Chapter 61: Assessment of the Endocrine System

Chapter 61: Assessment of the Endocrine System

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A nurse cares for a client who is prescribed a drug that blocks a hormone’s receptor site. Which therapeutic effect should the nurse expect?
   1. Greater hormone metabolism
   2. Decreased hormone activity
   3. Increased hormone activity
   4. Unchanged hormone response

ANS:   B

Hormones cause activity in the target tissues by binding with their specific cellular receptor sites, thereby changing the activity of the cell. When receptor sites are occupied by other substances that block hormone binding, the cell’s response is the same as when the level of the hormone is decreased.

DIF:     Understanding/Comprehension         REF: 1255                   KEY: Endocrine system| assessment/diagnostic examination                MSC:                         Integrated Process: Nursing Process: Evaluation                                         NOT:                          Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

2. A nurse cares for a client with a deficiency of aldosterone. Which assessment finding should the nurse correlate with this deficiency?
   1. Increased urine output
   2. Vasoconstriction
   3. Blood glucose of 98 mg/dL
   4. Serum sodium of 144 mEq/L

ANS:   A

Aldosterone, the major mineralocorticoid, maintains extracellular fluid volume. It promotes sodium and water reabsorption and potassium excretion in the kidney tubules. A client with an aldosterone deficiency will have increased urine output. Vasoconstriction is not related. These sodium and glucose levels are normal; in aldosterone deficiency, the client would have hyponatremia and hyperkalemia.

DIF:     Applying/Application                         REF: 1258                   KEY: Endocrine system| assessment/diagnostic examination                MSC:                         Integrated Process: Nursing Process: Assessment                                       NOT:                          Client Needs Category: Physiological Integrity: Physiological Adaptation

3. A nurse cares for a client with excessive production of thyrocalcitonin (calcitonin). For which electrolyte imbalance should the nurse assess?
   1. Potassium
   2. Sodium
   3. Calcium
   4. Magnesium

ANS:           C

Parafollicular cells produce thyrocalcitonin (calcitonin), which regulates serum calcium levels. Calcitonin has no impact on potassium, sodium, or magnesium balances.

DIF:            Applying/Application                         REF:    1259                 KEY: Endocrine system| assessment/diagnostic examination| electrolyte imbalance MSC:            Integrated Process: Nursing Process: Assessment                                               NOT: Client Needs Category: Physiological Integrity: Physiological Adaptation

4. A nurse assesses a client who is prescribed a medication that stimulates beta₁ Which assessment finding should alert the nurse to urgently contact the health care provider?
   1. Heart rate of 50 beats/min
   2. Respiratory rate of 18 breaths/min
   3. Oxygenation saturation of 92%
   4. Blood pressure of 144/69 mm Hg

ANS:           A

Stimulation of beta₁ receptor sites in the heart has positive chronotropic and inotropic actions. The nurse expects an increase in heart rate and increased cardiac output. The client with a heart rate of 50 beats/min would be cause for concern because this would indicate that the client was not responding to the medication. The other vital signs are within normal limits and do not indicate a negative response to the medication.

DIF:            Applying/Application                         REF:    1259                 KEY: Endocrine system| medications| adverse effects                                   MSC: Integrated Process: Nursing Process: Assessment                      NOT:                                                 Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies