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Name Endocrine Description You have 30 minutes to complete this 15 question quiz. Please read over the anterior and posterior pituitary gland prior to taking this quiz. Please utilize your book to answer the questions. This quiz is part of your course grade. Instructions Identify the choice that best completes the statement or answers the question. Modify Add Question Here Multiple Choice 6.7 points Modify Remove Question When evaluating the laboratory findings of a patient with increased secretion of the anterior pituitary hormones, the nurse would expect to find: Answer (^) a. an increase in urinary free cortisol. b. decreased serum thyroxine levels. c. elevated serum aldosterone levels. d. low urinary excretion of catecholamines. Incorrect Feedback Increased secretion of anterior pituitary hormones would incresce serum thyroxine levels and increase urinary excretion of catecholamines. Aldosterone levels are regulated by the renin-angioten. system. Add Question Here Multiple Choice 6.7 points Modify Question 1 Question 2
Remove Question When a patient eats a bag of potato chips, the nurse recognizes that hypernatremia is likely to occur if the patient is experiencing a decreased production of: Answer a. cortisol. b. aldosterone. c. pancreatic stomatostatin. d. antidiuretic hormone (ADH). Correct Feedback ADH is resleased from the posterior pituitary. a decreased production of ADH will result in the renal tubules not RE-absorbing water. The serum sodium levels will increase. Incorrect Feedback Decreased production of cortisol and aldosterone is adrenal hypofunction. This adrenal hypofunction would result in sodium excretion which would result in hyponatremia. Add Question Here Multiple Choice 6.7 points Modify Remove Question A patient is scheduled for a growth hormone stimulation test. In preparation for the test, the nurse will obtain a: Answer (^) a. vial of 50% dextrose solution. b. vial of glargine insulin. c. cardiac monitor. d. basin of ice. Correct Feedback Used to reverse the hypoglycemic state induced with regular insulin during the stimulation test. This may be found in IGGY-pg 1459. The stimulation test induces hypoglycemia which results in an increased secretion of GH. Incorrect Feedback Only regular insulin is used for the GH stimulation test. Glargine is not a short/rapid acting insulin. Cardiac monitor and basin of ice do not apply to this test. Recognize that there is a GH surpression test that uses dextrose to induce high glucose levels. High gluecose levels suppress the release of growth hormone. The test is positive for hyperpituitarism (Giantism) if the growth hormone levels do not drop. Add Question Here Multiple Choice 6.7 points Modify Remove Question When caring for a patient having a water deprivation test, which assessment obtained by the nurse will be of most concern? Answer (^) a. The patient complains of intense thirst. b. The patient has a 5 pound weight loss. c. The patient feels dizzy when sitting up on the edge of the bed. d. The patient"s urine osmolality does not change after ADH is given' Correct Feedback Greater than 2 KG loss will indicate severe dehydration. One Kg of weight loss = 1000mL. Incorrect Feedback Greater than 2 KG loss will indicate severe dehydration which can lead to hypovolemic shock. The water deprivation test is used to diagnose Diabetes Insipidus (ADH deficiency) which results in excessive water loss. In the water deprivation test it is important to maintain NPO status (which can be difficult). These patients are expected to have extreme thirst. Normally, a person who is NPO will have decreased urine output. With DI, the client will continue to produce urine. DI patients will produce greater than 4 liters of urine in a 24 hours period. The patient's urine osmolality and sp gravity will increase. In essense, the urine begins to concentrate after ADH becuase water will be retained. Need to look at drugs on pg 1468 chart 66-6 and 66-
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b. changes in secondary sex characteristics. c. high blood pressure. d. tachycardia and cardiac palpitations. Correct Feedback You will have changes in the secondary sex characteristics due to the decreased FSH and LH. Incorrect Feedback Will have decreased FSH/LH = loss of secondary sex characteristics ACTH/Cortisol= hypoglycemia not hyperglycemia ACTH/Cortisol/some aldosteroneo=hypotension TSH=bradycardia Add Question Here Multiple Choice 6.7 points Modify Remove Question A patient seen at the clinic for an upper respiratory infection reports receiving subscutaneous somatotropin (Genotropin) when asked by the nurse about current medications. The nurse questions the patient further about a history of: Answer (^) a. adrenal disease. b. untreated acromegaly. c. a pituitary tumor. d. diabetes insipidus. Correct Feedback See table 66- Incorrect Feedback Genotropin enhances growth in cells and tissue. Adrenal disease you would replace cortisol. Untreated acromegaly would have gigantism which is excessive growth hormone. The client would have dwarfism or at risk thus the reason for the replacement hormone. Diabetes insipidus is given vasopressin as the replacement hormone. Add Question Here Multiple Choice 6.7 points Modify Remove Question A patient with an antidiuretic hormone (ADH)-secreting small-cell cancer of the lung is treated with demeclocycline (Declomycin) to control the symptoms of syndrome of inappropriate secetion of antidiurectic hormone (SIADH). The nurse determines that the demeclocycline is effective upon finding that the: Answer (^) a. patient's daily weight is stable. b. urine specific gravity is increased. c. patient's urinary output is increased. d. peripheral edema is decreased. Correct Feedback Declomycin induces nephrogenic diabetes insipidus inducing increased urinary output. This was not necessary to answer the question. If you knew the underlying pathophysiology of SIADH you could have answered by the process of elimination or with the understanding that SIADH retains water and your treatment is to eliminate the water. Incorrect Feedback The patient will have wt. loss after Declomycin. SIADH retain water only in the extracellular fluid. Edema is usually not present. They do not retain sodium and get dilutional hyponatremia. The urine specific gravity would decrease and become more diluted after Declomycin. SIADH is commonly treated with diuretics. Add Question Here Multiple Choice 6.7 points Modify Remove Question When teaching a patient with chronic SIADH about long-term management of the disorder, the nurse determines that additional instruction is needed when the patient says, Question 9 Question 10 Question 11
Answer (^) a. "I need to shop for foods that are low in sodium and avoid adding salt to foods." b. "I should weigh myself daily and report any sudden weight loss or gain." c. "I need to limit my fluid intake to no more than 1 quart of liquids a day." d. "I will eat foods high is potassium because the diuretics cause potassium loss." Correct Feedback The client is at risk for hyponatremia and needs to educated on high sodium diet or sodium supplements may be prescribed. Incorrect Feedback All other responses are correct and verify understanding of the treatment of SIADH. Add Question Here Multiple Choice 6.7 points Modify Remove Question A patient is hospitalized with possible SIADH. The patient is confused and reports a headache, muscle cramps, and twitching. The nurse would expect the initial laboratory results to include a: Answer (^) a. serum sodium of 125 mEq/L. b. hematocrit of 52%. c. blood urea nitrogen (BUN) of 22 mg/dl. d. serum chloride of 110 mEq/L. Correct Feedback Normal Na+ 135-145 meq/L. Which cause the above symptoms. Incorrect Feedback With SIADH--hematocrit would be decreased because vascular volume is diluted with water. BUN decreases with fluid volume excess. This BUN is normal (10-20 mg/dl). Serum chloride of 110 is elevated (Normal 98- mEq/L)serum chloride will decrease with Na+. Add Question Here Multiple Choice 6.7 points Modify Remove Question The RN observes a nursing assistant (NA) caring for a patient after a hypophysectomy. Which action by the NA requires that the RN intervene? Answer (^) a. The NA lowers the head of the bed to the flat position. b. The NA cautions the patient to avoid coughing. c. The NA cleans the patient's mouth with a swab. d. The NA collects a urine specimen for specific gravity. Correct Feedback HOB is to be between 10-30 degrees to decrease the pressure on the sella turcica to avoid the headache. Incorrect Feedback All other interventions provided by the NA are correct. Add Question Here Multiple Choice 6.7 points Modify Remove Question A patient is admitted with possible SIADH. Which information obtained by the nurse is most important to communicate rapidly to the health care provider? Answer (^) a. The patient complains of a severe headache. b. The patient complains of severe thirst. c. The patient has a urine specific gravity of 1.025. d. The patient has a serum sodium level of 119 mEq/L. Correct Feedback Serum sodium levels less than 120 increase risk of seizure/coma/death. This needs to be communicated rapidly. The severe headache will need Question 12 Question 13 Question 14
