Chapter 23: Endocrine Clinical Assessment and Diagnostic Procedures

Chapter 23: Endocrine Clinical Assessment and Diagnostic Procedures

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. Which of the following laboratory results is found in a patient with hyperglycemia?

ANS:  C

In diabetic ketoacidosis, fat breakdown (lipolysis) occurs so rapidly that fat metabolism is incomplete, and the ketone bodies (acetone, b-hydroxybutyric acid, and acetoacetic acid) accumulate in the blood (ketonemia) and are excreted in the urine (ketonuria). It is recommended that all patients with diabetes perform self-test or have their blood or urine tested for the presence of ketones during any alteration in level of consciousness or acute illness with elevated blood glucose.

2. A hydration assessment consists of checking a variety of parameters, including

ANS:  A

A hydration assessment includes observations of skin integrity, skin turgor, and buccal membrane moisture. Moist, shiny buccal membranes indicate satisfactory fluid balance. Skin turgor that is resilient and returns to its original position in less than 3 seconds after being pinched or lifted indicates adequate skin elasticity. Skin over the forehead, clavicle, and sternum is the most reliable for testing tissue turgor because it is less affected by aging and thus more easily assessed for changes related to fluid balance.

3. Glycosylated hemoglobin levels provide information about

ANS:  A

The glycated hemoglobin test (also known as the glycosylated hemoglobin, or HbA_1C or A_1C), provides information about the average amount of glucose that has been present in the patient’s bloodstream over the previous 3 to 4 months. During the 120-day life span of red blood cells (erythrocytes), the hemoglobin within each cell binds to the available blood glucose through a process known as glycosylation.

4. Which of the following laboratory studies or diagnostic procedures is most useful in identifying central diabetes insipidus (DI)?

ANS:  D

Serum antidiuretic hormone ADH levels are compared with the blood and urine osmolality to differentiate syndrome of inappropriate antidiuretic hormone (SIADH) from central diabetes insipidus (DI). Increased ADH levels in the bloodstream compared with a low serum osmolality and elevated urine osmolality confirms the diagnosis of SIADH. Reduced levels of serum ADH in a patient with high serum osmolality, hypernatremia, and reduced urine concentration signal central DI.

5. A 16-year-old young woman is admitted to the critical care unit with severe hyperglycemia caused by new-onset type 1 diabetes mellitus. Which of the following signs and symptoms obtained as part of the patient’s history might indicate the presence of hyperglycemia?

ANS:  D

The patient or family member may relay information about recent, unexplained changes in weight, thirst, hunger, and urination patterns.