Chapter 51: Care of the Patient With an Endocrine Disorder

The nurse explains that the negative feedback inhibition controls hormone release by communication between which two anatomical areas?

• the pituitary and the target organ.

• the thymus and the bloodstream.

• lymphatic system and the target organ.

• central nervous system and the bloodstream.

Answer explanation

The amount of hormone released is controlled by negative feedback inhibition. The negative feedback inhibition process is when a gland releases a primary hormone, which stimulates target cells to release a secondary hormone; the gland slows the release of the primary hormone as it senses the rise of the secondary hormone. Information is constantly being exchanged via the bloodstream between target organs and endocrine glands.

Which diagnostic test for diabetes mellitus provides a measure of glucose levels for the previous 8 to 12 weeks?

• Fasting blood sugar (FBS)

• Oral glucose tolerance test (OGT)

• Glycosylated hemoglobin (HbA1c)

• Postprandial glucose test (PPBG)

Answer explanation

Glycosylated hemoglobin (HbA1c)—This blood test measures the amount of glucose that has become incorporated into the hemoglobin within an erythrocyte. Because glycosylation occurs constantly during the 120-day lifespan of the erythrocyte, this test reveals the effectiveness of diabetes therapy for the preceding 8 to 12 weeks.

Which test will furnish immediate feedback for a newly diagnosed diabetic who is not yet under control?

• Fasting blood sugar (FBS)

• Glycosylated hemoglobin (HbA1c)

• Oral glucose tolerance test (OGTT)

• Clinitest

Answer explanation

Diabetics should do a finger-stick blood glucose level test before each meal and at bedtime each day until their disease is under control. The HbA1c serum test reveals the effectiveness of diabetes therapy for the preceding 8 to 12 weeks.

To which diet should a patient with Cushing syndrome adhere?

• Less sodium

• More calories

• Less potassium

• More carbohydrates

Answer explanation

The diet should be lower in sodium to help decrease edema.

The patient is a 20-year-old college student who has type 1 diabetes and normally walks each evening as part of an exercise regimen. The patient plans to enroll in a swimming class. Which adjustment will the nurse suggest to the patient based on this information?

• Time the morning insulin injection so that the peak action will occur during swimming class.

• Delete normal walks on swimming class days.

• Delay the meal before the swimming class until the session is over.

• Monitor glucose level before, during, and after swimming to determine the need for alterations in food or insulin.

Answer explanation

Exercise can reduce insulin resistance and increase glucose uptake for as long as 72 hours, as well as reducing blood pressure and lipid levels. However, exercise can carry some risks for patients with diabetes, including hypoglycemia.

Which disorder is a long-term complication of diabetes mellitus?

• Diverticulitis

• Renal failure

• Hypothyroidism

• Hyperglycemia

Answer explanation

Long-term complications of diabetes include blindness, cardiovascular problems, and renal failure.

A patient has returned to his room after a thyroidectomy with signs of thyroid crisis. During thyroid crisis, exaggerated hyperthyroid manifestations may lead to the development of which potentially lethal complication?

• severe nausea and vomiting.

• bradycardia.

• delirium with restlessness.

• congestive heart failure.

Answer explanation

In thyroid crisis, all the signs and symptoms of hyperthyroidism are exaggerated. The patient may develop congestive heart failure and die.

In diabetes insipidus, a deficiency of which hormone causes clinical manifestations?

• Antidiuretic hormone (ADH)

• Follicle-stimulating hormone (FSH)

• Thyroid-stimulating hormone (TSH)

• Adrenocorticotropic hormone (ACTH)

Answer explanation

Diabetes insipidus develops when there is a decrease in production of ADH from the posterior pituitary or the action of ADH is diminished.

The nurse expects to see which intervention in the plan of care for a patient who has recently been diagnosed with acromegaly?

• Encourage fluids

• Maintain leg joints in flexion

• Assist with activities of daily living

• Monitor for episodes of bleeding into the joints

Answer explanation

Nursing interventions are mainly supportive. The presence of muscle weakness, joint pain, or stiffness warrants assisting with activities of daily living.

The use of radioactive iodine in the treatment of hyperthyroidism is for which purpose?

• stimulate the thyroid gland.

• depress the pituitary.

• destroy some of the thyroid tissue.

• alter the stimulus from the pituitary.

Answer explanation

Radioactive iodine 131 destroys some of the hyperactive thyroid gland to produce a more normally functioning gland.