Nokea
The nurse is evaluating the laboratory results for a patient who has increased secretion of the anterior pituitary hormones. Which of the following findings should the nurse anticipate when reviewing the laboratory findings?
- A. Decreased serum thyroxine levels
- B. Elevated serum aldosterone levels
- C. An increase in urinary free cortisol
- D. Low urinary excretion of catecholamines
Correct Answer: C
Rationale: 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.
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The nurse is caring for a patient in the outpatient clinic who has a prescription for blood cortisol testing. Which of the following instructions should 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.
Correct Answer: C
Rationale: 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.
Which of the following information about a patient who is scheduled for an oral glucose tolerance test should be reported to the health care provider before starting the test?
- A. Occasional orthostatic dizziness
- B. A 5 kg weight gain in the last month
- C. Intake of 1 L of water an hour previously
- D. Oral corticosteroid use for rheumatoid arthritis
Correct Answer: D
Rationale: Corticosteroids can affect blood glucose results. The other information will be provided to the provider but will not affect the test results.
The nurse is caring for a patient who is taking spironolactone. Which of the following parameters should the nurse monitor?
- A. Decreased urinary output
- B. Evidence of fluid overload
- C. Increased serum sodium levels
- D. Elevated serum potassium levels
Correct Answer: D
Rationale: Spironolactone is a diuretic and it blocks aldosterone. Recalling that aldosterone increases the excretion of potassium, a medication that blocks aldosterone will tend to cause hyperkalemia. Aldosterone also promotes the reabsorption of sodium and water in the renal tubules, so spironolactone will tend to cause increased urine output, a decreased or normal serum sodium level, and signs of dehydration.
The regulation of oxytocin during childbirth is an example of which of the following mechanisms?
- A. Physiological rhythm
- B. Secondary input
- C. Loop regulation
- D. Positive feedback
Correct Answer: D
Rationale: An example of the regulation of oxytocin during childbirth is an example of positive feedback. The positive feedback mechanism increases the target organ action beyond normal. The release of oxytocin is stimulated by pressure receptors in the vagina. As the fetus enters the vagina during childbirth, the pressure receptors sense increased pressure and signal the brain to release more oxytocin.
The nurse is obtaining the health history from a patient. Which of the following statements by the 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.
Correct Answer: D
Rationale: Difficulty in swallowing can occur with a goitre. Nocturia is associated with diseases such as diabetes mellitus, diabetes insipidus, or persistent kidney disease. Breast tenderness would occur with excessive gonadal hormone levels. Thirst is a sign of disease such as diabetes.