Chapter 56: Assessment of the Endocrine System
Ignatavicius: Medical-Surgical Nursing, 10th Edition
1. The nurse assesses an older client. What age-related physiologic changes would the nurse expect?
a. Heat intolerance
b. Rheumatoid arthritis
c. Dehydration
d. Increased appetite
ANS: C
As people age, the many of the endocrine glands decrease hormone production, including a decrease in
antidiuretic hormone production. This change, in addition to less body fluid being present as one ages,
can cause dehydration. Older adults usually have cold intolerance and a decrease in appetite.
Rheumatoid arthritis is not an age-related change; osteoarthritis causes primarily by aging.
2. A client is scheduled to have a glycosylated hemoglobin (A1C) drawn and asks the nurse why she has
to have it. How would the nurse respond?
a. "It measures your average blood glucose level for the past 3 months."
b. "It determines what type of anemia you may have."
c. "It measures the amount of liver glycogen you have."
d. "It determines you have some type of leukemia or other blood cancer."
ANS: A
A1C measures the average blood glucose level to determine if the client is a diabetic or how controlled a
diabetic client is.
3. The nurse assesses a client who is scheduled to have a laboratory test to determine if the client's
adrenal glands are hypoactive. What type of testing would the client likely have?
a. Catecholamine testing
b. Suppression testing
c. Bone marrow testing
d. Provocative testing
ANS: D
Provocative testing is done to determine if an endocrine gland is capable of producing its normal level of
hormone(s), especially when a client is suspected of having a hypoactive endocrine gland.
4. A nurse assesses a client who is prescribed a medication that stimulates beta1 receptors. Which
assessment finding would indicate that the medication is effective?
a. Heart rate of 92 beats/min
b. Respiratory rate of 18 breaths/min
c. Oxygenation saturation of 92%
d. Blood pressure of 144/69 mm Hg
, Chapter 56: Assessment of the Endocrine System
Ignatavicius: Medical-Surgical Nursing, 10th Edition
ANS: A
Stimulation of beta1 receptor sites in the heart has positive chronotropic and inotropic actions. The
nurse expects an increase in heart rate and increased cardiac output. The other vital signs are within
normal limits and do not indicate any response to the medication.
5. A nurse collaborates with assistive personnel (AP) to provide care for a client who is prescribed a 24-
hour urine specimen collection. Which statement would the nurse include when teaching the AP about
this activity?
a. "Note the time of the client's first void and collect urine for 24 hours."
b. "Add the preservative to the container at the end of the test."
c. "Start the collection by saving the first urine of the morning."
d. "It is okay if one urine sample during the 24 hours is not collected."
ANS: A
The collection of a 24-hour urine specimen is often delegated to AP. The nurse must ensure that the AP
understands the proper process for collecting the urine. The 24-hour urine collection specimen is started
after the client's first urination. The first urine specimen is discarded because there is no way to know
how long it has been in the bladder, but the time of the client's first void is noted. The client adds all
urine voided after that first discarded specimen during the next 24 hours. When the 24-hour mark is
reached, the client voids one last time and adds this specimen to the collection. The preservative, if
used, must be added to the container at the beginning of the collection. All urine samples need to be
collected for the test results to be accurate.
6. A nurse assesses a female client who presents with hirsutism. Which question would the nurse ask
when assessing this client?
a. "How do you plan to pay for your treatments?"
b. "How do you feel about yourself?"
c. "What medications are you prescribed?"
d. "What are you doing to prevent this from happening?"
Ans, B
Hirsutism, or excessive hair growth on the face and body, can result from endocrine disorders. This may
cause a disruption in body image, especially for female clients. The nurse would inquire into the client's
body image and self-perception. Asking about the client's financial status or current medications does
not address the client's immediate problem. The client is not doing anything to herself to cause the
problem, nor can the client prevent it from happening.
7. A nurse is caring for a patient who has excessive catecholamine release. Which assessment finding
would the nurse correlate with this condition?
a. Decreased blood pressure
b. Increased pulse
Ignatavicius: Medical-Surgical Nursing, 10th Edition
1. The nurse assesses an older client. What age-related physiologic changes would the nurse expect?
a. Heat intolerance
b. Rheumatoid arthritis
c. Dehydration
d. Increased appetite
ANS: C
As people age, the many of the endocrine glands decrease hormone production, including a decrease in
antidiuretic hormone production. This change, in addition to less body fluid being present as one ages,
can cause dehydration. Older adults usually have cold intolerance and a decrease in appetite.
Rheumatoid arthritis is not an age-related change; osteoarthritis causes primarily by aging.
2. A client is scheduled to have a glycosylated hemoglobin (A1C) drawn and asks the nurse why she has
to have it. How would the nurse respond?
a. "It measures your average blood glucose level for the past 3 months."
b. "It determines what type of anemia you may have."
c. "It measures the amount of liver glycogen you have."
d. "It determines you have some type of leukemia or other blood cancer."
ANS: A
A1C measures the average blood glucose level to determine if the client is a diabetic or how controlled a
diabetic client is.
3. The nurse assesses a client who is scheduled to have a laboratory test to determine if the client's
adrenal glands are hypoactive. What type of testing would the client likely have?
a. Catecholamine testing
b. Suppression testing
c. Bone marrow testing
d. Provocative testing
ANS: D
Provocative testing is done to determine if an endocrine gland is capable of producing its normal level of
hormone(s), especially when a client is suspected of having a hypoactive endocrine gland.
4. A nurse assesses a client who is prescribed a medication that stimulates beta1 receptors. Which
assessment finding would indicate that the medication is effective?
a. Heart rate of 92 beats/min
b. Respiratory rate of 18 breaths/min
c. Oxygenation saturation of 92%
d. Blood pressure of 144/69 mm Hg
, Chapter 56: Assessment of the Endocrine System
Ignatavicius: Medical-Surgical Nursing, 10th Edition
ANS: A
Stimulation of beta1 receptor sites in the heart has positive chronotropic and inotropic actions. The
nurse expects an increase in heart rate and increased cardiac output. The other vital signs are within
normal limits and do not indicate any response to the medication.
5. A nurse collaborates with assistive personnel (AP) to provide care for a client who is prescribed a 24-
hour urine specimen collection. Which statement would the nurse include when teaching the AP about
this activity?
a. "Note the time of the client's first void and collect urine for 24 hours."
b. "Add the preservative to the container at the end of the test."
c. "Start the collection by saving the first urine of the morning."
d. "It is okay if one urine sample during the 24 hours is not collected."
ANS: A
The collection of a 24-hour urine specimen is often delegated to AP. The nurse must ensure that the AP
understands the proper process for collecting the urine. The 24-hour urine collection specimen is started
after the client's first urination. The first urine specimen is discarded because there is no way to know
how long it has been in the bladder, but the time of the client's first void is noted. The client adds all
urine voided after that first discarded specimen during the next 24 hours. When the 24-hour mark is
reached, the client voids one last time and adds this specimen to the collection. The preservative, if
used, must be added to the container at the beginning of the collection. All urine samples need to be
collected for the test results to be accurate.
6. A nurse assesses a female client who presents with hirsutism. Which question would the nurse ask
when assessing this client?
a. "How do you plan to pay for your treatments?"
b. "How do you feel about yourself?"
c. "What medications are you prescribed?"
d. "What are you doing to prevent this from happening?"
Ans, B
Hirsutism, or excessive hair growth on the face and body, can result from endocrine disorders. This may
cause a disruption in body image, especially for female clients. The nurse would inquire into the client's
body image and self-perception. Asking about the client's financial status or current medications does
not address the client's immediate problem. The client is not doing anything to herself to cause the
problem, nor can the client prevent it from happening.
7. A nurse is caring for a patient who has excessive catecholamine release. Which assessment finding
would the nurse correlate with this condition?
a. Decreased blood pressure
b. Increased pulse
