Palpation of the neck of a person diagnosed with Graves disease would detect a thyroid
that is:
a. Left of midline
b. Normal in size
c. Small with discrete nodules
d. Diffusely enlarged - Answer-*D
Which condition may result from pressure exerted by a pituitary tumor?
a. Hypothyroidism
b. D...
Maryville University: NURS611 Patho
Exam 3
Palpation of the neck of a person diagnosed with Graves disease would detect a thyroid
that is:
a. Left of midline
b. Normal in size
c. Small with discrete nodules
d. Diffusely enlarged - Answer-*D
Which condition may result from pressure exerted by a pituitary tumor?
a. Hypothyroidism
b. Diabetes insipidus
c. Hypercortisolism
d. Insulin hypo-secretion - Answer-*A
*If the tumor exerts sufficient pressure, then thyroid and adrenal hypofunction may
occur because of lack of thyroid-stimulating hormone (TSH) and adrenocorticotropic
hormone (ACTH). These result in the symptoms of hypothyroidism and hypocortisolism.
Where is antidiuretic hormone (ADH) synthesized and where does it act?
a. hypothalamus, renal tubular cells
b. anterior pituitary, posterior pituitary
c. renal tubules, renal collecting ducts
posterior pituitary, loop of henle - Answer-*A
*Once synthesized in the hypothalamus, ADH acts on the vasopressin 2 receptors of
the renal duct cells to increase their permeability.
What are clinical manifestations of hypothyroidism?
a. intolerance to heat, tachycardia, and weight loss
b. oligomenorrhea, fatigue, and warm skin
c. restlessness, increased appetite, and menorrhagia
d. constipation, decreased heart rate, and lethargy - Answer-*D
*The lower levels of TH result in decreased energy metabolism, resulting in
constipation, bradycardia, and lethargy.
How does a faulty negative-feedback mechanism result in a hormonal imbalance?
a. hormones are not synthesized in response to cellular and tissue activities
b. decreased hormonal secretion is a response to rising hormone levels
c. too little hormone production is initiated
d. excessive hormone production results from a failure to turn off the system - Answer-
*D
,*Negative-feedback systems are important in maintaining hormones within physiologic
ranges. The lack of negative-feedback inhibition on hormonal release often results in
pathologic conditions. Excessive hormone production, which is the result of the failure to
turn off the system, can cause various hormonal imbalances and related conditions.
What imbalance lessens the rate of secretion of parathyroid hormone
a. Increased serum calcium levels
b. Decreased serum magnesium levels
c. Decreased levels of thyroid-stimulating hormone
d. Increased levels of thyroid-stimulating hormone - Answer-*A
*The overall effect of PTH is to increase serum calcium and decrease serum phosphate.
If calcium levels are increased, the rate of secretion of PTH will be low.
Thyroid-stimulating hormone (TSH) is released to stimulate thyroid hormone (TH) and is
inhibited when plasma levels of TH are adequate. This is an example of:
a. positive feedback
b. neural regulation
c. negative feedback
d. physiologic regulation - Answer-*C
*Negative feedback occurs because the changing chemical, neural, or endocrine
response to a stimulus negates the initiating change that triggered the release of the
hormone.
Graves disease develops from a(n):
a. Viral infection of the thyroid gland that causes overproduction of thyroid hormone.
b. Autoimmune process during which lymphocytes and fibrous tissue replace thyroid
tissue.
c. Thyroid-stimulating immunoglobulin that causes overproduction of thyroid hormones.
d. Ingestion of goitrogens that inhibits the synthesis of the thyroid hormones, causing a
goiter. - Answer-*C
*The pathologic features of Graves disease indicates that normal regulatory
mechanisms are overridden by abnormal immunologic mechanisms that result in the
stimulation of excessive TH.
Pathologic changes associated with Graves disease include:
a. High levels of circulating thyroid-stimulating immunoglobulins
b. Diminished levels of thyrotropin-releasing hormone
c. High levels of thyroid-stimulating hormone
d. Diminished levels of thyroid-binding globulin - Answer-*A
*The only option that correctly describes the changes associated with Graves disease
identifies high levels of circulating thyroid-stimulating immunoglobulins that are found in
more than 95% of individuals diagnosed with the disease.
The signs of thyrotoxic crisis include:
a. Constipation with gastric distention
b. Hyperthermia and tachycardia
, c. Bradycardia and bradypnea
d. Constipation and lethargy - Answer-B
The level of thyroid-stimulating hormone (TSH) in individuals with Graves disease is
usually:
a. High
b. Normal
c. Low
d. In constant flux - Answer-*C
*The hyperfunction of the thyroid gland leads to suppression of TSH because of the
normal negative feedback mechanism.
The effects of the syndrome of inappropriate antidiuretic hormone (SIADH) secretion
include solute:
a. Retention and water retention
b. Dilution and water retention
c. Retention and water loss
d. Dilution and water loss - Answer-*B
Which laboratory value would the nurse expect to find if a person is experiencing a
syndrome of inappropriate antidiuretic hormone (SIADH)?
a. Hypernatremia and urine hypo-osmolality
b. Serum potassium (K+) level of 5 mEq/L and urine hyper-osmolality
c. Serum sodium (Na+) level of 120 mEq/L and serum hypo-osmolality
d. Hypokalemia and serum hyper-osmolality - Answer-*C
*A diagnosis of SIADH requires a serum sodium level of less than 135 mEq/L, serum
hypo-osmolality less than 280 mOsm/kg, and urine hyper-osmolarity. Potassium levels
are not considered a factor.
A patient who is diagnosed with a closed head injury has a urine output of 6 to 8 L/day.
Electrolytes are within normal limits, but his antidiuretic hormone (ADH) level is low.
Although he has had no intake for 4 hours, no change in his polyuria level has occurred.
These symptoms support a diagnosis of:
a. Neurogenic diabetes insipidus
b. Syndrome of inappropriate antidiuretic hormone
c. Psychogenic polydipsia
d. Osmotically induced diuresis - Answer-*A
*Remember, sodium has to be below 135 to meet the requirement for SIADH.
Which laboratory value is consistently low in a patient with diabetes insipidus (DI)?
a. Urine-specific gravity
b. Urine protein
c. Serum sodium
d. Serum total protein - Answer-*A
*The basic criteria for diagnosing DI include a low urine-specific gravity while sodium
levels are high. Protein levels are not considered.
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