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A patient has a low serum T3 level. The health care provider orders measurement of the TSH level. If the TSH level is elevated, what does this indicate?
- A. The cause of the low T3 level is most likely primary hypothyroidism.
- B. The negative feedback system is failing to stimulate the anterior pituitary gland.
- C. The patient has an underactive thyroid gland that is not receiving TSH stimulation.
- D. Most likely there is a tumor on the anterior pituitary gland that is causing increased production of TSH.
Correct Answer: A
Rationale: Elevated TSH levels indicate that the thyroid gland is underactive and is not producing enough T3 and T4, characteristic of primary hypothyroidism.
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During care of the patient with SIADH, what should the nurse do?
- A. Monitor neurologic status at least every 2 hours.
- B. Teach the patient receiving treatment with diuretics to restrict sodium intake.
- C. Keep the head of the bed elevated to prevent antidiuretic hormone (ADH) release.
- D. Notify the health care provider if the patient's blood pressure decreases more than 20 mm Hg from baseline.
Correct Answer: A
Rationale: Frequent neurologic monitoring is essential for patients with SIADH due to the risk of cerebral edema from hyponatremia.
Which gland controls basal metabolic rate (BMR)?
- A. Parathyroid
- B. Pancreas
- C. Testes
- D. Thyroid
Correct Answer: D
Rationale: The correct answer is D: Thyroid. The thyroid gland produces hormones T3 and T4, which regulate the body's metabolism, including the basal metabolic rate (BMR). These hormones play a crucial role in controlling how the body uses energy. The other choices, A: Parathyroid, B: Pancreas, and C: Testes, do not directly regulate BMR. Parathyroid regulates calcium levels, pancreas regulates blood sugar levels, and testes produce hormones related to male reproductive functions. Thyroid is the only gland among the choices that specifically controls BMR through its hormone production.
Which of the following sympathomimetics is not a catecholamine:
- A. Adrenaline
- B. Noradrenaline
- C. Amphetamine
- D. Isoprenaline
Correct Answer: C
Rationale: The correct answer is C: Amphetamine. Amphetamine is not a catecholamine because it is a synthetic drug, not naturally produced by the body like adrenaline (A), noradrenaline (B), and isoprenaline (D). Catecholamines are a class of neurotransmitters that include dopamine, adrenaline, and noradrenaline, all of which have a catechol group in their chemical structure. Amphetamine, on the other hand, is a substituted phenethylamine with no catechol group. This distinction makes amphetamine the only non-catecholamine among the given options.
Priority Decision: A patient with diabetes calls the clinic because she is experiencing nausea and flu-like symptoms. Which advice from the nurse will be the best for this patient?
- A. Administer the usual insulin dosage.
- B. Hold fluid intake until the nausea subsides.
- C. Come to the clinic immediately for evaluation and treatment.
- D. Monitor the blood glucose every 1 to 2 hours and call if it rises over 150 mg/dL (8.3 mmol/L).
Correct Answer: D
Rationale: Illness can cause blood glucose to rise, so the patient should monitor frequently and report if glucose levels exceed 150 mg/dL.
The endocrine system works together with the ________ system to maintain the body’s equilibrium?
- A. digestive system
- B. nervous system
- C. respiratory system
- D. reproductive system
Correct Answer: B
Rationale: The correct answer is B: nervous system. The endocrine system and nervous system work together in maintaining the body's equilibrium through communication and regulation of bodily functions. The nervous system controls rapid responses, while the endocrine system regulates slower, long-term responses through hormones. The digestive system (A) primarily focuses on breaking down food and absorbing nutrients. The respiratory system (C) is responsible for gas exchange. The reproductive system (D) is involved in reproduction and hormone production, but not in maintaining the body's equilibrium.