Quiz 22: Alterations of Hormonal Regulation
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1. The effects of the syndrome of inappropriate antidiuretic hormone (SIADH) secretion include solute:
a. Retention and water retention c. Dilution and water retention
b. Retention and water loss d. Dilution and water loss
2. The common cause of elevated levels of antidiuretic hormone (ADH) secretion is:
a. Ectopically produced ADH c. Posterior pituitary tumor
b. Inflammation of the hypothalamus d. Inflammation of the nephrons
3. Which laboratory value would the nurse expect to find if a person is experiencing syndrome of inappropriate antidiuretic hormone (SIADH)?
a. Hypernatremia and urine hypoosmolality
b. Serum potassium (K+) level of 5 mEq/L and urine hyperosmolality
c. Serum sodium (Na+) level of 120 mEq/L and serum hypoosmolality
d. Hypokalemia and serum hyperosmolality
4. Diabetes insipidus is a result of:
a. Antidiuretic hormone hyposecretion c. Insulin hyposecretion
b. Antidiuretic hormone hypersecretion d. Insulin hypersecretion
5. A patient who is diagnosed with a closed head injury has a urine output of 6 to 8 L/day. Electrolytes are within normal limits, but his antidiuretic hormone (ADH) level is low. Although he has had no intake for 4 hours, no change in his polyuria level has occurred. These symptoms support a diagnosis of:
a. Neurogenic diabetes insipidus
b. Syndrome of inappropriate antidiuretic hormone
c. Psychogenic polydipsia
d. Osmotically induced diuresis
6. Diabetes insipidus, diabetes mellitus, and syndrome of inappropriate antidiuretic hormone all exhibit which symptom?
a. Polyuria c. Vomiting
b. Edema d. Thirst
7. The cause of neurogenic diabetes insipidus (DI) is related to an organic lesion of the:
a. Anterior pituitary c. Posterior pituitary
b. Thalamus d. Renal tubules
8. Which form of diabetic insipidus (DI) will result if the target cells for antidiuretic hormone (ADH) in the renal collecting tubules demonstrate insensitivity?
a. Neurogenic c. Psychogenic
b. Nephrogenic d. Ischemic
9. Which laboratory value is consistently low in a patient with diabetes insipidus (DI)?
a. Urine-specific gravity c. Urine protein
b. Serum sodium d. Serum total protein
10. Which form of diabetes insipidus (DI) is treatable with exogenous antidiuretic hormone (ADH)?
a. Neurogenic c. Nephrogenic
b. Psychogenic d. Ischemic
11. Which condition may result from pressure exerted by a pituitary tumor?
a. Hypothyroidism c. Diabetes insipidus
b. Hypercortisolism d. Insulin hyposecretion
12. The term used to describe a person who experiences a lack of all hormones associated with the anterior pituitary is:
a. Panhypopituitarism c. Hypopituitarism
b. Adrenocorticotropic hormone deficiency d. Anterior pituitary failure
13. Visual disturbances are a result of a pituitary adenoma because of the:
a. Liberation of anterior pituitary hormones into the optic chiasm
b. Pituitary hormones clouding the lens of the eyes
c. Pressure of the tumor on the optic chiasm
d. Pressure of the tumor on the optic and oculomotor cranial nerves
14. Which disorder is considered a co-morbid condition of acromegaly?
a. Hypotension c. Brain cancer
b. Diabetes d. Thyroid cancer
15. Which disorder is caused by hypersecretion of the growth hormone (GH) in adults?
a. Cushing syndrome c. Giantism
b. Acromegaly d. Myxedema
16. Giantism occurs only in children and adolescents because their:
a. Growth hormones are still diminished.
b. Epiphyseal plates have not yet closed.
c. Skeletal muscles are not yet fully developed.
d. Metabolic rates are higher than in adulthood.
17. Amenorrhea, galactorrhea, hirsutism, and osteoporosis are each caused by a:
a. Posterior pituitary adenoma c. Prolactinoma
b. Thymoma d. Growth hormone adenoma
18. Graves disease develops from a(n):
a. Viral infection of the thyroid gland that causes overproduction of thyroid hormone
b. Autoimmune process during which lymphocytes and fibrous tissue replace thyroid tissue
c. Thyroid-stimulating immunoglobulin that causes overproduction of thyroid hormones
d. Ingestion of goitrogens that inhibits the synthesis of the thyroid hormones, causing a goiter
19. The signs of thyrotoxic crisis include:
a. Constipation with gastric distention c. Hyperthermia and tachycardia
b. Bradycardia and bradypnea d. Constipation and lethargy
20. Pathologic changes associated with Graves disease include:
a. High levels of circulating thyroid-stimulating immunoglobulins
b. Diminished levels of thyrotropin-releasing hormone
c. High levels of thyroid-stimulating hormone
d. Diminished levels of thyroid-binding globulin
21. The level of thyroid-stimulating hormone (TSH) in individuals with Graves disease is usually:
a. High c. Normal
b. Low d. In constant flux
22. Palpation of the neck of a person diagnosed with Graves disease would detect a thyroid that is:
a. Left of midline c. Normal in size
b. Small with discrete nodules d. Diffusely enlarged
23. A deficiency of which chemical may result in hypothyroidism?
a. Iron c. Zinc
b. Iodine d. Magnesium
24. What are clinical manifestations of hypothyroidism?
a. Intolerance to heat, tachycardia, and weight loss
b. Oligomenorrhea, fatigue, and warm skin
c. Restlessness, increased appetite, and metrorrhagia
d. Constipation, decreased heat rate, and lethargy
25. Diagnosing a thyroid carcinoma is best performed with:
a. Measurement of serum thyroid levels c. Ultrasonography
b. Radioisotope scanning d. Fine-needle aspiration biopsy
26. Renal failure is the most common cause of which type of hyperparathyroidism?
a. Primary c. Exogenous
b. Secondary d. Inflammatory
27. The most common cause of hypoparathyroidism is:
a. Pituitary hyposecretion c. Parathyroid gland damage
b. Parathyroid adenoma d. Autoimmune parathyroid disease
28. The most probable cause of low serum calcium after a thyroidectomy is:
a. Hyperparathyroidism, secondary to Graves disease
b. Myxedema, secondary to surgery
c. Hypoparathyroidism caused by surgical injury
d. Hypothyroidism caused by the lack of thyroid replacement
29. A patient diagnosed with diabetic ketoacidosis (DKA) has the following laboratory values: arterial pH 7.20; serum glucose 500 mg/dl; positive urine glucose and ketones; serum potassium (K+) 2 mEq/L; serum sodium (Na+) 130 mEq/L. The patient reports that he has been sick with the “flu” for 1 week. What relationship do these values have to his insulin deficiency?
a. Increased glucose use causes the shift of fluid from the intravascular to the intracellular space.
b. Decreased glucose use causes fatty acid use, ketogenesis, metabolic acidosis, and osmotic diuresis.
c. Increased glucose and fatty acids stimulate renal diuresis, electrolyte loss, and metabolic alkalosis.
d. Decreased glucose use results in protein catabolism, tissue wasting, respiratory acidosis, and electrolyte loss.
30. Polyuria occurs with diabetes mellitus because of the:
a. Formation of ketones c. Elevation in serum glucose
b. Chronic insulin resistance d. Increase in antidiuretic hormone
31. Type 2 diabetes mellitus is best described as a(an):
a. Resistance to insulin by insulin-sensitive tissues
b. Need for lispro instead of regular insulin
c. Increase of glucagon secretion from cells of the pancreas
d. Presence of insulin autoantibodies that destroy cells in the pancreas
32. A person diagnosed with type 1 diabetes experiences hunger, lightheadedness, tachycardia, pallor, headache, and confusion. The most probable cause of these symptoms is:
a. Hyperglycemia caused by incorrect insulin administration
b. Dawn phenomenon from eating a snack before bedtime
c. Hypoglycemia caused by increased exercise
d. Somogyi effect from insulin sensitivity
33. Which serum glucose level would indicate hypoglycemia in a newborn?
a. 28 mg/dl c. 60 mg/dl
b. 40 mg/dl d. 80 mg/dl
34. When comparing the clinical manifestations of both diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar nonketotic syndrome (HHNKS), which condition is associated with only DKA?
a. Fluid loss c. Increased serum glucose
b. Weight loss d. Kussmaul respirations
35. Hypoglycemia, followed by rebound hyperglycemia, is observed in those with:
a. The Somogyi effect
b. The dawn phenomenon
c. Diabetic ketoacidosis
d. Hyperosmolar hyperglycemic nonketotic syndrome
36. The first laboratory test that indicates type 1 diabetes is causing the development of diabetic nephropathy is:
a. Dipstick test for urine ketones
b. Increase in serum creatinine and blood urea nitrogen
c. Protein on urinalysis
d. Cloudy urine on the urinalysis
37. Which classification of oral hypoglycemic drugs decreases hepatic glucose production and increases insulin sensitivity and peripheral glucose uptake?
a. Biguanide (metformin) c. Meglitinides (glinides)
b. Sulfonylureas (glyburide) d. -Glycosidase inhibitor (miglitol)
38. What causes the microvascular complications in patients with diabetes mellitus?
a. The capillaries contain plaques of lipids that obstruct blood flow.
b. Pressure in capillaries increase as a result of the elevated glucose attracting water.
c. The capillary basement membranes thicken, and cell hyperplasia develops.
d. Fibrous plaques form from the proliferation of subendothelial smooth muscle of arteries.
39. Retinopathy develops in patients with diabetes mellitus because:
a. Plaques of lipids develop in the retinal vessels.
b. Pressure in the retinal vessels increase as a result of increased osmotic pressure.
c. Ketones cause microaneurysms in the retinal vessels.
d. Retinal ischemia and red blood cell aggregation occur.
40. A person has acne, easy bruising, thin extremities, and truncal obesity. These clinical manifestations are indicative of which endocrine disorder?
a. Hyperthyroidism c. Diabetes insipidus
b. Hypoaldosteronism d. Cushing disease
41. A person may experience which complications as a result of a reduction in parathyroid hormone (PTH)? (Select all that apply.)
a. Muscle spasms
b. Tonic-clonic seizures
c. Laryngeal spasms
42. A chronic complication of diabetes mellitus is likely to result in microvascular complications in which areas? (Select all that apply.)
b. Coronary arteries
c. Renal system
d. Peripheral vascular system
Match the phrases with the corresponding terms.
______ A. Acromegaly
______ B. Cushing disease
______ C. Addison disease
______ D. Graves disease
______ E. Myxedema
______ F. Pheochromocytoma
43. Hypersecretion of thyroid hormone (TH)
44. Hypersecretion of adrenocorticotropic hormone (ACTH)
45. Hypersecretion of adrenal medulla hormones
46. Hyposecretion of thyroid hormone (TH)
47. Hyposecretion of adrenal cortex hormones
48. Hypersecretion of growth hormone (GH)