Chapter 48: Nursing Assessment: Endocrine System

Chapter 48: Nursing Assessment: Endocrine System

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE
1. When evaluating the laboratory results for a patient with increased secretion of the
anterior pituitary hormones, the nurse would expect to find
a. decreased serum thyroxine levels.
b. elevated serum aldosterone levels.
c. an increase in urinary free cortisol.
d. low urinary excretion of catecholamines.
ANS: C
Increased secretion of adrenocorticotropic hormone (ACTH) by the anterior pituitary
gland will lead to an increase in serum and urinary cortisol levels. An increase, rather
than a decrease, in thyroxine level would be expected with increased secretion of thyroid
stimulating hormone (TSH) by the anterior pituitary. Aldosterone and catecholamine
levels are not controlled by the anterior pituitary.
DIF: Cognitive Level: Comprehension REF: 1203-1205
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
2. When the nurse is obtaining the health history, which statement by a patient indicates
further assessment of thyroid function may be necessary?
a. “I notice my breasts are tender lately.”
b. “I am so thirsty that I drink all day long.”
c. “I get up several times at night to urinate.”
d. “I feel a lump in my throat when I swallow.”
ANS: D
Difficulty in swallowing can occur with a goiter. Nocturia is associated with diseases
such as diabetes mellitus, diabetes insipidus, or chronic kidney disease. Breast tenderness
would occur with excessive gonadal hormone levels. Thirst is a sign of disease such as
diabetes.
DIF: Cognitive Level: Application REF: 1209
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
3. A patient is admitted with a serum sodium level of 118 mEq/L. The nurse will anticipate
the need for which diagnostic test?
a. Urinary 17-ketosteroids
b. Antidiuretic hormone level
c. Growth hormone stimulation test
d. Adrenocorticotropic hormone level
Test Bank 48-2
ANS: B
Elevated levels of antidiuretic hormone will cause water retention and decrease serum
sodium levels. The other tests would not be helpful in determining possible causes of the
patient’s hyponatremia.
DIF: Cognitive Level: Application REF: 1204-1205 TOP: Nursing Process:
Planning
MSC: NCLEX: Physiological Integrity
4. The nurse is interviewing a patient who has a possible thyroid disorder. Which question
will provide the most useful information?
a. “What methods do you use to help cope with stress?”
b. “Have you experienced any blurring or double vision?”
c. “Do you have to get up at night to empty your bladder?”
d. “Have you had any recent unplanned weight gain or loss?”
ANS: D
Because thyroid function affects metabolic rate, changes in weight may indicate hyper- or
hypofunction of the thyroid gland. Nocturia, visual difficulty, and changes in stress level
are associated with other endocrine disorders.
DIF: Cognitive Level: Application REF: 1205
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
5. When a patient in the outpatient clinic has an order for blood cortisol testing, which
instruction will the nurse provide for the patient?
a. “Avoid adding any salt to your foods for 24 hours before the test.”
b. “You will need to lie down for 30 minutes before the blood is drawn.”
c. “Come to the laboratory to have the blood drawn early in the morning.”
d. “Do not have anything to eat or drink before the blood test is obtained.”
ANS: C
Cortisol levels are usually drawn in the morning, when levels are highest. The other
instructions would be given to patients who were having other endocrine testing.
DIF: Cognitive Level: Application REF: 1214-1215
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity