(Osborn) Chapter 51: Learning Outcomes (Number and Title)

[Osborn] chapter 51
Learning Outcomes [Number and Title]

Learning Outcome 1
Identify the components of the endocrine system.
Learning Outcome 2
Explain the general structure and function of hormones.
Learning Outcome 3
Explain the concept of hormonal regulation as it relates to the
hypothalamus, pituitary, thyroid, parathyroid, adrenals, gonads,
and pancreas glands.
Learning Outcome 4
Explain subjective and objective data related to the general
assessment of the endocrine system.
Learning Outcome 5
Discuss the purpose, preparation, and nursing functions related
to diagnostic testing of the endocrine system.
Osborn, et al., Test Item File for Medical-Surgical Nursing: Preparation for Practice
Copyright 2010 by Pearson Education, Inc.
1. The nurse performing an assessment of a clients endocrine system expects to address the
structure and function of the:
Select all that apply.
1.
2.
3.
4.
5.
Hypothalamus.
Thyroid gland.
Gonads.
Salivary glands.
Lacrimal glands.
Answer:
1. Hypothalamus.
2. Thyroid gland.
3. Gonads.
Rationale: Hypothalamus. The assessment of the endocrine system (hormones are secreted into the
bloodstream in order to affect body functions) would include the hypothalamus. Thyroid gland. The
assessment of the endocrine system (hormones are secreted into the bloodstream in order to affect
body functions) would include the thyroid. Gonads. The assessment of the endocrine system
(hormones are secreted into the bloodstream in order to affect body functions) would include the
gonad glands. Salivary glands. Salivary glands are exocrine glands (excrete their fluids to the
outside of the body). Lacrimal glands. Lacrimal glands are exocrine glands (excrete their fluids to
the outside of the body).
Cognitive Level: Analysis
Nursing Process: Assessment
Client Need: Health Promotion and Maintenance
LO: 1
2. When a client asks the nurse, Why is the doctor concerned about my pituitary gland? the nurses
response is based on an understanding that this gland influences:
1.
2.
3.
4.
5.
Renal function.
Growth of body tissue.
Bone density.
Arterial blood flow.
Gender traits.
Answer:
1.
2.
3.
4.
5.
Renal function.
Growth of body tissue.
Bone density.
Arterial blood flow.
Gender traits.
Rationale: Renal function. The pituitary gland is often called the master gland because its
hormones regulate many body functions. The pituitary influences renal function. Growth of body
tissue. The pituitary gland is often called the master gland because its hormones regulate many
body functions. The pituitary influences tissue growth via the hormones that it releases. Bone
density. The pituitary gland is often called the master gland because its hormones regulate many
body functions. The pituitary influences bone density via the hormones that it releases. Arterial
blood flow. The pituitary gland is often called the master gland because its hormones regulate
many body functions. The pituitary influences arterial blood flow via the hormones that it releases.
Gender traits. Gonads produce the hormones that are important for the progression into puberty,
and they control other physical traits that differentiate men from women.
Nursing Process: Planning
Client Need: Physiological Integrity
LO: 1
3. A client recently diagnosed with type 1 diabetes mellitus asks the nurse to explain, Whats wrong
with my pancreas? The nurses response is based on the knowledge that there is a malfunction of
pancreas:
1. Beta cells.
2. Alpha cells.
3. Delta cells.
4. PP cells.
Answer: Beta cells.
Rationale: Throughout the pancreas are clusters of cells called the islets of Langerhans. Islets are
made up of several types of cells, including beta cells that make insulin that facilitate the uptake and
use of glucose by the cells and prevent excessive breakdown of glycogen. Alpha cells are responsible
for the production of glucagon. Delta cells produce somatostatin, which inhibits GH, TSH, and
gastrointestinal hormones, such as glucagon and insulin, by the alpha and beta cells of the pancreas.
PP cells produce pancreatic polypeptides, or digestive enzymes, which are responsible for the
exocrine activity of the pancreas.
LO: 1
4. A nurse is preparing to discuss the importance of neuroendrocrine regulation with a group of

nurses who work in the endocrine clinic. The nurse plans to stress that this collaborative effort
facilitates the regulation of physiological function that includes a persons ability to:
1.
2.
3.
4.
5.
Grow physically.
Reproduce.
Adapt to external changes.
Critically think.
Reason.
Answer:
1. Grow physically.
2. Reproduce.
3. Adapt to external changes.
Rationale: Grow physically. The endocrine systems functioning is intimately connected to that of
the nervous system. This connection is referred to as neuroendrocrine regulation. The systems work
synergistically to regulate overall physiological functioning. Through the combined efforts of the
two systems, growth and development can occur. Reproduce. The endocrine systems functioning is
intimately connected to that of the nervous system. This connection is referred to as neuroendrocrine
regulation. The systems work synergistically to regulate overall physiological functioning. Through
the combined efforts of the two systems, reproduction can occur. Adapt to external changes. The
endocrine systems functioning is intimately connected to that of the nervous system. This
connection is referred to as neuroendrocrine regulation. The systems work synergistically to regulate
overall physiological functioning. Through the combined efforts of the two systems, adaptability to
changes in the external environment can occur. Critically think. Critically thinking is a cognitive
function that is not regulated by neuroendrocrine collaboration. Reason. Reasoning is a cognitive
function that is not regulated by neuroendrocrine collaboration.
LO: 2
5. When asked to explain the hormone regulation process directed by circadian rhythms, the nurse
provides the example of:
1.
2.
3.
4.
The release of cortisol to peak in the early morning.

The regulation of the female menstrual cycle.
The stimulation of insulin production by an increased level of glucose.
The increased production of luteinizing hormone (LH) during the menstrual cycle.
Answer: The release of cortisol to peak in the early morning.

Rationale: An example of circadian rhythms regulation is the release of cortisol, whose peaks and
troughs vary during a 24-hour period. Infradian rhythms are those that last for more than 24 hours.
This is seen in the female menstrual cycle. The increased production of insulin as stimulated by the
brains perception of increased serum glucose is an example of the neural regulatory process.
Feedback systems can be positive or negative. An example of positive feedback is the release of
leuteinizing hormone in response to higher estrogen levels.
LO: 2
6. The lock-and-key method is the process by which the endocrine system brings about specific
responses within target organ tissue. The nurse best explains this process by stating:
1.
2.
3.
4.
The process relies on the target organ to react to the appropriate hormone.
Each hormone is keyed to facilitate a specific response.
Hormones are transported to the target organs via the circulatory system.
The specific process is either turned on or turned off by the hormone.
Answer: The process relies on the target organ to react to the appropriate hormone.
Rationale: The receptors within the endocrine system are able to distinguish a specific hormone
from all other chemicals in circulation and bind to it in a lock-and-key type of manner. This binding
process then triggers the target tissues or organs to produce the desired response. While each
hormone facilitates a specific response, it cannot do so unless it is recognized by the target organ.
Hormones are transported via the circulatory system to the target organs, but this does not
adequately explain the lock-and-key process. A specific hormone is required to bring about the
response that may be either to cause or stop a response by the target organ, but this does not
adequately explain the lock-and-key process.
LO: 2
7. The nurse is providing care to a client with hypoparathyroidism. Which of the following
assessment findings would be consistent with this diagnosis?
1.
2.
3.
4.
5.
Answer:
1.
2.
3.
4.
Facial grimacing
Abdominal cramps
Hair loss
Arrhythmias
Exceptionally smooth, soft skin
Facial grimacing
Abdominal cramps
Hair loss
Arrhythmias
Rationale: Facial grimacing. Hypoparathyroidism affects the musculoskeletal, integumentary,

gastrointestinal, cardiovascular, and central nervous systems. Assessment findings would include
facial grimacing (musculoskeletal). Abdominal cramps. Hypoparathyroidism affects the
musculoskeletal, integumentary, gastrointestinal, cardiovascular, and central nervous systems.
Assessment findings would include abdominal cramps (gastrointestinal). Hair loss.
Hypoparathyroidism affects the musculoskeletal, integumentary, gastrointestinal, cardiovascular, and
central nervous systems. Assessment findings would include hair loss (integumentary).
Arrhythmias. Hypoparathyroidism affects the musculoskeletal, integumentary, gastrointestinal,
cardiovascular, and central nervous systems. Assessment findings would include arrhythmias
(cardiovascular). Exceptionally smooth, soft skin. Exceptionally smooth, soft skin is not a common
finding in the client with hypoparathyroidism.
LO: 3
8. The nurse is caring for a client diagnosed with Cushings disease. Which of the following nursing
interventions would have highest priority for a client with increased levels of both cortisol and
aldosterone?
1. Monitor blood pressure frequently.
2. Plan for frequent rest periods.
3. Assess for signs of infection.
4. Review coping strategies.
Answer: Monitor blood pressure frequently.
Rationale: Increased levels of cortisol and aldosterone may result in hypertension, so frequent
monitoring of BP is a nursing priority. Providing rest periods addresses the clients fatigue issues but
does not have priority over BP concerns. Assessing for signs of infection is appropriate but does not
have priority over BP concerns. Reviewing coping strategies is appropriate but does not have priority
over BP concerns.
LO: 3
9. A client is admitted with dehydration and excessive urination. The nurse realizes that the client
might be experiencing an alteration in which of the following hormones?
1. Antidiuretic hormone (ADH)
2. Follicle-stimulating hormone (FSH)
3. Adrenocorticotropic hormone (ACTH)
4. Thyroid-stimulating hormone (TSH)
Answer: Antidiuretic hormone (ADH)
Rationale: Antidiuretic hormone, or ADH, decreases urine production by causing the renal tubules to
reabsorb water form the urine and return it to the circulating blood. This client is demonstrating
excessive urination, which might indicate an alteration in this hormone. FSH (follicle-stimulating
hormone) functions in ovum and sperm formation. ACTH (adrenocorticotropic hormone) stimulates
the adrenal function. TSH (thyroid-stimulating hormone) stimulates thyroid function. Alteration in
these hormones does not have as direct of a relationship to the clients symptoms as ADH does.
Cognitive Level: Application
Nursing Process: Diagnosis
LO: 3
10. When performing an endocrine assessment, a client shares with the nurse that she has
experienced a significant weight gain over the last 4 months without even eating any differently.
The nurse recognizes that unexplainable weight gains can indicate secretion dysfunction of which of
the following?
1.
2.
3.
4.
5.
Adrenals
Thyroid
Pituitary
Parathyroids
Gonads
Answer:
1. Adrenals
2. Thyroid
3. Pituitary
Rationale: Adrenals. In adrenal disease, the clients weight changes might provide information as to
the endocrine disorder the client is experiencing. The client might gain weight with increased fat
deposits in the abdomen with an adrenal disorder such as Cushings disease. Thyroid. In thyroid
disease, the clients weight changes might provide information as to the endocrine disorder the client
is experiencing. The client might experience general weight gain with a thyroid disease such as
hypothyroidism. Pituitary. In adrenal disease, the clients weight changes might provide information
as to the endocrine disorder the client is experiencing. The pituitary gland controls ADH, which
influences the renal tubules to absorb water, which can result in fluid retention leading to weight
gain. Parathyroids. The parathyroid gland regulates calcium and phosphorous. Gonads. The gonads
influence estrogen and androgens.
LO: 4
11. An older adult client has been given instructions concerning an endocrine assessment the nurse
will be conducting. Which statement made by the client would indicate to the nurse that further
instruction is necessary?
1.
2.
3.
4.
Because of my age, theyll be checking for hyperthyroidism.

Ill be sure to let the nurse know that diabetes runs in my family.
The nurse will look at my skin, nails, and hair.
Ill be asked to swallow when my thyroid gland is being checked.
Answer: Because of my age, theyll be checking for hyperthyroidism.

Rationale: Relative to the aging population, the most frequent sign of hormonal imbalance is
hypothyroidism. Diabetes mellitus is an endocrine disorder that appears to have some degree of
family connection, so the client is correct in providing this information. The endocrine assessment
does include inspection of the skin, nails, and hair, as well as palpation of the thyroid while asking
the client to swallow.
Nursing Process: Evaluation
LO: 4
12. The nurse is conducting a health history interview on a female client. In order to best assess the
clients endocrine system, the nurse asks:
1.
2.
3.
4.
Is your menstrual cycle regularly every 28 days?

Do you have problems with indigestion?
Is there a history of cancer in your family?
Have you ever experienced difficulty breathing?
Answer: Is your menstrual cycle regularly every 28 days?

Rationale: The client who has an irregular menstrual cycle might be experiencing an endocrine
disorder such as increased androgen production or decreased estrogen levels. Gastrointestinal and
respiratory function is not directly related to endocrine system functioning, and there is no known
connection between a dysfunction of the endocrine system and cancer.
LO: 4
13. When caring for a client diagnosed with Graves disease, the nurse recognizes the importance of
regular monitoring of which of the following laboratory results?
1.
2.
3.
4.
Thyroxine (T4)
Urine-specific gravity
Cortisol level
Calcium level
Answer: Thyroxine (T4)

Rationale: Graves disease is influenced by the secretions of the thyroid gland. Thyroxine (T4) is the
hormone secreted by the thyroid gland. Urine-specific gravity would be measured to provide
information about the posterior pituitary. The adrenal gland produces cortisol. The parathyroid gland
regulates calcium and phosphorous levels.
LO: 5
14. A clients endocrine system is being evaluated for dysfunction as the possible origin of his
current symptomology. When it is learned that the results of the water deprivation test showed no
changes in urine osmolality, the nurse realizes that this finding is consistent with:
1. An absence of endocrine pathology.
2. Diabetes insipidus.
3. Diabetes mellitus.
4. Syndrome of inappropriate antidiuretic hormone.
Answer: An absence of endocrine pathology.
Rationale: In clients without pathology, there is no change in urine and plasma osmolality. Diabetes
insipidus and syndrome of inappropriate antidiuretic hormone would result in changes in urine
osmolality. Water deprivation testing is not used to detect diabetes mellitus.
Nursing Process: Diagnosis
LO: 5
15. A client has had diagnostic laboratory testing that confirms the diagnosis of metastatic bone
cancer. The nurse prepares to explain the implications of:
1. A decrease in parathyroid hormone (PTH) levels.
2. An increase in thyroid-stimulating hormone (TSH).
3. An absence of testosterone.
4. The presence of cortisol.
Answer: A decrease in parathyroid hormone (PTH) levels.
Rationale: A decrease in parathyroid hormone (PTH) levels is reflective of the presence of metastatic
bone cancer. The remaining hormones are not evaluated for diagnosis of metastatic bone cancer.
LO: 5

(Osborn) Chapter 51: Learning Outcomes (Number and Title)

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[Osborn] chapter 51

Learning Outcomes [Number and Title]

4. A nurse is preparing to discuss the importance of neuroendrocrine regulation with a group of

The release of cortisol to peak in the early morning.

Answer: The release of cortisol to peak in the early morning.

Rationale: Facial grimacing. Hypoparathyroidism affects the musculoskeletal, integumentary,

Because of my age, theyll be checking for hyperthyroidism.

Answer: Because of my age, theyll be checking for hyperthyroidism.

Is your menstrual cycle regularly every 28 days?

Answer: Is your menstrual cycle regularly every 28 days?

Answer: Thyroxine (T4)

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