Nur-265 Exam 3
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1. A young adult patient who is being seen ANS: A
in the clinic has excessive secretion of Increased secretion of adrenocorticotropic hor-
the anterior pituitary hormones. Which mone (ACTH) by the anterior pituitary gland
laboratory test result would the nurse will lead to an increase in serum and urinary
expect? cortisol levels. An increase, rather than a de-
a. Increased urinary cortisol crease, in thyroxine level would be expected
b. Decreased serum thyroxine with increased secretion of thyroid-stimulating
c. Elevated serum aldosterone hormone (TSH) by the anterior pituitary. The
d. Low urinary catecholamines anterior pituitary does not control aldosterone
and catecholamine levels.
2. Which statement made by a 50-yr-old fe- ANS: C
male patient indicates to the nurse that An enlarged thyroid gland can cause problems
further assessment of thyroid function swallowing or a change in neck size. Nocturia
may be needed? is associated with diseases such as diabetes,
a. "I am so thirsty that I drink all day diabetes insipidus, or chronic kidney disease.
long." Breast tenderness would occur with excessive
b. "I get up several times at night to gonadal hormone levels. Thirst is a sign of dis-
urinate." ease such as diabetes.
c. "I feel a lump in my throat when I
swallow."
d. "I notice my breasts are always tender
lately."
3. A patient seen in the emergency depart- ANS: B
ment for severe headache and acute Elevated levels of antidiuretic hormone will
confusion has a serum sodium level of cause water retention and decrease serum
118 mEq/L. The nurse would anticipate sodium levels. The other tests would not be
the need for which diagnostic test? helpful in determining the cause of the pa-
a. Urinary 17-ketosteroids tient's hyponatremia.
b. Antidiuretic hormone level
, Nur-265 Exam 3
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c. Growth hormone stimulation test
d. Adrenocorticotropic hormone level
4. Which question from the nurse during ANS: C
a patient interview would provide fo- Because thyroid function affects metabolic rate,
cused information about a possible thy- changes in weight may indicate hyperfunction
roid disorder? or hypofunction of the thyroid gland. Nocturia,
a. "What methods do you use to help visual difficulty, and changes in stress level are
cope with stress?" associated with other endocrine disorders.
b. "Have you experienced any blurring
or double vision?"
c. "Have you had a recent unplanned
weight gain or loss?"
d. "Do you have to get up at night to
empty your bladder?"
5. A patient is scheduled in the outpatient ANS: C
clinic for blood cortisol testing. Which Cortisol levels are usually drawn in the morning,
instruction would the nurse provide? when levels are highest. The other instructions
a. "Avoid adding any salt to your foods would be given to patients who were having
for 24 hours before the test." other endocrine testing.
b. "You will need to lie down for 30 min-
utes 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."
6. A patient admitted with pneumonia has ANS: D
a total serum calcium level of 13.3 Parathyroid hormone (PTH) is the major con-
mg/dL. Which serum level would the troller of blood calcium levels. Although calci-
nurse anticipate will be tested next? tonin secretion is a counter mechanism to PTH,
, Nur-265 Exam 3
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a. Calcitonin it does not play a major role in calcium balance.
b. Catecholamine Catecholamine and thyroid hormone levels do
c. Thyroid hormone not affect serum calcium level.
d. Parathyroid hormone
7. During the physical examination, the ANS: B
nurse cannot feel the patient's thyroid The thyroid is usually nonpalpable. The nurse
gland. Which action would the nurse would simply document the finding. Deep pal-
take? pation of the neck is not appropriate; do not
a. Palpate the patient's neck more press too hard or massage an enlarged thyroid
deeply. gland as this can cause a sudden release of thy-
b. Document that the thyroid was non- roid hormone into an already overloaded sys-
palpable. tem. There is no need to notify the health care
c. Notify the health care provider imme- provider immediately about a normal finding.
diately. There is no indication for thyroid-stimulating
d. Teach the patient about thyroid hor- hormone (TSH) testing unless there is evidence
mone testing. of thyroid dysfunction.
8. Which laboratory value would the nurse ANS: C
review to determine whether a patient's A low TSH level indicates that the patient's hy-
hypothyroidism is caused by a problem pothyroidism is caused by decreased anterior
with the anterior pituitary gland? pituitary secretion of TSH. Low T3 and T4 levels
a. Thyroxine (T4) level are not diagnostic of the primary cause of the
b. Triiodothyronine (T3) level hypothyroidism. TRH levels indicate the func-
c. Thyroid-stimulating hormone (TSH) tion of the hypothalamus.
level
d. Thyrotropin-releasing hormone (TRH)
level
9. Which information will a patient's glyco- ANS: C
sylated hemoglobin (A1C) result provide Glycosylated hemoglobin testing measures
to the nurse? glucose control over the last 3 months. Glucose
, Nur-265 Exam 3
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a. Fasting preprandial glucose levels testing before/after a meal or random testing
b. Glucose levels 2 hours after a meal may reveal impaired glucose tolerance and in-
c. Glucose control over the past 90 days dicate prediabetes, but it is not done on pa-
d. Hypoglycemic episodes in the past 3 tients who already have a diagnosis of diabetes.
months There is no test to evaluate for hypoglycemic
episodes in the past.
10. A patient is taking a drug that blocks ANS: C
the action of aldosterone. Which addi- Because aldosterone increases the excretion
tional effect of the medication would the of potassium, a medication that blocks aldos-
nurse monitor? terone will tend to cause hyperkalemia. Aldos-
a. Increased serum sodium terone also promotes the reabsorption of sodi-
b. Decreased urinary output um and water in the renal tubules, so spirono-
c. Elevated serum potassium lactone will tend to cause increased urine out-
d. Evidence of fluid overload put, a decreased or normal serum sodium level,
and signs of dehydration.
11. A patient has been newly diagnosed ANS: B
with type 2 diabetes. Which information When dealing with a patient with a chronic
about the patient will be most useful condition such as diabetes, identification of the
to the nurse who is helping the patient patient's values and beliefs can assist the in-
develop strategies for successful adap- terprofessional team in choosing strategies for
tation to this disease? successful lifestyle change. The other informa-
a. Ideal weight tion also will be useful but is not as important in
b. Value system developing an individualized plan for the nec-
c. Activity level essary lifestyle changes.
d. Visual changes
12. An 18-yr-old male patient with small ANS: D
stature is scheduled for a growth hor- Hypoglycemia is induced during the growth
mone stimulation test. Which item hormone stimulation test, and the nurse should
would the nurse obtain in preparation be ready to administer 50% dextrose immedi-
Study online at https://quizlet.com/_gxqwp4
1. A young adult patient who is being seen ANS: A
in the clinic has excessive secretion of Increased secretion of adrenocorticotropic hor-
the anterior pituitary hormones. Which mone (ACTH) by the anterior pituitary gland
laboratory test result would the nurse will lead to an increase in serum and urinary
expect? cortisol levels. An increase, rather than a de-
a. Increased urinary cortisol crease, in thyroxine level would be expected
b. Decreased serum thyroxine with increased secretion of thyroid-stimulating
c. Elevated serum aldosterone hormone (TSH) by the anterior pituitary. The
d. Low urinary catecholamines anterior pituitary does not control aldosterone
and catecholamine levels.
2. Which statement made by a 50-yr-old fe- ANS: C
male patient indicates to the nurse that An enlarged thyroid gland can cause problems
further assessment of thyroid function swallowing or a change in neck size. Nocturia
may be needed? is associated with diseases such as diabetes,
a. "I am so thirsty that I drink all day diabetes insipidus, or chronic kidney disease.
long." Breast tenderness would occur with excessive
b. "I get up several times at night to gonadal hormone levels. Thirst is a sign of dis-
urinate." ease such as diabetes.
c. "I feel a lump in my throat when I
swallow."
d. "I notice my breasts are always tender
lately."
3. A patient seen in the emergency depart- ANS: B
ment for severe headache and acute Elevated levels of antidiuretic hormone will
confusion has a serum sodium level of cause water retention and decrease serum
118 mEq/L. The nurse would anticipate sodium levels. The other tests would not be
the need for which diagnostic test? helpful in determining the cause of the pa-
a. Urinary 17-ketosteroids tient's hyponatremia.
b. Antidiuretic hormone level
, Nur-265 Exam 3
Study online at https://quizlet.com/_gxqwp4
c. Growth hormone stimulation test
d. Adrenocorticotropic hormone level
4. Which question from the nurse during ANS: C
a patient interview would provide fo- Because thyroid function affects metabolic rate,
cused information about a possible thy- changes in weight may indicate hyperfunction
roid disorder? or hypofunction of the thyroid gland. Nocturia,
a. "What methods do you use to help visual difficulty, and changes in stress level are
cope with stress?" associated with other endocrine disorders.
b. "Have you experienced any blurring
or double vision?"
c. "Have you had a recent unplanned
weight gain or loss?"
d. "Do you have to get up at night to
empty your bladder?"
5. A patient is scheduled in the outpatient ANS: C
clinic for blood cortisol testing. Which Cortisol levels are usually drawn in the morning,
instruction would the nurse provide? when levels are highest. The other instructions
a. "Avoid adding any salt to your foods would be given to patients who were having
for 24 hours before the test." other endocrine testing.
b. "You will need to lie down for 30 min-
utes 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."
6. A patient admitted with pneumonia has ANS: D
a total serum calcium level of 13.3 Parathyroid hormone (PTH) is the major con-
mg/dL. Which serum level would the troller of blood calcium levels. Although calci-
nurse anticipate will be tested next? tonin secretion is a counter mechanism to PTH,
, Nur-265 Exam 3
Study online at https://quizlet.com/_gxqwp4
a. Calcitonin it does not play a major role in calcium balance.
b. Catecholamine Catecholamine and thyroid hormone levels do
c. Thyroid hormone not affect serum calcium level.
d. Parathyroid hormone
7. During the physical examination, the ANS: B
nurse cannot feel the patient's thyroid The thyroid is usually nonpalpable. The nurse
gland. Which action would the nurse would simply document the finding. Deep pal-
take? pation of the neck is not appropriate; do not
a. Palpate the patient's neck more press too hard or massage an enlarged thyroid
deeply. gland as this can cause a sudden release of thy-
b. Document that the thyroid was non- roid hormone into an already overloaded sys-
palpable. tem. There is no need to notify the health care
c. Notify the health care provider imme- provider immediately about a normal finding.
diately. There is no indication for thyroid-stimulating
d. Teach the patient about thyroid hor- hormone (TSH) testing unless there is evidence
mone testing. of thyroid dysfunction.
8. Which laboratory value would the nurse ANS: C
review to determine whether a patient's A low TSH level indicates that the patient's hy-
hypothyroidism is caused by a problem pothyroidism is caused by decreased anterior
with the anterior pituitary gland? pituitary secretion of TSH. Low T3 and T4 levels
a. Thyroxine (T4) level are not diagnostic of the primary cause of the
b. Triiodothyronine (T3) level hypothyroidism. TRH levels indicate the func-
c. Thyroid-stimulating hormone (TSH) tion of the hypothalamus.
level
d. Thyrotropin-releasing hormone (TRH)
level
9. Which information will a patient's glyco- ANS: C
sylated hemoglobin (A1C) result provide Glycosylated hemoglobin testing measures
to the nurse? glucose control over the last 3 months. Glucose
, Nur-265 Exam 3
Study online at https://quizlet.com/_gxqwp4
a. Fasting preprandial glucose levels testing before/after a meal or random testing
b. Glucose levels 2 hours after a meal may reveal impaired glucose tolerance and in-
c. Glucose control over the past 90 days dicate prediabetes, but it is not done on pa-
d. Hypoglycemic episodes in the past 3 tients who already have a diagnosis of diabetes.
months There is no test to evaluate for hypoglycemic
episodes in the past.
10. A patient is taking a drug that blocks ANS: C
the action of aldosterone. Which addi- Because aldosterone increases the excretion
tional effect of the medication would the of potassium, a medication that blocks aldos-
nurse monitor? terone will tend to cause hyperkalemia. Aldos-
a. Increased serum sodium terone also promotes the reabsorption of sodi-
b. Decreased urinary output um and water in the renal tubules, so spirono-
c. Elevated serum potassium lactone will tend to cause increased urine out-
d. Evidence of fluid overload put, a decreased or normal serum sodium level,
and signs of dehydration.
11. A patient has been newly diagnosed ANS: B
with type 2 diabetes. Which information When dealing with a patient with a chronic
about the patient will be most useful condition such as diabetes, identification of the
to the nurse who is helping the patient patient's values and beliefs can assist the in-
develop strategies for successful adap- terprofessional team in choosing strategies for
tation to this disease? successful lifestyle change. The other informa-
a. Ideal weight tion also will be useful but is not as important in
b. Value system developing an individualized plan for the nec-
c. Activity level essary lifestyle changes.
d. Visual changes
12. An 18-yr-old male patient with small ANS: D
stature is scheduled for a growth hor- Hypoglycemia is induced during the growth
mone stimulation test. Which item hormone stimulation test, and the nurse should
would the nurse obtain in preparation be ready to administer 50% dextrose immedi-
