Chapter 47: Assessment of Endocrine System Lewis: Medical-Surgical Nursing, 10th Edition

1. A young adult patient is being seen in the clinic with increased secretion of the anterior pituitary hormones. The nurse would expect the laboratory test results to show a. increased urinary cortisol. c. elevated serum aldosterone levels. b. decreased serum thyroxine. d. low urinary catecholamines excretion. ANS: A 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. DIF: Cognitive Level: Understand (comprehension) REF: 1107 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity 2. Which statement by a 50-yr-old female patient indicates to the nurse that 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.” ANS: D Difficulty in swallowing can occur with a goiter. Nocturia is associated with diseases such as diabetes mellitus, diabetes insipidus, or chronic kidney disease. Breast tenderness would occur with excessive gonadal hormone levels. Thirst is a sign of disease such as diabetes. DIF: Cognitive Level: Apply (application) REF: 1109 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity 3. A patient seen in the emergency department for severe headache and acute confusion has a serum sodium level of 118 mEq/L. The nurse will anticipate the need for which diagnostic test? a. Urinary 17-ketosteroids b. Antidiuretic hormone level c. Growth hormone s