NURSING > QUESTIONS & ANSWERS > NURS 8022 Chapter 19: Alterations of Hormonal Regulation Huether & McCance: Understanding Pathophys (All)

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NURS 8022 Chapter 19: Alterations of Hormonal Regulation Huether & McCance: Understanding Pathophysiology

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MULTIPLE CHOICE 1. Besides hyposecretion and hypersecretion, endocrine system dysfunction can result from: a. abnormal receptor activity. b. abnormal hormone levels. c. increased synthesis of second messengers. d. extracellular electrolyte alterations. ANS: A Dysfunction may result from abnormal cell receptor function or from altered intracellular response to the hormone-receptor complex. Abnormal hormone levels can occur but are not the cause of endocrine dysfunction. Intracellular storage of second-messenger hormones would not lead to dysfunction; receptor function does. Extracellular electrolyte alterations may result from dysfunction, but they are not a cause. REF: p. 460 2. What is the most common cause of elevated levels of antidiuretic hormone (ADH) secretion? a. Autoimmune disease b. Cancer c. Pregnancy d. Heart failure ANS: B The most common cause of elevated levels of ADH is cancer, not autoimmune disorders, pregnancy, or heart failure. REF: p. 461 3. A 54-year-old patient with pulmonary tuberculosis is evaluated for syndrome of inappropriate ADH secretion (SIADH). Which electrolyte imbalance would be expected in this patient? a. Hyponatremia b. Hyperkalemia c. Hypernatremia d. Hypokalemia ANS: A Hyponatremia occurs due to increased water reabsorption by kidneys. Hyperkalemia does not occur due to increased water reabsorption. Sodium levels are lowered with hyponatremia; they are not elevated. Hypokalemia does not occur; SIADH is a problem of sodium. REF: pp. 461-462 4. A 44-year-old patient with pulmonary tuberculosis is evaluated for SIADH. Which assessment finding would support this diagnosis? a. Peripheral edema b. Tachycardiac. Low blood pressure d. Concentrated urine ANS: D Clinical manifestations of SIADH include urine that is inappropriately concentrated with respect to serum osmolarity. Symptomology of SIADH does not include peripheral edema, tachycardia, or low blood pressure. REF: p. 462 5. A nurse is caring for a patient diagnosed with SIADH. What severe complication should the nurse assess for? a. Stroke b. Diabetes insipidus c. Neurologic damage d. Renal failure ANS: C When the hyponatremia of SIADH becomes severe, 110-115 milliequivalents per liter, confusion, lethargy, muscle twitching, convulsions, and severe and sometimes irreversible neurologic damage may occur. Neither stroke, diabetes insipidus, nor renal failure is associated with SIADH. REF: p. 462 6. A patient is admitted to the intensive care unit with a closed head injury sustained in a motorcycle accident. The injury has caused severe damage to the posterior pituitary. Which of the following complications should the nurse anticipate? a. Dilutional hyponatremia b. Dehydration from polyuria c. Cardiac arrest from hyperkalemia d. Metabolic acidosis ANS: B Diabetes insipidus is a well-recognized complication of closed head injury and is manifested by polyuria leading to dehydration. The patient will experience hypernatremia, not hyponatremia. Electrolytes other than sodium are typically not affected with diabetes insipidus. Acidosis is not associated with diabetes insipidus. REF: p. 462 7. While planning care for a patient from general anesthesia, which principle should the nurse remember? A side effect of some general anesthetic agents is _____ diabetes insipidus. a. neurogenic b. nephrogenic c. psychogenic d. allogenic ANS: B General anesthetics can lead to nephrogenic diabetes insipidus (DI). General anesthetics are not associated with any of the other forms of DI.

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