1. The effects of syndrome of inappropriate antidiuretic hormone (SIADH) include solute:a.retention and water retention.b.retention and water loss.c.dilution and water retention.d.dilution and water loss.

dilution and water retention.

1. What hormone or electrolyte imbalance slows down the rate of secretion of parathyroid hormone (PTH)?a.Increased serum calcium levelsb.Decreased serum magnesium levelsc.Decreased levels of thyroid-stimulating hormone (TSH)d.Increased levels of thyroid-stimulating hormone (TSH)

Increased serum calcium levels

2. Regulation of the release of epinephrine from the adrenal medulla is an example of _____ regulation.a.negative-feedbackb.positive-feedbackc.neurald.physiologic

neural

2. The most common cause of elevated levels of antidiuretic hormone (ADH) secretion is:a.ectopically produced ADH.b.inflammation of the hypothalamus.c.posterior pituitary tumor.d.inflammation of the nephrons

ectopically produced ADH.

3. Hormones are effective communicators because they:a.are regularly synthesized in response to cellular and tissue activities.b.increase their secretion in response to rising hormone levels.c.are rapidly degraded once they enter the cell.d.decrease their secretion in response to rising plasma hormone levels.

decrease their secretion in response torising plasma hormone levels.

3. Which of the following laboratory values would the nurse expect to find if a person is experiencing syndrome ofinappropriate antidiuretic hormone (SIADH)?a.Hypernatremia and urine hypo-osmolalityb.Serum K+ 5 and urine hyperosmolalityc.Serum Na+ 120 and serum hypo-osmolalityd.Hypokalemia and serum hyperosmolality

Serum Na+ 120 and serum hypo-osmolality

4. Diabetes insipidus is a result of:a.antidiuretic hormone (ADH) hyposecretion.b.antidiuretic hormone (ADH) hypersecretion.c.insulin hyposecretion.d.insulin hypersecretion

antidiuretic hormone (ADH)hyposecretion.

4. Which of the following is a protein hormone that is water soluble?a.

Thyroxine (T4b. )

Aldosteronec.

Follicle

insulin

5. A man with a closed head injury has a urine output of 6 to 8 L/day. Electrolytes are within normal limits but hisantidiuretic hormone (ADH) level is low. Although he has had no intake for 4 hours, there is no change in his polyuria.These are indications of:a.neurogenic diabetes insipidus.b.syndrome of inappropriate antidiuretic hormone (SIADH).c.psychogenic polydipsia.d.osmotically induced diuresis

neurogenic diabetes insipidus

5. Which of the following is a lipid-soluble hormone?a.Cortisolb.Thyroxine (T4c. )Epinephrined.Growth hormone (GH)

a.Cortisol

6. Diabetes insipidus, diabetes mellitus, and syndrome of inappropriate antidiuretic hormone all exhibit which of thefollowing symptoms?a.Polyuriab.Edemac.Vomitingd.Thirst

Thirst

6. Most protein hormones are transported in the bloodstream:a.bound to a lipid-soluble carrier.b.free in an unbound, water-soluble form.c.bound to a water-soluble-binding protein.d.free because of their lipid-soluble chemistry.

free in an unbound, water-soluble form

7. The cause of neurogenic diabetes insipidus (DI) is related to an organic lesion of the:a.anterior pituitary.b.thalamus.c.posterior pituitary.d.renal tubules.

posterior pituitary.

7. When insulin binds its receptors on muscle cells, an increase in glucose uptake by the muscle cells is the result. This is anexample of a _____ effect by a hormone.a.pharmacologicb.permissivec.synergisticd.direct

direct

8. If the target cells for antidiuretic hormone (ADH) do not have receptors, the result is which type of diabetes insipidus(DI)?a.Neurogenicb.Nephrogenicc.Psychogenicd.Ischemic

Nephrogenic

8. Thyroid-stimulating hormone (TSH) is released to stimulate thyroid hormones and is inhibited when plasma levels ofthyroid hormone are adequate. This is an example of:a.positive feedback.b.negative feedback.c.neural regulation.d.physiologic regulation

negative feedback.

9. Lipid-soluble hormone receptors are located:a.inside the plasma membrane in the cytoplasm.b.on the outer surface of the plasma membrane.c.inside the mitochondria.d.on the inner surface of the plasma membrane.

inside the plasma membrane in thecytoplasm.

b.9. Which of the following laboratory values is consistently low in a client with diabetes insipidus (DI)?a.Urine specific gravityb.Serum sodiumc.Urine proteind.Serum total protein

Urine specific gravity

10. Which form of diabetes insipidus (DI) is treatable with exogenous antidiuretic hormone (ADH)?a.Neurogenicb.Psychogenicc.Nephrogenicd.Ischemic

Neurogenic

10. Which second messenger is stimulated by epinephrine binding to a -adrenergic receptor?a.Calciumb.Inositol triphosphate (IP3c. )Diacylglycerol (DAG)d.Cyclic adenosine monophosphate (cAMP)

Cyclic adenosine monophosphate (cAMP)

11. Hyperpituitarism is generally caused by:a.a pituitary adenoma.b.hypothalamic hyposecretion.c.autoimmune disorder of the pituitary.d.a neurohypophysial tumor.

a pituitary adenoma

11. Which of the following hormones acts on its target cell via a second messenger?a.Angiotensin IIb.Thyroxinec.Estrogend.Testosterone

a.Angiotensin II

12. Calcium is rigidly controlled within cells. It is highly regulated because it:a.is controlled by the calcium negative-feedback loop.b.is continuously synthesized.c.acts as a second messenger.d.carries lipid-soluble hormones in the bloodstream

acts as a second messenger.

12. The term used to describe a person who experiences a lack of all hormones associated with the anterior pituitary is:a.panhypopituitarism.b.adrenocorticotropic hormone (ACTH) deficiency.c.hypopituitarism.d.anterior pituitary failure.

panhypopituitarism

13. The portion of the pituitary that secretes oxytocin is the _____ pituitary.a.posteriorb.inferiorc.anteriord.superior

posterior

13. Visual disturbances are a result of a pituitary adenoma because of the:a.liberation of anterior pituitary hormones into the optic chiasm.b.pituitary hormones clouding the lens of the eyes.c.pressure of the tumor on the optic chiasm.d.pressure of the tumor on the optic and oculomotor cranial nerves.

pressure of the tumor on the optic chiasm

14. A primary adenoma causes thyroid and adrenal hypofunction because the tumor:a.metastasizes to the thyroid and adrenal glands through the lymphatic system causing reduced secretion of necessaryhormones.b.has a paradoxical effect on adjacent cells, which results in hyposecretion of other anterior pituitary hormones.c.invades the hypothalamus adjacent to it and causes a reduction in the amount of hormones produced.d.releases tumor markers that occupy the hormone receptor sites of other endocrine organs

has a paradoxical effect on adjacent cells,which results in hyposecretion of other

anterior pituitary hormones14. Under what circumstances does antidiuretic hormone act to cause vasoconstriction?a.When urine output is less than 20 ml/hrb.When serum osmolality is increasedc.When osmotic and oncotic pressures are increasedd.When vasopressin is given pharmacologically

When vasopressin is givenpharmacologically

15. What is the target tissue for prolactin-releasing factor (PRF)?a.Hypothalamusb.Anterior pituitaryc.Mammary glandsd.Posterior pituitary

Anterior pituitary

15. Which disorder is caused by hypersecretion of the growth hormone (GH) in adults?a.Cushing syndromeb.Acromegalyc.Giantismd.Myxedema

Acromegaly

16. Giantism only occurs in children and adolescents because their:a.growth hormones are still diminished.b.epiphyseal plates have not yet closed.c.skeletal muscles are not yet fully developed.d.metabolic rates are higher than in adulthood.

epiphyseal plates have not yet closed.c.

16. Where is antidiuretic hormone (ADH) synthesized and where does it act?a.Synthesized in the hypothalamus; acts in renal collecting ductsb.Synthesized in the renal tubules; acts in renal collecting ductsc.Synthesized in the anterior pituitary; acts in the posterior pituitaryd.Synthesized in the posterior pituitary; acts in loop of Henle

Synthesized in the hypothalamus; acts inrenal collecting ducts

b.17. Amenorrhea, galactorrhea, hirsutism, and osteopenia are each caused by a:a.posterior pituitary adenoma.b.thymoma.c.prolactinoma.d.growth hormone adenoma.

prolactinoma.

17. Where is oxytocin synthesized?a.Hypothalamusb.Paraventricular nucleic.Anterior pituitaryd.Posterior pituitary

Hypothalamus

18. Graves disease develops from a(n):a.viral infection of the thyroid gland that causes overproduction of thyroid hormone (TH).b.autoimmune process in which thyroid tissue is replaced by lymphocytes and fibrous tissue.c.thyroid-stimulating immunoglobulins that causes overproduction of thyroid hormones.d.ingestion of goitrogens that inhibits synthesis of the thyroid hormones, causing a goiter.

thyroid-stimulating immunoglobulins thatcauses overproduction of thyroid hormones.

d.18. The releasing hormones that are made in the hypothalamus travel to the anterior pituitary via the:a.vessels of the zona fasciculata.b.infundibular stem.c.hypophysial stalk.d.portal hypophysial blood vessels.

portal hypophysial blood vessels.

19. The signs of thyroid crisis resulting from Graves disease include:a.constipation with gastric distention.b.bradycardia and bradypnea.c.hyperthermia and tachycardia.d.constipation and lethargy.

hyperthermia and tachycardia.

19. Which mineral is needed for the synthesis of thyroid hormones?a.

Ironb.

Zincc.

Iodided.

Copper

Iodide

20. Norepinephrine stimulates the release of which hormone?a.Thyroxineb.Adrenocorticotropic hormone (ACTH)c.Growth hormone (GH)d.Insulin

Growth hormone (GH)

20. Pathologic changes associated with Graves disease include:a.high levels of circulating thyroid-stimulating immunoglobulins.b.high levels of thyrotropin-releasing hormone (TRH).c.diminished levels of thyroid-stimulating hormone (TSH).d.diminished levels of thyroid-binding globulin

high levels of circulating thyroid-stimulating immunoglobulins.

21. The level of thyroid-stimulating hormone (TSH) in Graves disease is usually:a.high.b.low.c.normal.d.in constant flux

low.

21. What effect does hyperphosphatemia have on other electrolytes?a.It increases serum calcium.b.It decreases serum calcium.c.It decreases serum magnesium.d.It increases serum magnesium

It decreases serum calcium.

22. Palpation of the neck of a person with Graves disease would detect a thyroid that is:a.left of midline.b.small with discrete nodules.c.normal in size.d.enlarged diffusely.

enlarged diffusely.

22. Which electrolyte does insulin transport in the cell?a.

Potassiumb.

Calciumc.

Sodiumd.

Magnesium

Potassium

23. A deficiency of which of the following may result in hypothyroidism?a.

Ironb.

Iodinec.

Zincd.

Magnesium

Iodine

23. A person who has experienced physiologic stresses will have increased levels of which hormone?a.Adrenocorticotropic hormone (ACTH)b.Thyroid hormonesc.Somatostatind.Alpha endorphin

Adrenocorticotropic hormone (ACTH)

24. What are clinical manifestations of hypothyroidism?a.Intolerance to heat, tachycardia, and weight lossb.Oligomenorrhea, fatigue, and warm skinc.Restlessness, increased appetite, and metrorrhagiad.Constipation, decreased heat rate, and lethargy

Constipation, decreased heat rate, andlethargy

24. What is the action of calcitonin?a.Increases metabolismb.Decreases metabolismc.Increases serum calciumd.Decreases serum calcium

Decreases serum calcium

25. Diagnosing a thyroid carcinoma is best done with:a.measurement of serum thyroid levels.b.radioisotope scanning.c.ultrasonography.d.fine-needle aspiration biopsy.

fine-needle aspiration biopsy.

25. Which hormone is involved in the regulation of serum calcium levels?a.Parathyroid hormone (PTH)b.Thyroxine (T4c. )Adrenocorticotropic horm

Parathyroid hormone (PTH)

26. Renal failure is the most common cause of which type of hyperparathyroidism?a.Primaryb.Secondaryc.Exogenousd.Inflammatory

Secondary

26. Which lab value would be expected for a person with hypothyroidism?a.Increased triiodothyronine (T3b. )Increased thyroxine (T4c. )Increased thyroid-stimulating hormone (TSH)d.Increased calcitonin

Increased thyroid-stimulating hormone(TSH)

27. Target cells for parathyroid hormone (PTH) are located in the:a.tubules of nephrons.b.thyroid gland.c.glomeruli of nephrons.d.smooth and skeletal muscles

tubules of nephrons

27. The most common cause of hypoparathyroidism is:a.pituitary hyposecretion.b.parathyroid adenoma.c.parathyroid gland damage.d.autoimmune parathyroid disease

parathyroid gland damage.

28. Which of the following is secreted by the adrenal medulla?a.

Cortisolb.

Epinephrinec.

Androgensd.

Aldosterone

Epinephrine

29. A surgical individual just arrived on the unit from the postanesthesia care unit. This person's respirations are four perminute and shallow. As the nurse calls for assistance, the nurse suddenly feels jittery, and breathing quickens. Which of thefollowing feedback loops is operating for the nurse in this situation?a.The central nervous system stimulates hypothalamus-releasing factor, which acts on the anterior pituitary gland to secretethyroid-stimulating hormone (TSH) and stimulates the release of thyroxine (T4) and triiodothyronine (T3b. ).The central nervous system directly stimulates the release of insulin, which reduces blood glucose levels.c.The central nervous system directly stimulates the adrenal medulla to secrete epinephrine and stimulates hypothalamus-releasing factor, which acts on the anterior pituitary gland to secrete adrenocorticotropic-stimulating hormone (ACTH),stimulating the release of cortisol.d.The central nervous system stimulates the hypothalamus to synthesize oxytocin and antidiuretic hormone, which are secretedby the posterior pituitary, activating uterine contraction and renal absorption of water.

c.The central nervous system directly stimulates the adrenal medulla tosecrete epinephrine and stimulates hypothalamus-releasing factor,which acts on the anterior pituitary gland to secrete adrenocorticotropic-stimulating hormone (ACTH), stimulating the release of cortisol.

29. The most probable cause of low serum calcium following a thyroidectomy is:a.hyperparathyroidism secondary to Graves disease.b.myxedema secondary to surgery.c.hypoparathyroidism caused by surgical injury.d.hypothyroidism caused by lack of thyroid replacement

hypoparathyroidism caused by surgicalinjury.

30. A man with diabetic ketoacidosis (DKA) has the following laboratory values: arterial pH 7.20; serum glucose 500mg/dl; urine glucose and ketones positive; serum K+ 2 mEq/L; serum Na+ 130 mEq/L. He reports that he has been sickwith the "flu" for 1 week. What relationship do these values have to his insulin deficiency?a.Increased glucose use causes the shift of fluid from the intravascular to the intracellular space.b.Decreased glucose use causes fatty acid use, ketogenesis, metabolic acidosis, and osmotic diuresis.c.Increased glucose and fatty acids stimulate renal diuresis, electrolyte loss, and metabolic alkalosis.d.Decreased glucose use results in protein catabolism, tissue wasting, respiratory acidosis, and electrolyte loss.

Decreased glucose use causes fatty aciduse, ketogenesis, metabolic acidosis, and

osmotic diuresis.30. What are actions of glucocorticoids?a.Protein catabolism and liver gluconeogenesisb.Fat storage and glucose usec.Decreased blood glucose and fat mobilizationd.Fat, protein, and carbohydrate anabolism

Protein catabolism and livergluconeogenesis

31. Aldosterone synthesis and secretion are primarily regulated by the:a.liver.b.renin-angiotensin-aldosterone system.c.adrenal glands.d.hypothalamus

renin-angiotensin-aldosterone system.

31. Polyuria occurs with diabetes mellitus because of:a.the formation of ketones.b.chronic insulin resistance.c.an elevation in serum glucose.d.an increase in antidiuretic hormone

an elevation in serum glucose.

32. Type 2 diabetes mellitus is best described as:a.a resistance to insulin by insulin-sensitive tissues.b.the need for lispro instead of regular insulin.c.an increase of glucagon secretion from cells of the pancreas.d.the presence of insulin autoantibodies that destroy cells in the pancreas

a resistance to insulin by insulin-sensitivetissues.

32. What are the effects of high levels of aldosterone?a.Hypokalemia and alkalosisb.Hyperkalemia and alkalosisc.Hyperkalemia and acidosisd.Hypokalemia and acidosis

Hypokalemia and alkalosis

33. A person with type 1 diabetes experiences hunger, lightheadedness, tachycardia, pallor, headache, and confusion. Themost probable cause of these symptoms is:a.hyperglycemia caused by incorrect insulin administration.b.fawn phenomenon from eating a snack before bedtime.c.hypoglycemia caused by increased exercise.d.Somogyi effect from insulin sensitivity.

hypoglycemia caused by increasedexercise.

33. What effect does aldosterone have on fluid and electrolyte imbalances?a.It directly increases magnesium reabsorption.b.It directly increases calcium reabsorption.c.It directly increases sodium reabsorption.d.It directly increases water reabsorption.

It directly increases sodium reabsorptio

34. Hyperkalemia develops in the presence of diabetic ketoacidosis because:a.serum sodium is low stimulating aldosterone to retain sodium and potassium.b.hydrogen ions shift into the cell in exchange for potassium to compensate for metabolic acidosis.c.phosphorus shifts into the cell in exchange for potassium due to the lack of insulin.d.the blood is concentrated due to the loss of water from polyuria.

hydrogen ions shift into the cell in exchange forpotassium to compensate for metabolic acidosis.

c.

34. Which of the following is an expected change in an older patient?a.Thyroid-stimulating hormone (TSH) secretion below normalb.Triiodothyronine (T3c. ) level below normalCortisol level above normald.Adrenocorticotropic hormone (ACTH) level above normal

Thyroid-stimulating hormone (TSH)secretion below normal

35. Which of the following clinical manifestations is not common to both diabetic ketoacidosis (DKA) and hyperglycemichyperosmolar nonketotic syndrome (HHNKS)?a.Fluid lossb.Glycosuriac.Increased serum glucosed.Kussmaul respirations

Kussmaul respirations

36. Hypoglycemia followed by rebound hyperglycemia is seen in:a.the Somogyi effect.b.the dawn phenomenon.c.diabetic ketoacidosis (DKA).d.hyperosmolar hyperglycemic nonketotic syndrome (HHNKS

the Somogyi effect.

37. The first lab test that indicates type 1 diabetes is causing the development of diabetic nephropathy is:a.dipstick test for urine ketones.b.increase in serum creatinine and blood urea nitrogen (BUN).c.protein on urinalysis.d.cloudy urine on the urinalysis.

protein on urinalysis.

38. Patients with diabetes mellitus develop hyperlipidemia because of:a.increases in both low-density lipoproteins (LDLs) and triglycerides (TGs).b.decreased low-density lipoproteins (LDLs) and increased triglycerides (TGs).c.decreased low-density lipoproteins (LDLs) and increased high-density lipoproteins (HDLs).d.increased high-density lipoproteins (HDLs) and decreased triglycerides (TGs).

increases in both low-density lipoproteins(LDLs) and triglycerides (TGs).

39. What causes the microvascular complications of clients with diabetes mellitus?a.The capillaries contain plaques of lipids that obstruct blood flow.b.There is increased pressure within capillaries as a result of the elevated glucose attracting water.c.The capillary basement membranes thicken and there is endothelial cell

The capillary basement membranesthicken and there is endothelial cell

40. Retinopathy develops in patients with diabetes mellitus because:a.there are plaques of lipids within the retinal vessels.b.of an increased pressure within the retinal vessels from the increased osmotic pressure.c.ketones cause microaneurysms within the retinal vessels.d.of retinal ischemia and red blood cell aggregation.

of retinal ischemia and red blood cellaggregation.

A person with syndrome of inappropriateantidiuretic hormone (SIADH) usually

craves fluids.true

Abnormal immunologic mechanismsproducing autoantibodies are responsible for

Graves disease as well as hypothyroidism.false, hyperthyroidism

Adrenocorticotropic hormone (ACTH)directly affects melanocyte stimulation false

Aldosterone secretion is stimulated byangiotensin I. fales, angiotensinII

Antidiuretic hormone (ADH) has no directeffect on electrolyte levels true

calcitonin thyroid

chronic complication of diabetes mellitus islikely to result in microvascularcomplications in which of the following areas

eyes, renal system nerves

cortisol andrenal cortex

Deficiencies in calcitonin lead tohypocalcemia fales

Diabetes insipidus is caused by insufficientsecretion of insulin. false, insufficient amounts of ADH

epinephrine adrenal medulla

Giantism occurs only in children andadolescents true

Glucagon is synthesized by the beta cellsof the pancreas false, alpha

Glucose levels are considerably lower in hyperosmolarhyperglycemic nonketotic syndrome (HHNKS) than indiabetic ketoacidosis (DKA

false

glycoproteins (fsh) (lh) anterior pituitary

hypersecretion of adrenal medullahormones pheochromocytoma

hypersecretion of adrenocorticotropichormone (ACTH) cushing disease

hypersecretion of growth hormone (GH) acromegaly

hypersecretion of thyroid hormone (TH) graves disease

hyposecretion of adrenal cortex hormones addison disease

hyposecretion of thyroid hormone (TH) myxedema

Individuals with type 2 diabetes mellitushave a greater degree of pancreatic changesthan individuals with type 1 diabetes.

false

More epinephrine than norepinephrine issecreted by the adrenal medulla. true

Myxedema coma is caused by severehypoparathyroidism false, hypothyroidism

Osmoreceptors of the hypothalamus donot affect the release of antidiuretic

hormone (ADH).false

oxytocin posterior pituitary

Pituitary adenomas are malignant tumors false, benign

Somatostatin produced by the hypothalamus inhibits the release of growth hormone and thyroid-stimulating hormone (TSH true

Syndrome of inappropriate antidiuretic hormone (SIADH) is characterized by increased levels of antidiuretic hormone(ADH). true

The brain does not require insulin forglucose uptake true

The most common cause ofhypoparathyroidism is damage to the

glands during surgery.true

The pituitary gland is located in the bonysella turcica. true

The relationship between the endocrinesystem and aging has been clearly defined. false

The thyroid gland produces 90% T4 and10% T3, but T3 has the greater metabolic

effect.true

Thyroid carcinoma, although rare, is themost common endocrine malignancy true

Type 2 diabetes mellitus is more commonthan type 1. true