ENDOCRINE DISORDERS MCQS
CRISIS 5
ASSESEMENT AND MANAGEMENT OF PATIENTS WITH ENDORINE DISORDER
COMPILED QUESTIONS
MCQS
Read each question
carefully and provide appropriate answer.
1.
An example of exocrine glands are the:
a.
Adrenals.
b.
Ovaries.
c.
Parathyroid.
d. Sweat glands.
2.
The nurse knows that the anterior pituitary gland is responsible for secreting all of the
following except the:
a.
Adrenocorticotropic hormone (ACTH).
b. Antidiuretic hormone (ADH).
c.
Follicle-stimulating hormone (FSH).
d.
Thyroid-stimulating hormone (TSH).
3.
The major structure balancing the rapid action
of the nervous system with slower hormonal action is the:
a. Hypothalamus.
b.
Pineal gland.
c.
Hypophysis.
d.
Thyroid gland.
4.
Diabetes
insipidus is a disorder related to a deficiency of:
a.
Growth
hormone.
b.
Prolactin.
c.
Oxytocin.
d.
Vasopressin.
5.
When thyroid
hormone is administered for prolonged hypothyroidism, the nurse knows to
monitor the patient for:
a. Angina.
b.
Depression.
c.
Mental confusion.
d.
Hypoglycemia.
6.
The preferred medication for treating hypothyroidism is:
a.
Lithium.
b.
Proprandol.
c.
Propylthiouracil.
d. Synthroid.( levothyroxine (Synthroid or
Levothroid))
7.
A clinical manifestation not usually associated
with hyperthyroidism is:
a.
A pulse
rate slower than 90 bpm.
b.
An elevated systolic blood pressure.
c.
Muscular fatigability.
d.
Weight loss.
8.
Patients with hyperthyroidism are
characteristically:
a.
Apathetic and anorexic.
b.
Calm.
c.
Emotionally stable.
d. Sensitive to heat.
9.
Iodine or iodide compounds are used for the
treatment of hyperthyroidism because they do all of the following except:
a.
Decrease the basal metabolic rate.
b. Increase the vascularity of the gland.
c.
Lessen the release of thyroid hormones.
d.
Reduce the size of the gland.
10.
The objectives of pharmacotherapy for
hyperthyroidism include:
a.
Destroying over reactive thyroid cells.
b. Preventing thyroid hormonal synthesis.
c.
Increasing the amount of thyroid tissue.
d.
All of the above.
11. Signs of thyroid storm (related to
hyperthyroidism) include all of the following except:
a. Bradycardia.
b.
Delirium or somnolence.
c.
Dyspnea and chest pain.
d.
Hyperpyrexia.
12.
Medical management for thyroid crisis (related to hypothyroidism) includes:
a.
Intravenous dextrose fluids.
b.
Hypothermia measures.
c.
Oxygen therapy.
d. All of the above.
13.
Pharmacotherapy for thyroid storm (related to hyperthyroidism) would not include the
administration of:
a.
Acetaminophen.
b.
Iodine.
c.
Propylthiouracil.
d. Synthetic levothyroxine. (this is for the
management of thyroid crisis related to hypothyroidism)
14.
The most
common type of goiter is etiologically related to a deficiency of:
a.
Thyrotropin.
b. Iodine.
c.
Thyroxine.
d.
Calcitonin.
15.
The nurse knows that the most common and least aggressive type of cancer is:
a.
Anaplastic.
b.
Follicular adenocarcinoma.
c.
Medullary.
d. Papillary adenocarcinoma.
16. A
diagnosis of hyperparathyroidism can be established by all of the following
signs except:
a. A negative reading on a Sulkowitch test.
b.
A serum calcium level of 12 mg/dL.
c.
An elevated level of parathyroid hormone.
d.
Bone demineralization seen on an x-ray film.
17.
A recommended breakfast for a hyperparathyroid
patient would be:
a.
Cereal with milk and bananas.
b.
Fried eggs and bacon.
c.
Orange juice and toast.
d. Pork sausage and cranberry juice. (this
group of food is not rich in calcium)
18.
One of the most
important and frequently occurring complications of hyperparathyroidism is:
a. Kidney stones.
b.
Pancreatitis.
c.
Pathologic
fractures.
d.
Peptic
ulcer.
19. The
pathophysiology of hypoparathyroidism is associated with all of the following except:
a.
A decrease in serum calcium.
b.
An elevation of blood phosphate.
c.
An
increase in the renal excretion of phosphate.
d.
A lowered renal excretion of calcium.
20.
The goal of medical management for
hypoparathyroidism is to:
a.
Achieve a serum calcium level of 9 to 10 mg/dL.
b.
Eliminate clinical symptoms.
c.
Reverse the symptoms of hypocalcaemia.
d.
Accomplish
all of the above.
21. Nursing
management for a hypoparathyroid patient would
not include:
a.
Maintaining a quiet, subdued environment.
b.
Making certain that calcium gluconate is kept at
the bedside.
c.
Observing the patient for signs of tetany.
d. Supplementing the diet with milk and milk products.
22.
A pheochromocytoma is an adrenal medulla tumor
that causes arterial hypertension by increasing the level of circulating:
a. Catecholamines.
b.
Enzymes.
c.
Hormones.
d.
Glucocorticoids.
23.
A positive test for over activity of the adrenal
medulla is an epinephrine value of:
a.
50 pg/mL.
b.
100 pg/mL.
c.
100 to 300 pg/mL.
d. 450 pg/mL.
24. Laboratory
findings suggestive of Addison’s disease
include all of the following except:
a.
A relative lymphocytosis.
b.
Hyperkalemia and hyponatremia.
c. Hypertension.
d.
Hypoglycemia.
25.
A positive diagnosis of Cushing’s syndrome is
associated with:
a.
The disappearance of lymphoid tissue.
b.
A reduction in circulating eosinophils.
c.
An elevated cortisol level.
d. All of the above.
26.
Clinical manifestations of Cushing’s syndrome may be modified with a diet that is:
a.
High in protein.
b.
Low in carbohydrates.
c.
Low in sodium.
d. All of the above.
27. A
patient with aldosteronism would be
expected to exhibit all of the following symptoms except.
a.
Alkalosis.
b.
Hypokalemia.
c. Hyponatremia.
d.
An increased pH.
28.
The nurse needs to be aware that large-dose
corticosteroid therapy is most effective when administered:
a. At 8:00 AM.
b.
At 8:00 PM.
c.
Between 4:00 AM and 5:00 AM.
d.
Between 4:00 PM and 6:00 PM.
29.
Nursing assessment for a patient who is receiving corticosteroid therapy
includes observation for the unacceptable side effect of:
a. Glaucoma.
b.
Facial mooning.
c.
Potassium loss.
d.
Weight gain.
MATCHING
Match the hormonal
function listed in column II with its corresponding hormone listed in column I.
Column I
1.
______ Glucagon
2.
______ Aldosterone
3.
______ Oxytocin
4.
______ Somatotropin
5.
______ Vasopressin
6.
______ Calcitonin
7.
______ Prolactin
8.
______ Melatonin
9.
______ Parathormone
10.
______ Insulin
Column II
a.
Controls excretion of water by the kidneys
b.
Lowers blood sugar
c.
Inhibits bone resorption
d.
Influences metabolism that is essential for
normal growth
e.
Supports sexual maturation
f.
Promotes the secretion of milk
g.
Stimulates the reabsorption of sodium and the
elimination of potassium
h.
Promotes glycogenolysis
i.
Increases the force of uterine contractions
during parturition
j.
Regulates serum calcium
Answer:
1.
H
o
Glucagon
promotes glycogenolysis
2.
G
o
Aldosterone
stimulates the reabsorption of sodium and the elimination of potassium
3.
I
o
Oxytocin increases
the force of uterine contractions during parturition
4.
D
o
Somatotropin
influence metabolism that is essential for normal growth
5.
A
o
Vasopressin
controls the excretion of water by the kidney
6.
C
o
Calcitonin
inhibits bone resorption
7.
F
o
Prolactin
promotes the secretion of milk
8.
E
o
Melatonin
supports sexual maturation
9.
J
o
Parathormone
regulates serum calcium
10.
B
o
Insulin lowers
blood sugar
SHORT ANSWER
Read each statement
carefully. Write your response in the space provided.
1. The term used to describe the regulation of hormone
concentration in the bloodstream is: _____________.
2. Hormones are classified four ways: __________________,
__________________, ______________________, and __________________.
3. The two major hormones secreted by the posterior lobe of
the pituitary gland are: __________________, which controls
______________________________ and __________________________, which
facilitates
_________________________.
4. Over secretion of adrenocorticotropic hormone (ACTH) or
the growth hormone results in
_______________disease.
5. A deficiency of ADH or vasopressin can result in the
disorder known as __________________, which is characterized by
__________________________ and ______________________________.
6. The thyroid gland produces three hormones:
___________________, __________________, and
__________________.
7. The most common cause of hypothyroidism is: __________________________________________________.
8. Hyperthyroidism is second only to __________________ as a
common endocrine disorder.
9. The most common type of hyperthyroidism is:
___________________.
10. The two most common medications used to treat
hyperthyroidism are: __________________ and
__________________.
11. Tetany is suspected when either of these signs are
positive: ___________________ or
___________________.
12. Name the three types of steroid hormones produced by the adrenal cortex:
______________________, ______________________, and _____________________.
Answer:
1.
Negative feedback
2.
Answer should include four of the following:
steroids, proteins or peptides, polypeptides and glycoproteins, amines and
amino acids, and fatty acid derivatives.
3.
Vasopressin, which controls the excretion of
water by the kidneys and oxytocin, which controls milk ejection during
lactation
4.
Cushing’s syndrome or acromegaly
5.
Diabetes insipidus; excessive thirst Polydipsia),
and large volumes of dilute urine (Polyuria)
6.
Thyroxine, triiodothyronine, and calcitonin
7.
Autoimmune thyroiditis (Hashimoto’s disease)
8.
Diabetes mellitus
9.
Graves’ disease
10.
Methimazole (Tapazole) and propylthiouracil
(PTU)
11.
Trousseau’s or Chvostek’s
12.
Glucocorticoids, mineralocorticoids, and
androgen
MCQS
Read the following
case studies. Circle the correct answer.
CASE STUDY: Primary Hypothyroidism
Connie had been hospitalized for 1 week for studies to
confirm a diagnosis of primary hypothyroidism.
1.
Several tests were used in Connie’s assessment.
All of the following results are consistent with her diagnosis of
hypothyroidism except for:
a.
An increased level of thyrotropin (TSH).
b.
A low uptake of radioactive iodine (131I).
c.
A protein-bound iodine reading of 3 mg/dL.
d.
A T3 uptake value of 45%.
2.
Nursing care for Connie includes assessing for
clinical manifestations associated with hypothyroidism. A manifestation not
consistent with her diagnosis is a:
a.
Change in her menstrual pattern.
b.
Pulse rate of 58 bpm.
c.
Temperature of 95.88F.
d.
Weight loss of 10 lb over a 2-week
period.
3.
The principal objective of medical management is
to:
a.
Irradiate the gland in an attempt to stimulate Hormonal
secretion.
b.
Replace the missing hormone.
c.
Remove the diseased gland.
d.
Withhold exogenous iodine to create a negative feedback
response, which will force the gland to secrete hormones.
4.
Nursing comfort measures for Connie should
include:
a.
Encouraging frequent periods of rest throughout the
day.
b.
Offering her additional blankets to help prevent
chilling.
c.
Using a cleansing lotion instead of soap for her
Skin.
d.
All of the above.
5.
Health teaching for Connie includes making sure
that she knows that iodine-based chemotherapy is:
a.
Administered intravenously for 1 week so that her
symptoms may be rapidly put into remission.
b.
Needed for life.
c.
Recommended for 1 to 3 months.
d.
Used until her symptoms disappear.
CASE STUDY: Hyperparathyroidism
Emily is a 65-year-old woman and has been complaining of
continued emotional irritability. Her family described her as always being “on
edge” and neurotic. After several months of exacerbated symptoms, Emily
underwent a complete physical examination and was diagnosed with
hyperparathyroidism.
1. Emily’s clinical symptoms are all related to an increase
in serum:
a.
Calcium.
b.
Magnesium.
c.
Potassium.
b.
Sodium
2. As a nurse, you know that the normal level of the mineral
(calcium) identified in the previous question is:
a.
8.8 to 10 mg/dL.
b.
1.3 to 2.1 mEq/L.
c.
3.5 to 5.0 mEq/L.
d.
135 to 148 mmol/L.
3. Describe eight symptoms usually seen when
hyperparathyroidism involves several body systems:
______________________, ______________________,
______________________, ______________________,
_____________________, _____________________,
_____________________, and ______________________.
Answer:
·
Apathy
·
Fatigue
·
Muscular weakness
·
Nausea
·
Vomiting
·
Constipation
·
Hypertension
·
Cardiac dysrhythmias
4. Name one of the most important organ complications of
hyperparathyroidism: _______________________.
Answer:
Kidney stone
5. A musculoskeletal symptom found with hyperparathyroidism
is:
a.
Deformities due to demineralization.
b.
Pain on weight bearing joints or musculoskeletal
system.
c.
Pathologic fractures due to osteoclast growth.
d.
All of the above.
6. The recommended treatment for primary hyperparathyroidism
is:
a.
Pharmacotherapy until the elevated serum levels
return to normal.
b.
Surgical removal of the abnormal
parathyroid tissue.
c.
Adrenalectomy.
d.
All of the above treatments.
7. Acute hypercalcemic crises can occur in
hyperparathyroidism. The treatment would involve immediate:
a.
Administration of diuretic agents to promote
renal excretion of calcium.
b.
Phosphate therapy to correct hypophosphatemia.
c.
Dehydration with large volumes of
intravenous fluids.
d.
Management with all of the above modalities.
CASE STUDY: Subtotal Thyroidectomy
Darrell, a 37-year-old father of two, has just returned to
the clinical area from the recovery room. Darrell has had a subtotal thyroidectomy.
1.
Postoperatively, Darrell is assisted from the
stretcher to the bed. The most comfortable position for him to assume would be:
a.
High-Fowler’s position with his neck supported
by a soft collar.
b.
Recumbent position with his neck hyperextended
and supported by a neck pillow.
c.
Recumbent position with sandbags preventing his
neck from rotating.
d.
Semi-Fowler’s position with his
head supported by pillows.
2.
Postoperative bleeding when the patient is in
the dorsal position would probably be evidenced:
a.
Anteriorly.
b.
Laterally.
c.
Posteriorly.
b.
In any of the above areas.
3.
Indicators of internal bleeding include:
a.
A sensation of fullness at the incision site.
b.
Hypotension.
c.
Tachycardia.
d.
All of the above.
4.
The nurse should assess for the common
manifestation of recurrent laryngeal nerve damage, which is:
a.
Any voice change.
b.
The inability to speak.
c.
Pain while speaking.
b.
Pain while swallowing.
5.
The nurse expects Darrell’s postoperative diet
to be:
a.
Clear liquids, such as tea and carbonated
beverages.
b.
High in calories.
c.
Low in fat and protein.
d.
Low in minerals, especially calcium.
6.
The nurse should monitor serum calcium levels for
hypocalcaemia, which will occur with a serum calcium level of:
a.
5 mg/dL.
b.
9 mg/dL.
c.
13 mg/dL.
b.
17 mg/dL.
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