Question 1

The nurse is caring for a client who had been receiving supplemental cortisone. The client developed a bleeding ulcer, and the steroid was discontinued. The bleeding has stopped but the blood pressure remains unstable. The nurse recognizes that the unstable blood pressure is related to:

Accepted Answer

Down-regulation of corticosteroid receptors can occur after prolonged use of cortisone. This can lead to decreased responsiveness to corticosteroid hormones, including those involved in regulating blood pressure. With the discontinuation of cortisone, there is a sudden decrease in these hormones, which can contribute to instability in blood pressure.

Question 2

A client with hyperthyroidism has been reading about PTU on the internet. The client asks the nurse, "How do anti-hormones work to help my condition?" Which is the nurse's best response?

Accepted Answer

PTU is an anti-thyroid medication that works by blocking the synthesis of thyroid hormones, which reduces the amount of thyroid hormone in the body. It does not regenerate the thyroid gland or replace abnormal thyroid hormone with normal hormone.

Question 3

The nurse notes that several clients prescribed supplemental thyroid hormone are all receiving different doses of the same drug. The nurse recognizes that this variation is mostly driven by:

Accepted Answer

The individual client's tissue receptors vary in the number and sensitivity, which can result in the need for different doses of the same drug. Age, ethnicity, psychological status, acceptance of hormone therapy, height, and weight are not primary factors driving variation in thyroid hormone doses.

Question 4

A client with an exacerbation of COPD is receiving steroid therapy in tapering doses. The nurse recognizes that this approach is medically appropriate because it applies what principle of up-regulation?

Accepted Answer

Up-regulation requires time for the regrowth of cell-wall hormone receptors, and steroid therapy in tapering doses allows for the body to up-regulate the number of these receptors over time. This increases the overall sensitivity of the body to the hormone, allowing for a more effective response to the medication. A and B are incorrect because up-regulation increases the number and sensitivity of hormone receptors, and D is incorrect because up-regulation does not change the configuration of hormone receptors.

Question 5

A nurse is instructing an adolescent on the reproductive system. Which of the following hormones does the nurse explain is responsible for maturation of ovarian follicles ant the production of estrogen? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

The answer of A nurse is instructing an adolescent on...

Question 6

The nurse is evaluating a client who is receiving a thyroid hormone supplement. The client's TSH level has gone down, and the T3 and T4 levels have increased. How does the nurse interpret these results?

Accepted Answer

A decrease in TSH is desirable in clients receiving thyroid hormone supplements. It indicates that the thyroid gland is being properly stimulated by the supplement and there is no need for further release of TSH from the pituitary gland. An increase in T3 and T4 levels is expected as the thyroid hormone supplement is working effectively.

Question 7

A client with a pituitary defect is being treated for Addison disease with supplemental corticosteroids. The client develops signs and symptoms of Cushing syndrome. Which of the following is the mechanism responsible for this syndrome?

Accepted Answer

The development of Cushing syndrome in this context is due to the disruption of feedback mechanisms. Excessive corticosteroid supplementation can suppress the hypothalamic-pituitary-adrenal axis, leading to decreased ACTH production and subsequent symptoms of Cushing syndrome.

Question 8

The nurse in an endocrinology practice is seeing a client with low growth hormone levels. The client's history reveals extensive pituitary damage secondary to a large adenoma. The nurse recognizes that the client's small stature results from:

Accepted Answer

The client's small stature is due to an inability to respond to GH as a result of extensive pituitary damage from the adenoma. This suggests a lack of GH receptors or an inability to utilize GH, resulting in low levels of GH despite negative feedback mechanisms. High levels of ACTH would not affect GH levels and the lack of tissue receptors for GH would not explain the underlying cause of the client's low GH levels.

Question 9

The nurse is caring for a client with hyperglycemia. When choosing nursing interventions, the nurse is aware that a high serum blood sugar produces changes in the client's pancreas that are consistent with a:

Accepted Answer

Hyperglycemia produces a humoral stimulus in the pancreas, leading to the release of insulin, which helps lower blood sugar levels.

Question 10

The nurse is checking lab work on a client's record. The client's FSH and LH levels are low. What health problem related to these deficiencies does the nurse suspect?

Accepted Answer

FSH and LH are both hormones released by the pituitary gland that play a crucial role in the reproductive system. Low levels of these hormones can indicate issues with the hypothalamus, pituitary gland, or ovaries/testes, which can lead to fertility problems, irregular menstrual cycles, and other reproductive health issues.

Question 11

A client with hypothyroidism is told by the health care provider that the thyroid-stimulating hormone level is elevated. The client says to the nurse, "I don't understand why my TSH is high. I thought I had low thyroid levels." The most appropriate response by the nurse is:

Accepted Answer

TSH (thyroid-stimulating hormone) is a hormone released by the pituitary gland that signals the thyroid gland to produce thyroid hormones. When thyroid hormone levels are low, the pituitary gland releases more TSH to stimulate the thyroid to produce more hormones. High levels of TSH in the blood can indicate an underactive thyroid or hypothyroidism.

Question 12

The nurse is assisting a postpartum client who is new to breastfeeding. Which hormonal mechanism is responsible for the production of breast milk?

Accepted Answer

Prolactin, which is produced in the pituitary gland, binds to receptors in the breast secretory cells, leading to the production of breast milk. Follicular-stimulating hormone and luteinizing hormone play roles in ovulation, while epinephrine is a hormone involved in the body's stress response and does not contribute to breast milk production.

Question 13

The nurse is administering hormones to several clients. Which of the following represents an exaggerated response therapy?

Accepted Answer

Corticosteroids are typically given in higher doses than the body would normally produce in response to stress or inflammation. This qualifies as an exaggerated response therapy. Insulin, vasopressin, and thyroid hormone are given at doses to restore normal physiologic levels in the body.

Question 14

A child who is small-for-age is to receive supplemental injections of growth hormone. The mother of the client asks, "Why does my child have to take these shots? I read in the paper that hormones are dangerous." Which response by the nurse is most appropriate?

Accepted Answer

The answer of A child who is small-for-age is to...

Question 15

The nurse is administering testosterone to a client with breast cancer. How does this treatment work?

Accepted Answer

Testosterone can be used to treat breast cancer in women who are postmenopausal and have hormone receptor positive tumors. Testosterone blocks the growth of estrogen-sensitive cancers by competing with estrogen for binding sites on cancer cells. As testosterone levels increase, the amount of available estrogen receptors decreases, limiting the ability of estrogen to stimulate tumor growth.

Question 16

The nurse is caring for a client with hypocalcemia. In planning to meet the client's needs, the nurse would expect which alteration?

Accepted Answer

Hypocalcemia triggers the parathyroid glands to release more parathyroid hormone (PTH) to increase calcium levels in the blood.

Question 17

A client is diagnosed with a disorder of the pituitary gland. When reviewing this client's medical history, the nurse will identify which health problems as potential results of the pituitary disorder? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

The answer of A client is diagnosed with a disorder...

Question 18

When a client's blood sugar drops too low, the pancreas refrains from releasing insulin. The nurse caring for the client recognizes that the drop in insulin production is a result of:

Accepted Answer

Negative feedback is a mechanism in which a change in a physiological variable triggers a response that counteracts the initial change, in order to maintain homeostasis. In the case of a client's blood sugar dropping too low, the body responds by decreasing insulin production, in order to prevent glucose from being taken up by cells and worsening the hypoglycemia. This is an example of negative feedback, as the initial decline in blood sugar triggers a response that opposes it.

Question 19

A client who is acutely ill is having difficulty maintaining a steady blood pressure. What hormonal mechanism takes immediate action when the client's blood pressure drops?

Accepted Answer

Epinephrine, released by the adrenal medulla, triggers vasoconstriction in response to a drop in blood pressure, which helps raise blood pressure back to normal levels. Aldosterone conserves water by increasing renal absorption of sodium and potassium ions, and does not have an immediate effect on blood pressure. Cortisol and insulin have important roles in metabolism and energy regulation, but do not play a significant role in the immediate response to low blood pressure.

Question 20

While reviewing a medical record, the nurse notes that a client's ACTH levels are low. Which of the following levels will this deficit impact?

Accepted Answer

ACTH stimulates the production of corticosteroids by the adrenal gland, so a deficit in ACTH levels will impact the production of corticosteroids.

Quiz 6: Pharmacology of Alterations in the Endo-crine System