1.

The effects of syndrome of inappropriate antidiuretic hormone (SIADH) include solute:

a.
retention and water retention.
b.
retention and water loss.
c.
dilution and water retention.
d.
dilution and water loss.
dilution and water retention.
1. What hormone or electrolyte imbalance slows down the rate of secretion of parathyroid hormone (PTH)?
a.
Increased serum calcium levels
b.
Decreased serum magnesium levels
c.
Decreased levels of thyroid-stimulating hormone (TSH)
d.
Increased levels of thyroid-stimulating hormone (TSH)
Increased serum calcium levels
2. Regulation of the release of epinephrine from the adrenal medulla is an example of _____ regulation.
a.
negative-feedback
b.
positive-feedback
c.
neural
d.
physiologic
neural
2. The most common cause of elevated levels of antidiuretic hormone (ADH) secretion is:
a.
ectopically produced ADH.
b.
inflammation of the hypothalamus.
c.
posterior pituitary tumor.
d.
inflammation of the nephrons
ectopically produced ADH.
3. Hormones are effective communicators because they:
a.
are regularly synthesized in response to cellular and tissue activities.
b.
increase their secretion in response to rising hormone levels.
c.
are rapidly degraded once they enter the cell.
d.
decrease their secretion in response to rising plasma hormone levels.
decrease their secretion in response to
rising plasma hormone levels.
3. Which of the following laboratory values would the nurse expect to find if a person is experiencing syndrome of
inappropriate antidiuretic hormone (SIADH)?
a.
Hypernatremia and urine hypo-osmolality
b.
Serum K+ 5 and urine hyperosmolality
c.
Serum Na+ 120 and serum hypo-osmolality
d.
Hypokalemia and serum hyperosmolality
Serum Na+ 120 and serum hypo-
osmolality
4. Diabetes insipidus is a result of:
a.
antidiuretic hormone (ADH) hyposecretion.
b.
antidiuretic hormone (ADH) hypersecretion.
c.
insulin hyposecretion.
d.
insulin hypersecretion
antidiuretic hormone (ADH)
hyposecretion.
4. Which of the following is a protein hormone that is water soluble?
a.
Thyroxine (T4
b. )
Aldosterone
c.
Follicle
insulin
5. A man 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, there is no change in his polyuria.
These are indications of:
a.
neurogenic diabetes insipidus.
b.
syndrome of inappropriate antidiuretic hormone (SIADH).
c.
psychogenic polydipsia.
d.
osmotically induced diuresis
neurogenic diabetes insipidus
5. Which of the following is a lipid-soluble hormone?
a.
Cortisol
b.
Thyroxine (T4
c. )
Epinephrine
d.
Growth hormone (GH)
a.
Cortisol
6. Diabetes insipidus, diabetes mellitus, and syndrome of inappropriate antidiuretic hormone all exhibit which of the
following symptoms?
a.
Polyuria
b.
Edema
c.
Vomiting
d.
Thirst
Thirst
6. Most protein hormones are transported in the bloodstream:
a.
bound to a lipid-soluble carrier.
b.
free in an unbound, water-soluble form.
c.
bound to a water-soluble-binding protein.
d.
free because of their lipid-soluble chemistry.
free in an unbound, water-soluble form
7. The cause of neurogenic diabetes insipidus (DI) is related to an organic lesion of the:
a.
anterior pituitary.
b.
thalamus.
c.
posterior pituitary.
d.
renal tubules.
posterior pituitary.
7. When insulin binds its receptors on muscle cells, an increase in glucose uptake by the muscle cells is the result. This is an
example of a _____ effect by a hormone.
a.
pharmacologic
b.
permissive
c.
synergistic
d.
direct
direct
8. If the target cells for antidiuretic hormone (ADH) do not have receptors, the result is which type of diabetes insipidus
(DI)?
a.
Neurogenic
b.
Nephrogenic
c.
Psychogenic
d.
Ischemic
Nephrogenic
8. Thyroid-stimulating hormone (TSH) is released to stimulate thyroid hormones and is inhibited when plasma levels of
thyroid hormone are adequate. This is an example of:
a.
positive feedback.
b.
negative feedback.
c.
neural regulation.
d.
physiologic regulation
negative feedback.
9. Lipid-soluble hormone receptors are located:
a.
inside the plasma membrane in the cytoplasm.
b.
on the outer surface of the plasma membrane.
c.
inside the mitochondria.
d.
on the inner surface of the plasma membrane.
inside the plasma membrane in the
cytoplasm.
b.
9. Which of the following laboratory values is consistently low in a client with diabetes insipidus (DI)?
a.
Urine specific gravity
b.
Serum sodium
c.
Urine protein
d.
Serum total protein
Urine specific gravity
10. Which form of diabetes insipidus (DI) is treatable with exogenous antidiuretic hormone (ADH)?
a.
Neurogenic
b.
Psychogenic
c.
Nephrogenic
d.
Ischemic
Neurogenic
10. Which second messenger is stimulated by epinephrine binding to a -adrenergic receptor?
a.
Calcium
b.
Inositol triphosphate (IP3
c. )
Diacylglycerol (DAG)
d.
Cyclic adenosine monophosphate (cAMP)
Cyclic adenosine monophosphate (cAMP)
11. Hyperpituitarism is generally caused by:
a.
a pituitary adenoma.
b.
hypothalamic hyposecretion.
c.
autoimmune disorder of the pituitary.
d.
a neurohypophysial tumor.
a pituitary adenoma
11. Which of the following hormones acts on its target cell via a second messenger?
a.
Angiotensin II
b.
Thyroxine
c.
Estrogen
d.
Testosterone
a.
Angiotensin II
12. Calcium is rigidly controlled within cells. It is highly regulated because it:
a.
is controlled by the calcium negative-feedback loop.
b.
is continuously synthesized.
c.
acts as a second messenger.
d.
carries lipid-soluble hormones in the bloodstream
acts as a second messenger.
12. The term used to describe a person who experiences a lack of all hormones associated with the anterior pituitary is:
a.
panhypopituitarism.
b.
adrenocorticotropic hormone (ACTH) deficiency.
c.
hypopituitarism.
d.
anterior pituitary failure.
panhypopituitarism
13. The portion of the pituitary that secretes oxytocin is the _____ pituitary.
a.
posterior
b.
inferior
c.
anterior
d.
superior
posterior
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.
pressure of the tumor on the optic chiasm
14. A primary adenoma causes thyroid and adrenal hypofunction because the tumor:
a.
metastasizes to the thyroid and adrenal glands through the lymphatic system causing reduced secretion of necessary
hormones.
b.
has a paradoxical effect on adjacent cells, which results in hyposecretion of other anterior pituitary hormones.
c.
invades the hypothalamus adjacent to it and causes a reduction in the amount of hormones produced.
d.
releases tumor markers that occupy the hormone receptor sites of other endocrine organs
has a paradoxical effect on adjacent cells,
which results in hyposecretion of other
anterior pituitary hormones
14. Under what circumstances does antidiuretic hormone act to cause vasoconstriction?
a.
When urine output is less than 20 ml/hr
b.
When serum osmolality is increased
c.
When osmotic and oncotic pressures are increased
d.
When vasopressin is given pharmacologically
When vasopressin is given
pharmacologically
15. What is the target tissue for prolactin-releasing factor (PRF)?
a.
Hypothalamus
b.
Anterior pituitary
c.
Mammary glands
d.
Posterior pituitary
Anterior pituitary
15. Which disorder is caused by hypersecretion of the growth hormone (GH) in adults?
a.
Cushing syndrome
b.
Acromegaly
c.
Giantism
d.
Myxedema
Acromegaly
16. Giantism only occurs 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.
epiphyseal plates have not yet closed.
c.
16. Where is antidiuretic hormone (ADH) synthesized and where does it act?
a.
Synthesized in the hypothalamus; acts in renal collecting ducts
b.
Synthesized in the renal tubules; acts in renal collecting ducts
c.
Synthesized in the anterior pituitary; acts in the posterior pituitary
d.
Synthesized in the posterior pituitary; acts in loop of Henle
Synthesized in the hypothalamus; acts in
renal collecting ducts
b.
17. Amenorrhea, galactorrhea, hirsutism, and osteopenia are each caused by a:
a.
posterior pituitary adenoma.
b.
thymoma.
c.
prolactinoma.
d.
growth hormone adenoma.
prolactinoma.
17. Where is oxytocin synthesized?
a.
Hypothalamus
b.
Paraventricular nuclei
c.
Anterior pituitary
d.
Posterior pituitary
Hypothalamus
18. Graves disease develops from a(n):
a.
viral infection of the thyroid gland that causes overproduction of thyroid hormone (TH).
b.
autoimmune process in which thyroid tissue is replaced by lymphocytes and fibrous tissue.
c.
thyroid-stimulating immunoglobulins that causes overproduction of thyroid hormones.
d.
ingestion of goitrogens that inhibits synthesis of the thyroid hormones, causing a goiter.
thyroid-stimulating immunoglobulins that
causes overproduction of thyroid hormones.
d.
18. The releasing hormones that are made in the hypothalamus travel to the anterior pituitary via the:
a.
vessels of the zona fasciculata.
b.
infundibular stem.
c.
hypophysial stalk.
d.
portal hypophysial blood vessels.
portal hypophysial blood vessels.
19. The signs of thyroid crisis resulting from Graves disease include:
a.
constipation with gastric distention.
b.
bradycardia and bradypnea.
c.
hyperthermia and tachycardia.
d.
constipation and lethargy.
hyperthermia and tachycardia.
19. Which mineral is needed for the synthesis of thyroid hormones?
a.
Iron
b.
Zinc
c.
Iodide
d.
Copper
Iodide
20. Norepinephrine stimulates the release of which hormone?
a.
Thyroxine
b.
Adrenocorticotropic hormone (ACTH)
c.
Growth hormone (GH)
d.
Insulin
Growth hormone (GH)
20. Pathologic changes associated with Graves disease include:
a.
high levels of circulating thyroid-stimulating immunoglobulins.
b.
high levels of thyrotropin-releasing hormone (TRH).
c.
diminished levels of thyroid-stimulating hormone (TSH).
d.
diminished levels of thyroid-binding globulin
high levels of circulating thyroid-
stimulating immunoglobulins.
21. The level of thyroid-stimulating hormone (TSH) in Graves disease is usually:
a.
high.
b.
low.
c.
normal.
d.
in constant flux
low.
21. What effect does hyperphosphatemia have on other electrolytes?
a.
It increases serum calcium.
b.
It decreases serum calcium.
c.
It decreases serum magnesium.
d.
It increases serum magnesium
It decreases serum calcium.
22. Palpation of the neck of a person with Graves disease would detect a thyroid that is:
a.
left of midline.
b.
small with discrete nodules.
c.
normal in size.
d.
enlarged diffusely.
enlarged diffusely.
22. Which electrolyte does insulin transport in the cell?
a.
Potassium
b.
Calcium
c.
Sodium
d.
Magnesium
Potassium
23. A deficiency of which of the following may result in hypothyroidism?
a.
Iron
b.
Iodine
c.
Zinc
d.
Magnesium
Iodine
23. A person who has experienced physiologic stresses will have increased levels of which hormone?
a.
Adrenocorticotropic hormone (ACTH)
b.
Thyroid hormones
c.
Somatostatin
d.
Alpha endorphin
Adrenocorticotropic hormone (ACTH)
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
Constipation, decreased heat rate, and
lethargy
24. What is the action of calcitonin?
a.
Increases metabolism
b.
Decreases metabolism
c.
Increases serum calcium
d.
Decreases serum calcium
Decreases serum calcium
25. Diagnosing a thyroid carcinoma is best done with:
a.
measurement of serum thyroid levels.
b.
radioisotope scanning.
c.
ultrasonography.
d.
fine-needle aspiration biopsy.
fine-needle aspiration biopsy.
25. Which hormone is involved in the regulation of serum calcium levels?
a.
Parathyroid hormone (PTH)
b.
Thyroxine (T4
c. )
Adrenocorticotropic horm
Parathyroid hormone (PTH)
26. Renal failure is the most common cause of which type of hyperparathyroidism?
a.
Primary
b.
Secondary
c.
Exogenous
d.
Inflammatory
Secondary
26. Which lab value would be expected for a person with hypothyroidism?
a.
Increased triiodothyronine (T3
b. )
Increased thyroxine (T4
c. )
Increased thyroid-stimulating hormone (TSH)
d.
Increased calcitonin
Increased thyroid-stimulating hormone
(TSH)
27. Target cells for parathyroid hormone (PTH) are located in the:
a.
tubules of nephrons.
b.
thyroid gland.
c.
glomeruli of nephrons.
d.
smooth and skeletal muscles
tubules of nephrons
27. The most common cause of hypoparathyroidism is:
a.
pituitary hyposecretion.
b.
parathyroid adenoma.
c.
parathyroid gland damage.
d.
autoimmune parathyroid disease
parathyroid gland damage.
28. Which of the following is secreted by the adrenal medulla?
a.
Cortisol
b.
Epinephrine
c.
Androgens
d.
Aldosterone
Epinephrine
29. A surgical individual just arrived on the unit from the postanesthesia care unit. This person' s respirations are four per
minute and shallow. As the nurse calls for assistance, the nurse suddenly feels jittery, and breathing quickens. Which of the
following feedback loops is operating for the nurse in this situation?
a.
The central nervous system stimulates hypothalamus-releasing factor, which acts on the anterior pituitary gland to secrete
thyroid-stimulating hormone (TSH) and stimulates the release of thyroxine (T4) and triiodothyronine (T3
b. ).
The central nervous system directly stimulates the release of insulin, which reduces blood glucose levels.
c.
The central nervous system directly stimulates the adrenal medulla to secrete epinephrine and stimulates hypothalamus-
releasing factor, which acts on the anterior pituitary gland to secrete adrenocorticotropic-stimulating hormone (ACTH),
stimulating the release of cortisol.
d.
The central nervous system stimulates the hypothalamus to synthesize oxytocin and antidiuretic hormone, which are secreted
by the posterior pituitary, activating uterine contraction and renal absorption of water.
c.
The central nervous system directly stimulates the adrenal medulla to
secrete epinephrine and stimulates hypothalamus-releasing factor,
which acts on the anterior pituitary gland to secrete adrenocorticotropic-
stimulating hormone (ACTH), stimulating the release of cortisol.
29. The most probable cause of low serum calcium following a thyroidectomy is:
a.
hyperparathyroidism secondary to Graves disease.
b.
myxedema secondary to surgery.
c.
hypoparathyroidism caused by surgical injury.
d.
hypothyroidism caused by lack of thyroid replacement
hypoparathyroidism caused by surgical
injury.
30. A man with diabetic ketoacidosis (DKA) has the following laboratory values: arterial pH 7.20; serum glucose 500
mg/dl; urine glucose and ketones positive; serum K+ 2 mEq/L; serum Na+ 130 mEq/L. He 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.
Decreased glucose use causes fatty acid
use, ketogenesis, metabolic acidosis, and
osmotic diuresis.
30. What are actions of glucocorticoids?
a.
Protein catabolism and liver gluconeogenesis
b.
Fat storage and glucose use
c.
Decreased blood glucose and fat mobilization
d.
Fat, protein, and carbohydrate anabolism
Protein catabolism and liver
gluconeogenesis
31. Aldosterone synthesis and secretion are primarily regulated by the:
a.
liver.
b.
renin-angiotensin-aldosterone system.
c.
adrenal glands.
d.
hypothalamus
renin-angiotensin-aldosterone system.
31. Polyuria occurs with diabetes mellitus because of:
a.
the formation of ketones.
b.
chronic insulin resistance.
c.
an elevation in serum glucose.
d.
an increase in antidiuretic hormone
an elevation in serum glucose.
32. Type 2 diabetes mellitus is best described as:
a.
a resistance to insulin by insulin-sensitive tissues.
b.
the need for lispro instead of regular insulin.
c.
an increase of glucagon secretion from cells of the pancreas.
d.
the presence of insulin autoantibodies that destroy cells in the pancreas
a resistance to insulin by insulin-sensitive
tissues.
32. What are the effects of high levels of aldosterone?
a.
Hypokalemia and alkalosis
b.
Hyperkalemia and alkalosis
c.
Hyperkalemia and acidosis
d.
Hypokalemia and acidosis
Hypokalemia and alkalosis
33. A person 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.
fawn phenomenon from eating a snack before bedtime.
c.
hypoglycemia caused by increased exercise.
d.
Somogyi effect from insulin sensitivity.
hypoglycemia caused by increased
exercise.
33. What effect does aldosterone have on fluid and electrolyte imbalances?
a.
It directly increases magnesium reabsorption.
b.
It directly increases calcium reabsorption.
c.
It directly increases sodium reabsorption.
d.
It directly increases water reabsorption.
It directly increases sodium reabsorptio
34. Hyperkalemia develops in the presence of diabetic ketoacidosis because:
a.
serum sodium is low stimulating aldosterone to retain sodium and potassium.
b.
hydrogen ions shift into the cell in exchange for potassium to compensate for metabolic acidosis.
c.
phosphorus shifts into the cell in exchange for potassium due to the lack of insulin.
d.
the blood is concentrated due to the loss of water from polyuria.
hydrogen ions shift into the cell in exchange for
potassium to compensate for metabolic acidosis.
c.
34. Which of the following is an expected change in an older patient?
a.
Thyroid-stimulating hormone (TSH) secretion below normal
b.
Triiodothyronine (T3
c. ) level below normal
Cortisol level above normal
d.
Adrenocorticotropic hormone (ACTH) level above normal
Thyroid-stimulating hormone (TSH)
secretion below normal
35. Which of the following clinical manifestations is not common to both diabetic ketoacidosis (DKA) and hyperglycemic
hyperosmolar nonketotic syndrome (HHNKS)?
a.
Fluid loss
b.
Glycosuria
c.
Increased serum glucose
d.
Kussmaul respirations
Kussmaul respirations
36. Hypoglycemia followed by rebound hyperglycemia is seen in:
a.
the Somogyi effect.
b.
the dawn phenomenon.
c.
diabetic ketoacidosis (DKA).
d.
hyperosmolar hyperglycemic nonketotic syndrome (HHNKS
the Somogyi effect.
37. The first lab 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 (BUN).
c.
protein on urinalysis.
d.
cloudy urine on the urinalysis.
protein on urinalysis.
38. Patients with diabetes mellitus develop hyperlipidemia because of:
a.
increases in both low-density lipoproteins (LDLs) and triglycerides (TGs).
b.
decreased low-density lipoproteins (LDLs) and increased triglycerides (TGs).
c.
decreased low-density lipoproteins (LDLs) and increased high-density lipoproteins (HDLs).
d.
increased high-density lipoproteins (HDLs) and decreased triglycerides (TGs).
increases in both low-density lipoproteins
(LDLs) and triglycerides (TGs).
39. What causes the microvascular complications of clients with diabetes mellitus?
a.
The capillaries contain plaques of lipids that obstruct blood flow.
b.
There is increased pressure within capillaries as a result of the elevated glucose attracting water.
c.
The capillary basement membranes thicken and there is endothelial cell
The capillary basement membranes
thicken and there is endothelial cell
40. Retinopathy develops in patients with diabetes mellitus because:
a.
there are plaques of lipids within the retinal vessels.
b.
of an increased pressure within the retinal vessels from the increased osmotic pressure.
c.
ketones cause microaneurysms within the retinal vessels.
d.
of retinal ischemia and red blood cell aggregation.
of retinal ischemia and red blood cell
aggregation.
A person with syndrome of inappropriate
antidiuretic hormone (SIADH) usually
craves fluids.
true
Abnormal immunologic mechanisms
producing autoantibodies are responsible for
Graves disease as well as hypothyroidism.
false, hyperthyroidism
Adrenocorticotropic hormone (ACTH)
directly affects melanocyte stimulation
false
Aldosterone secretion is stimulated by
angiotensin I.
fales, angiotensinII
Antidiuretic hormone (ADH) has no direct
effect on electrolyte levels
true
calcitonin thyroid
chronic complication of diabetes mellitus is
likely to result in microvascular
complications in which of the following areas
eyes, renal system nerves
cortisol andrenal cortex
Deficiencies in calcitonin lead to
hypocalcemia
fales
Diabetes insipidus is caused by insufficient
secretion of insulin.
false, insufficient amounts of ADH
epinephrine adrenal medulla
Giantism occurs only in children and
adolescents
true
Glucagon is synthesized by the beta cells
of the pancreas
false, alpha
Glucose levels are considerably lower in hyperosmolar
hyperglycemic nonketotic syndrome (HHNKS) than in
diabetic ketoacidosis (DKA
false
glycoproteins (fsh) (lh) anterior pituitary
hypersecretion of adrenal medulla
hormones
pheochromocytoma
hypersecretion of adrenocorticotropic
hormone (ACTH)
cushing disease
hypersecretion of growth hormone (GH) acromegaly
hypersecretion of thyroid hormone (TH) graves disease
hyposecretion of adrenal cortex hormones addison disease
hyposecretion of thyroid hormone (TH) myxedema
Individuals with type 2 diabetes mellitus
have a greater degree of pancreatic changes
than individuals with type 1 diabetes.
false
More epinephrine than norepinephrine is
secreted by the adrenal medulla.
true
Myxedema coma is caused by severe
hypoparathyroidism
false, hypothyroidism
Osmoreceptors of the hypothalamus do
not affect the release of antidiuretic
hormone (ADH).
false
oxytocin posterior pituitary
Pituitary adenomas are malignant tumors false, benign
Somatostatin produced by the hypothalamus inhibits the release of growth hormone and thyroid-stimulating hormone (TSH
true
Syndrome of inappropriate antidiuretic hormone (SIADH) is characterized by increased levels of antidiuretic hormone
(ADH). true
The brain does not require insulin for
glucose uptake
true
The most common cause of
hypoparathyroidism is damage to the
glands during surgery.
true
The pituitary gland is located in the bony
sella turcica.
true
The relationship between the endocrine
system and aging has been clearly defined.
false
The thyroid gland produces 90% T4 and
10% T3, but T3 has the greater metabolic
effect.
true
Thyroid carcinoma, although rare, is the
most common endocrine malignancy
true
Type 2 diabetes mellitus is more common
than type 1.
true