hyperpituitarism
Explanation:
Acromegaly (hyperpituitarism) is a condition in which growth hormone is oversecreted after
the epiphyses of the long bones have sealed. A client with acromegaly has coarse features,
a huge lower jaw, thick lips, a thickened tongue, a bulging forehead, a bulbous nose, and
large hands and feet. When the overgrowth is from a tumor, headaches caused by pressure
on the sella turcica are common.
The nurse is assessing a client in the clinic who appears restless, excitable, and agitated.
The nurse observes that the client has exophthalmos and neck swelling. What diagnosis do
these clinical manifestations correlate with?
1. Hypothyroidism
2. Diabetes insipidus (DI)
3. Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
4. Hyperthyroidism - correct answer-Correct response:
Hyperthyroidism
Explanation:
, Clients with hyperthyroidism characteristically are restless despite felling fatigued and weak,
highly excitable, and constantly agitated. Fine tremors of the hand occur, causing unusual
clumsiness. The client cannot tolerate heat and has an increased appetite but loses weight.
Diarrhea also occurs. Visual changes, such as blurred or double vision, can develop.
Exophthalmos, seen in clients with severe hyperthyroidism, results from enlarged muscle
and fatty tissue surrounding the rear and sides of the eyeball. Neck swelling caused by the
enlarged thyroid gland often is visible. Hypothyroidism clinical manifestations are the
opposite of what is seen as hyperthyroidism. SIADH and DI clinical manifestations do not
correlate with the symptoms manifested by the client.
A client has been experiencing a decrease in serum calcium. After diagnostics, the physician
proposes the calcium level fluctuation is due to altered parathyroid function. What is the
typical number of parathyroid glands?
1. two
2. four
3. one
4. three - correct answer-Correct response:
four
Explanation:
The parathyroid glands are four (some people have more than four) small, bean-shaped
bodies, each surrounded by a capsule of connective tissue and embedded within the lateral
lobes of the thyroid.
What interventions can the nurse encourage the client with diabetes insipidus to do in order
to control thirst and compensate for urine loss?
1. Limit the fluid intake at night.
2. Consume adequate amounts of fluid.
3. Weigh daily.
4. Come to the clinic for IV fluid therapy daily. - correct answer-Correct response:
Consume adequate amounts of fluid.
Explanation:
The nurse teaches the client to consume sufficient fluid to control thirst and to compensate
for urine loss. The client will not be required to come in daily for IV fluid therapy. The client
should not limit fluid intake at night if thirst is present. Weighing daily will not control thirst or
compensate for urine loss.
The nurse is caring for a client with diabetes who developed hypoglycemia. What can the
nurse administer to the client to raise the blood sugar level?
1. Glucagon
2. Cortisone
3. Estrogen
4. Insulin - correct answer-Correct response:
Glucagon
Explanation:
