NURS 223: Exam 3 n n n
1. The nurse is teaching a client who has been newly diagnosed with hypothyr
n n n n n n n n n n n n n
oidism about the function of the thyroid. Which of these does the nurse explai
n n n n n n n n n n n n n
n to the client is the role of the thyroid gland?
n n n n n n n n n n
a) The thyroid gland is responsible for increasing the metabolic rate.
n n n n n n n n n
b) The thyroid gland promotes development of secondary sex characteristics.
n n n n n n n n
c) The thyroid gland releases neurotransmitters when the "flight or flight" mec
n n n n n n n n n n
hanism is stimulated. n n
d) The thyroid gland is responsible for regulating serum calcium levels.: a) The
n n n n n n n n n n n
thyroid gland is responsible for increasing the metabolic rate.
n n n n n n n n n
The thyroid gland produces thyroid hormones, T3 and T4. These hormones increase
n n n n n n n n n n n
the metabolic rate; increase protein and bone turnover; increase responsiveness to c
n n n n n n n n n n n
atecholamines; are necessary for fetal and infant growth and development. The para
n n n n n n n n n n n
hyroid gland regulates calcium metabolism. The adrenal glands regulate flight or figh
n n n n n n n n n n n
nand the testes or ovaries regulate development of secondary sex characteristics.
n n n n n n n n n n
2. Release and synthesis of anterior pituitary hormones are mainly regulated b
n n n n n n n n n n n
y the inhibiting or releasing actions of the:
n n n n n n n
a) hypothalamus.
b) cell receptors. n
c) thymus gland. n
d) adrenal gland.: a) hypothalamus. n n n
The hypophysis (pituitary plus hypothalamus) and hypothalamus stimulatory hormon
n n n n n n n n
es regulate the release and synthesis of anterior pituitary hormones. The adrenal gla
n n n n n n n n n n n n
nd and thymus gland hormones are regulated by the hypothalamus. Cell receptors ar
n n n n n n n n n n n n
e involved with the target cell response to the hormones.
n n n n n n n n n
3. A nursing instructor is teaching a group of students about the action of hor
n n n n n n n n n n n n n n
mones. The instructor determined that teaching was effective when the studen
n n n n n n n n n n
ts' recognize the local action of hormones as:
n n n n n n n
a) Autocrine
b) Pancreatic
c) Paracrine
d) Hormonal: c) Paracrine n n
1n/n103
, NURS 223: Exam 3 n n n
When hormones act locally on cells other than those that produced the hormone, the
n n n n n n n n n n n n n
action is called paracrine. Hormones also can exert an autocrine action on the cells in
n n n n n n n n n n n n n n
which they were produced. Pancreatic and hormonal are not actions.
n n n n n n n n n n
4. When explaining factors that influence the number of receptors present on t
n n n n n n n n n n n n
arget cells, the instructor will likely mention: Select all that apply.
n n n n n n n n n n
a) A decreased hormone level may produce increased receptor numbers.
n n n n n n n n
b) The role antibodies may have on receptor proteins.
n n n n n n n
c) A sustained excess hormone level brings about a decrease in receptor num
n n n n n n n n n n n
bers.
d) It may take days to weeks before a hormone can react to target cells.
n n n n n n n n n n n n n
e) How any given hormone can change its affinity to supply a need to all cells.:
n n n n n n n n n n n n n n n
a) A decreased hormone level may produce increased receptor numbers. b) The r
n n n n n n n n n n n n
ole antibodies may have on receptor proteins.
n n n n n n
c) A sustained excess hormone level brings about a decrease in receptor numbers.
n n n n n n n n n n n n
Target cell response varies with the number and affinity of the relevant receptors. The
n n n n n n n n n n n n n
nnumber of hormone receptors on a cell may be altered for any of several reasons. An
n n n n n n n n n n n n n n n
tibodies may destroy or block the receptor proteins. Increased or decreased hormon
n n n n n n n n n n n
e levels often induce changes in the activity of the genes that regulate receptor synth
n n n n n n n n n n n n n n
esis. For example, decreased hormone levels often produce an increase in receptor
n n n n n n n n n n n
numbers by means of a process called up- n n n n n n n
regulation; this increases the sensitivity of the body to existing hormone levels. Likew
n n n n n n n n n n n n
ise, sustained levels of excess hormone often bring about a decrease in receptor nu
n n n n n n n n n n n n n
mbers by down-regulation, producing a decrease in hormone sensitivity.
n n n n n n n n
5. A patient experiences an increase in thyroid hormone as a result of a thyroid
n n n n n n n n n n n n n n
tumor. Which of the following hormonal responses demonstrates the negative
n n n n n n n n n n
feedback mechanism? n
a) Decreased adrenocorticotropic hormone n n
b) Increased follicle-stimulating hormone n n n
c) Decreased thyroid-stimulating hormone (TSH) n n n
d) Increased thyrotropin-releasing hormone: c) Decreased thyroid- n n n n n
stimulating hormone (TSH) n n
Negative feedback occurs when secretion of one hormone causes a reduction in the
n n n n n n n n n n n n
secretion of the hormone that stimulates production of the first hormone. In this case,
n n n n n n n n n n n n n
TSH, which is manufactured by the anterior pituitary gland, would normally stimulate
n n n n n n n n n n n
2n/n103
, NURS 223: Exam 3 n n n
release of thyroid hormones, but with the increase of those hormones by the secretin
n n n n n n n n n n n n n
g tumor, enough thyroid hormones flood the system that there should be a reduction i
n n n n n n n n n n n n n n
n TSH levels.
n n
6. The nurse is planning to collect a 24-
n n n n n n n n
hour urine sample for hormone assay. In which of these situations does the nu
n n n n n n n n n n n n n
rse collaborate with the health care provider to find an alternate type of testing
n n n n n n n n n n n n n
?
a) Client has anemia. n n
b) Client has diabetes. n n
c) Client has anuria. n n
d) Client has hypothyroidism.: c) Client has anuria.
n n n n n n
The advantages of a urine test include the relative ease of obtaining urine samples an
n n n n n n n n n n n n n n
d the fact that blood sampling is not required. The disadvantage is that reliably timed
n n n n n n n n n n n n n n
urine collections often are difficult to obtain and rely on adequate renal function. Anur
n n n n n n n n n n n n n
a refers to the absence of urine output.
n n n n n n n
7. While reviewing the concept of nuclear receptors with a group of pathophysi
n n n n n n n n n n n n
ology students, the instructor uses the example of clients with type 2 diabetes
n n n n n n n n n n n n n
mellitus taking pioglitazone, a thiazolidinedione medication. Because of the p
n n n n n n n n n
eroxisome proliferator- n
activated receptors (PPARs), the drug has which effect on the clients' diabetes
n n n n n n n n n n n
? Select the best answer.
n n n n n
a) Increases the clients' metabolic rate, thereby giving them more energy,
n n n n n n n n n n
which results in weight loss.
n n n n n
b) Help the body burn fats more effectively thereby preventing any cardiovas-
n n n n n n n n n n
cular problems like myocardial infarction.
n n n n n
c) This medicines increases insulin resistance in muscle and fat and increas-
n n n n n n n n n n
es the amount of glucose produced by the liver.
n n n n n n n n n
d) Promote glucose uptake and increase the synthesis of certain proteins
n n n n n n n n n n
involved in fat metabolism, which reduces levels of certain types of lipids.: d) P
n n n n n n n n n n n n n
romote glucose uptake and increase the synthesis of certain proteins involved in fat
n n n n n n n n n n n n
metabolism, which reduces levels of certain types of lipids. n n n n n n n n
The peroxisome proliferator-
n n
activated receptors (PPARs) bind intracellular lipid metabolites and regulate the tran
n n n n n n n n n n
scription of genes involved in lipid metabolism and adipose tissue metabolism. Piogli
n n n n n n n n n n n
3n/n103
, NURS 223: Exam 3 n n n
azone is not given solely to increase metabolic rate or to just burn fats, even though th
n n n n n n n n n n n n n n n n
is may occur. Thiazolidimedione medications lower insulin resistance in muscle and f
n n n n n n n n n n n
at. They also reduce glucose produced by the liver.
n n n n n n n n
8. The physician suspects a client may be experiencing hypofunction of an en
n n n n n n n n n n n n
docrine organ. Select the most appropriate test to determine organ function. a)
n n n n n n n n n n nn
Suppression tests
n n
b) Imaging studies n
c) Genetic testing n
d) Stimulation tests: d) Stimulation tests n n n n
Stimulation tests are used when hypofunction of an endocrine organ is suspected.
n n n n n n n n n n n n
Suppression tests are used when hyperfunction of an endocrine organ is suspected.n n n n n n n n n n n
Genetic testing is used for DNA analysis, and imaging may be used as a follow-
n n n n n n n n n n n n n n
up after the diagnosis. n n n
9. An adult patient with suspected hypothyroidism is scheduled for a thyrotrop
n n n n n n n n n n n
in-
releasing hormone (TRH) stimulation test to evaluate pituitary response. Whic
n n n n n n n n n
h of the following test results would confirm secondary hypothyroidism?
n n n n n n n n n
a) No increase in TSH n n n n
b) No increase in calcitonin n n n
c) Increased calcitonin n n
d) Increased thyroid-stimulating hormone (TSH): a) No increase in TSH n n n n n n n n
A stimulation test is intended to determine if an organ that is undersecreting will produ
n n n n n n n n n n n n n n
ce an increased response. A normal response to the TRH stimulation test would be fo
n n n n n n n n n n n n n n
r the pituitary to produce an increased amount of TSH. If the pituitary gland responds
n n n n n n n n n n n n n n
with increased production, then hypothalamic undersecretion may be the cause of th
n n n n n n n n n n n
e condition. If the pituitary does not increase secretion, it can indicate secondary hyp
n n n n n n n n n n n n n
othyroidism. Calcitonin is not secreted by the pituitary. n n n n n n n
10. The nurse is teaching a new diabetic about fingerstick blood glucose testin
n n n n n n n n n n n n
g. When the client obtains a pre-
n n n n n n
meal fingerstick reading of 206 mg/dL, which teaching by the nurse is most ap
n n n n n n n n n n n n n
propriate?
a) This is an elevated reading - let's talk about adherence to insulin and diet.
n n n n n n n n n n n n n
b) This is a normal reading for after meals. n n n n n n n
c) Blood glucose levels of 206 are acceptable when you are ill.
n n n n n n n n n n
4n/n103
1. The nurse is teaching a client who has been newly diagnosed with hypothyr
n n n n n n n n n n n n n
oidism about the function of the thyroid. Which of these does the nurse explai
n n n n n n n n n n n n n
n to the client is the role of the thyroid gland?
n n n n n n n n n n
a) The thyroid gland is responsible for increasing the metabolic rate.
n n n n n n n n n
b) The thyroid gland promotes development of secondary sex characteristics.
n n n n n n n n
c) The thyroid gland releases neurotransmitters when the "flight or flight" mec
n n n n n n n n n n
hanism is stimulated. n n
d) The thyroid gland is responsible for regulating serum calcium levels.: a) The
n n n n n n n n n n n
thyroid gland is responsible for increasing the metabolic rate.
n n n n n n n n n
The thyroid gland produces thyroid hormones, T3 and T4. These hormones increase
n n n n n n n n n n n
the metabolic rate; increase protein and bone turnover; increase responsiveness to c
n n n n n n n n n n n
atecholamines; are necessary for fetal and infant growth and development. The para
n n n n n n n n n n n
hyroid gland regulates calcium metabolism. The adrenal glands regulate flight or figh
n n n n n n n n n n n
nand the testes or ovaries regulate development of secondary sex characteristics.
n n n n n n n n n n
2. Release and synthesis of anterior pituitary hormones are mainly regulated b
n n n n n n n n n n n
y the inhibiting or releasing actions of the:
n n n n n n n
a) hypothalamus.
b) cell receptors. n
c) thymus gland. n
d) adrenal gland.: a) hypothalamus. n n n
The hypophysis (pituitary plus hypothalamus) and hypothalamus stimulatory hormon
n n n n n n n n
es regulate the release and synthesis of anterior pituitary hormones. The adrenal gla
n n n n n n n n n n n n
nd and thymus gland hormones are regulated by the hypothalamus. Cell receptors ar
n n n n n n n n n n n n
e involved with the target cell response to the hormones.
n n n n n n n n n
3. A nursing instructor is teaching a group of students about the action of hor
n n n n n n n n n n n n n n
mones. The instructor determined that teaching was effective when the studen
n n n n n n n n n n
ts' recognize the local action of hormones as:
n n n n n n n
a) Autocrine
b) Pancreatic
c) Paracrine
d) Hormonal: c) Paracrine n n
1n/n103
, NURS 223: Exam 3 n n n
When hormones act locally on cells other than those that produced the hormone, the
n n n n n n n n n n n n n
action is called paracrine. Hormones also can exert an autocrine action on the cells in
n n n n n n n n n n n n n n
which they were produced. Pancreatic and hormonal are not actions.
n n n n n n n n n n
4. When explaining factors that influence the number of receptors present on t
n n n n n n n n n n n n
arget cells, the instructor will likely mention: Select all that apply.
n n n n n n n n n n
a) A decreased hormone level may produce increased receptor numbers.
n n n n n n n n
b) The role antibodies may have on receptor proteins.
n n n n n n n
c) A sustained excess hormone level brings about a decrease in receptor num
n n n n n n n n n n n
bers.
d) It may take days to weeks before a hormone can react to target cells.
n n n n n n n n n n n n n
e) How any given hormone can change its affinity to supply a need to all cells.:
n n n n n n n n n n n n n n n
a) A decreased hormone level may produce increased receptor numbers. b) The r
n n n n n n n n n n n n
ole antibodies may have on receptor proteins.
n n n n n n
c) A sustained excess hormone level brings about a decrease in receptor numbers.
n n n n n n n n n n n n
Target cell response varies with the number and affinity of the relevant receptors. The
n n n n n n n n n n n n n
nnumber of hormone receptors on a cell may be altered for any of several reasons. An
n n n n n n n n n n n n n n n
tibodies may destroy or block the receptor proteins. Increased or decreased hormon
n n n n n n n n n n n
e levels often induce changes in the activity of the genes that regulate receptor synth
n n n n n n n n n n n n n n
esis. For example, decreased hormone levels often produce an increase in receptor
n n n n n n n n n n n
numbers by means of a process called up- n n n n n n n
regulation; this increases the sensitivity of the body to existing hormone levels. Likew
n n n n n n n n n n n n
ise, sustained levels of excess hormone often bring about a decrease in receptor nu
n n n n n n n n n n n n n
mbers by down-regulation, producing a decrease in hormone sensitivity.
n n n n n n n n
5. A patient experiences an increase in thyroid hormone as a result of a thyroid
n n n n n n n n n n n n n n
tumor. Which of the following hormonal responses demonstrates the negative
n n n n n n n n n n
feedback mechanism? n
a) Decreased adrenocorticotropic hormone n n
b) Increased follicle-stimulating hormone n n n
c) Decreased thyroid-stimulating hormone (TSH) n n n
d) Increased thyrotropin-releasing hormone: c) Decreased thyroid- n n n n n
stimulating hormone (TSH) n n
Negative feedback occurs when secretion of one hormone causes a reduction in the
n n n n n n n n n n n n
secretion of the hormone that stimulates production of the first hormone. In this case,
n n n n n n n n n n n n n
TSH, which is manufactured by the anterior pituitary gland, would normally stimulate
n n n n n n n n n n n
2n/n103
, NURS 223: Exam 3 n n n
release of thyroid hormones, but with the increase of those hormones by the secretin
n n n n n n n n n n n n n
g tumor, enough thyroid hormones flood the system that there should be a reduction i
n n n n n n n n n n n n n n
n TSH levels.
n n
6. The nurse is planning to collect a 24-
n n n n n n n n
hour urine sample for hormone assay. In which of these situations does the nu
n n n n n n n n n n n n n
rse collaborate with the health care provider to find an alternate type of testing
n n n n n n n n n n n n n
?
a) Client has anemia. n n
b) Client has diabetes. n n
c) Client has anuria. n n
d) Client has hypothyroidism.: c) Client has anuria.
n n n n n n
The advantages of a urine test include the relative ease of obtaining urine samples an
n n n n n n n n n n n n n n
d the fact that blood sampling is not required. The disadvantage is that reliably timed
n n n n n n n n n n n n n n
urine collections often are difficult to obtain and rely on adequate renal function. Anur
n n n n n n n n n n n n n
a refers to the absence of urine output.
n n n n n n n
7. While reviewing the concept of nuclear receptors with a group of pathophysi
n n n n n n n n n n n n
ology students, the instructor uses the example of clients with type 2 diabetes
n n n n n n n n n n n n n
mellitus taking pioglitazone, a thiazolidinedione medication. Because of the p
n n n n n n n n n
eroxisome proliferator- n
activated receptors (PPARs), the drug has which effect on the clients' diabetes
n n n n n n n n n n n
? Select the best answer.
n n n n n
a) Increases the clients' metabolic rate, thereby giving them more energy,
n n n n n n n n n n
which results in weight loss.
n n n n n
b) Help the body burn fats more effectively thereby preventing any cardiovas-
n n n n n n n n n n
cular problems like myocardial infarction.
n n n n n
c) This medicines increases insulin resistance in muscle and fat and increas-
n n n n n n n n n n
es the amount of glucose produced by the liver.
n n n n n n n n n
d) Promote glucose uptake and increase the synthesis of certain proteins
n n n n n n n n n n
involved in fat metabolism, which reduces levels of certain types of lipids.: d) P
n n n n n n n n n n n n n
romote glucose uptake and increase the synthesis of certain proteins involved in fat
n n n n n n n n n n n n
metabolism, which reduces levels of certain types of lipids. n n n n n n n n
The peroxisome proliferator-
n n
activated receptors (PPARs) bind intracellular lipid metabolites and regulate the tran
n n n n n n n n n n
scription of genes involved in lipid metabolism and adipose tissue metabolism. Piogli
n n n n n n n n n n n
3n/n103
, NURS 223: Exam 3 n n n
azone is not given solely to increase metabolic rate or to just burn fats, even though th
n n n n n n n n n n n n n n n n
is may occur. Thiazolidimedione medications lower insulin resistance in muscle and f
n n n n n n n n n n n
at. They also reduce glucose produced by the liver.
n n n n n n n n
8. The physician suspects a client may be experiencing hypofunction of an en
n n n n n n n n n n n n
docrine organ. Select the most appropriate test to determine organ function. a)
n n n n n n n n n n nn
Suppression tests
n n
b) Imaging studies n
c) Genetic testing n
d) Stimulation tests: d) Stimulation tests n n n n
Stimulation tests are used when hypofunction of an endocrine organ is suspected.
n n n n n n n n n n n n
Suppression tests are used when hyperfunction of an endocrine organ is suspected.n n n n n n n n n n n
Genetic testing is used for DNA analysis, and imaging may be used as a follow-
n n n n n n n n n n n n n n
up after the diagnosis. n n n
9. An adult patient with suspected hypothyroidism is scheduled for a thyrotrop
n n n n n n n n n n n
in-
releasing hormone (TRH) stimulation test to evaluate pituitary response. Whic
n n n n n n n n n
h of the following test results would confirm secondary hypothyroidism?
n n n n n n n n n
a) No increase in TSH n n n n
b) No increase in calcitonin n n n
c) Increased calcitonin n n
d) Increased thyroid-stimulating hormone (TSH): a) No increase in TSH n n n n n n n n
A stimulation test is intended to determine if an organ that is undersecreting will produ
n n n n n n n n n n n n n n
ce an increased response. A normal response to the TRH stimulation test would be fo
n n n n n n n n n n n n n n
r the pituitary to produce an increased amount of TSH. If the pituitary gland responds
n n n n n n n n n n n n n n
with increased production, then hypothalamic undersecretion may be the cause of th
n n n n n n n n n n n
e condition. If the pituitary does not increase secretion, it can indicate secondary hyp
n n n n n n n n n n n n n
othyroidism. Calcitonin is not secreted by the pituitary. n n n n n n n
10. The nurse is teaching a new diabetic about fingerstick blood glucose testin
n n n n n n n n n n n n
g. When the client obtains a pre-
n n n n n n
meal fingerstick reading of 206 mg/dL, which teaching by the nurse is most ap
n n n n n n n n n n n n n
propriate?
a) This is an elevated reading - let's talk about adherence to insulin and diet.
n n n n n n n n n n n n n
b) This is a normal reading for after meals. n n n n n n n
c) Blood glucose levels of 206 are acceptable when you are ill.
n n n n n n n n n n
4n/n103
