1. A nurse recalls that direct stimulation of the insulin-secreting cells of the pancreas by the
autonomic nervous system is an example of which type of control?
a. Negative feedback
b. Positive feedback
c. Neural
d. Substrate-level dependent
ANS: C
Direct stimulation of the insulin-secreting cells of the pancreas by the autonomic
nervous system is a form of neural control. Direct stimulation of insulin-secreting cells
is not controlled by a feedback mechanism or by substrate-level dependency.
REF: p. 439
2. Which of the following is an example of the protein hormone?
a. Thyroxine (T4)
b. Aldosterone
c. Testosterone
d. Insulin
ANS: D
Protein hormones are also waNteUr-RsoSluIbNleGhTorBm.oCneOs,Mand insulin
is a part of this group. Thyroxine, aldosterone, and testosterone are all lipid-soluble
hormones and not protein
hormones.
REF: p. 440, Table 18-1
3. A patient who has elevated thyroxine production should be assessed for which accompanying
condition?
a. Increased thyroid-releasing hormone (TRH)
b. Increased anterior pituitary stimulation
c. Decreased T4
d. Decreased thyroid-stimulating hormone (TSH)
ANS: D
Secretion of TSH stimulates the synthesis and secretion of thyroid hormones. Increasing
levels of T4 and T3 then feedback negatively on the pituitary and hypothalamus to inhibit
TRHand TSH synthesis. With increased thyroxine production, TRH will be decreased.
Increased thyroxine would lead to decreased anterior pituitary stimulation. Thyroxine is T4;
its level willbe elevated.
REF: p. 440
4. Which of the following is a water-soluble amine?
a. Growth hormone (GH)
, b. Luteinizing hormone (LH)
c. Antidiuretic hormone (ADH)
d. Epinephrine
ANS: D
An example of a water-soluble amine is epinephrine. GH is a water-soluble hormone but is a
peptide. LH and ADH are water-soluble hormones, but both are polypeptides.
REF: p. 440, Table 18-1
5. What type of effect occurs when insulin binds to its receptors on muscle cells, resulting in an
increase in glucose uptake by those muscle cells?
a. Pharmacologic
b. Permissive
c. Biphasic
d. Direct
ANS: D
Direct effects are the obvious changes in cell function that result specifically from stimulation
by a particular hormone as is true with insulin. Pharmacologic effects are the result of high
doses of a drug. Permissive effects are less obvious hormone-induced changes that facilitate
the maximal response or functioning of a cell. Biphasic effects are twofold effects.
REF: p. 441
6. Which control mechanism will a patient’s target cells implement in order to adapt to high
hormone concentrations?
a. Negative feedback
b. Positive feedback
c. Down-regulation
d. Up-regulation
ANS: C
High concentrations of hormone decrease the number of receptors; this is called
down-regulation. Thus, the cell can adjust its sensitivity to the concentration of the signaling
hormone. Negative and positive feedbacks regulate hormone release. Up-regulation is a
response to low concentrations of hormone, thus increasing the number of receptors per cell.
REF: p. 441
7. How do lipid-soluble hormone receptors cross the plasma membrane?
a. Diffusion
b. Osmosis
c. Active transport
d. Endocytosis
ANS: A
Lipid-soluble hormones cross by diffusion, not by osmosis, active transport, or endocytosis.
REF: p. 443 | p. 444, Figure 18-6
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