According to the video, all of the following clusters of signs may suggest a critical endocrine imbalance or disorder, except: Koplik's spots with vertigo and apnea Fever with diaphoresis and tachycardia Impaired cognition with lethargy and edema Polyuria with polydipsia To properly manage endocrine signs and symptoms, the nurse should be able to do all of the following, except: Order the correct diagnostic tests Expertly assess signs and symptoms Provide life-saving treatments and nursing care Interpret assessment findings to help identify their most likely cause According to the video, to uncover the cause of endocrine signs and symptoms, nurse's assessment should be: Fast, accurate and highly focused Fast, predictive and lax Methodical, lax and discriminative Fast, highly focused and discriminative In thyrotoxic crisis, an excess in triiodothyronine and thyroxin can: Increase cardiac contractility, which may lead to vasodilation Decrease stroke volume, which may lead to vasodilation Decrease stroke volume and increase peripheral vascular resistance Shorten the gap between the systolic and diastolic pressures Stroke volume refers to: The amount of blood ejected with each heart beat The arteries' resistance to blood flow The ability of a cardiac muscle to contract The volume of blood being pumped by the heart These are examples of thyroid hormones: Thyroxin and triiodothyronine Monoiodotyrosine and diiodotyrosine Thyroperoxidase and thyroglobulin Iodothyronine deiodinase and thyroglobulin According to the video, the S₃ heart sound is produced when: Blood rapidly fills the ventricles, causing their walls to vibrate Atrial walls oscillate Atrioventricular valves suddenly close to block reverse blood flow Inflammation of the pericardium causes the inner and outer walls to rub against each other To hear S₃ better during auscultation, the nurse should: Turn the client to the left and use the bell of the stethoscope Ask the client to extend his/her neck forward as the nurse auscultates Turn the client to the left and use the diaphragm of the stethoscope Ask the client to look up as the nurse auscultates This statement about the S₃ heart sound is most true: It commonly results from increased blood volume and tachycardia It occurs just after atrial contraction (atrial kick) It is also known as an atrial gallop or a presystolic gallop It occurs late in the heart cycle Anxiety and diaphoresis occur when: The sympathetic nervous system triggers the release of catecholamines The sympathetic nervous system triggers the release of ADH and ACTH The parasympathetic nervous system triggers the release of secretin and motilin The parasympathetic nervous system triggers the release of cholecystokinin Exophthalmos is: The protrusion of one or both eyes A specific pattern of swelling in the central retina An eye disease that involves the clouding of the natural lens of the eye An eye disease characterized by an opaque white spot on the cornea When assessing for thyrotoxic crisis, to observe thyroid gland movement, the nurse should: Have the client swallow Have the client cough Ask the client to extend his/her neck forward Ask the client to look up When assessing for thyrotoxic crisis, the nurse should palpate the thyroid gland from the front by: Facing the client and using the finger pads of the right hand to feel the left lobe Facing the client and using the palm of the right hand to feel the left lobe Facing the client and using the finger pads of the right hand to feel the right lobe Facing the client and using the palm of the left hand to feel the left lobe During assessment for thyrotoxic crisis, to feel for the movement of the thyroid gland, the nurse should: Palpate on both sides of the cricoid cartilage until the thyroid isthmus is felt and then ask the client to swallow Palpate the right side of the cricoid cartilage until the hyoid bone is felt and then ask the client to swallow Palpate the left side of the cricoid cartilage until the hyoid bone is felt and then ask the client to swallow Palpate both sides of the cricoid cartilage until the thyreohyoideus is felt and then ask the client to cough When assessing for thyrotoxic crisis, if the nurse is having difficulty palpating the thyroid gland, the nurse should: Ask the client to flex his/her neck forward to relax the neck muscles Ask the client to flex his/her neck backward to relax the neck muscles Ask the client to tilt his/her head to the right to relax the neck muscles Ask the client to tilt his/her head to the left to relax the neck muscles All of the following statements characterize a normal thyroid gland, except: The left lobe has a slight palpable vibration It feels smooth and rubbery and rises easily with swallowing It is approximately 4 cm across The right lobe is slightly larger than the left lobe Hypertrophy usually results from: The overproduction of T₃4 hormones The bulging of the submaxillary triangle and the hyoid bone Increased sensitivity of cell receptor's to catecholamines Excessive ADH and ACTH secretion Most specifically, this signifies accelerated blood flow through an enlarged thyroid gland: Thyroid bruit Venous hum Arterial murmur Palpable thrill To assess the abdomen of a client suspected of experiencing thyrotoxic crisis, the nurse should start with: Inspection Palpation Percussion Auscultation If thyrotoxic crisis is suspected, the nurse should palpate the client's abdomen to assess for: Pain or tenderness High-pitched bowel sounds Low-pitched bowel sounds Pulsations and distention According to the video, increased peristalsis of a client with thyrotoxic crisis may occur with: Hunger, GI bleeding or thyrotoxic crisis Thirst, hunger or thyrotoxic crisis GI swelling, thyrotoxic crisis or thirst A feeling of fullness, GI swelling or thirst All of the following assessment findings may suggest thyrotoxic crisis, except: S₄ heart sound Fever Severe diaphoresis Tachycardia Thyrotoxic crisis is an exacerbation of: Hyperthyroidism Hypothyroidism Hyperemia Hyperadrenalism In thyrotoxic crisis, the metabolism of cells increases when: T₃ engages with receptors on mitochondria, forcing them to consume more oxygen and increasing their production of ATP T₄ engages with receptors on mitochondrion, forcing them to consume more oxygen and increasing their production of ADH T₃ engages with receptors on mitochondria, forcing them to consume less oxygen and decreasing their production of ATP T₄ engages with receptors on mitochondrion, forcing them to consume less oxygen and decreasing their production of ADH The thyroid function test of a thyrotoxic crisis client may show all of the following results, except: Decreased iodothyronine level Decreased thyroid stimulating hormone level Increased free thyroxin level Increased free triiodothyronine level This is a thyroid hormone inhibitor used for the immediate treatment of thyrotoxic crisis: Propylthiouracil Lerdelimumab Homatropine methyl bromide Sertaconazole nitrate According to the lesson, a quiet and calm environment should be provided to a client with thyrotoxic crisis to reduce: Anxiety Drowsiness Fatigue Languor Normally, triiodothyronine (T₃) increases: The cells' energy production, which increases their oxygen consumption The cells' metabolism, which decreases their oxygen consumption The cells' action potential, which decreases their energy production The cells' resting membrane potential, which increases the cells' metabolism Cell metabolism increases when: The cells' oxygen consumption increases The cells' oxygen consumption decreases The levels of calcitonin and ghrelin increase The levels of calcitonin and ghrelin decrease An increase in cell metabolism can result in: A higher body temperature A lower body temperature A higher thyroxine-binding globulin (TBG) level A lower thyroxine-binding globulin (TBG) level In a client with thyroid hormone deficiency, pericardial effusion may cause the: Heart to sound faint and distant during auscultation Heart to sound loud and near during auscultation Heart to produce a summation gallop Jugular vein to produce a palpable thrill Pericardial effusion most specifically refers to the: Collection of excess fluid in the pericardial sac Lack of fluid in the pericardial sac Inflammation of the pericardial sac Bruising of the pericardial sac In hypothyroidism and myxedema, these reflect decreased peristalsis: Hypoactive bowel sounds and constipation Hyperactive bowel sounds and constipation Hypoactive bowel sounds and diarrhea Absent bowel sounds and diarrhea All of the following assessment findings may indicate myxedema, except: Tachycardia Hypothermia Narrowed pulse pressure Impaired cognition This statement about myxedema is most true: It is an acute exacerbation of hypothyroidism Its symptoms include hyperthermia and distant heart sounds It results from the reduced production of calcitonins It usually characterized by dry skin and widened pulse pressure All of the following are appropriate nursing interventions for myxedema, except: Administer a synthetic thyroid hormone intramuscularly Monitor the client's vital signs at least every 4 hours Reorient the client if he/she becomes confused Provide a warm environment to prevent heat loss If a diabetic client voids large amounts of dilute urine, this may signal: Osmotic diuresis caused by hyperglycemia Nephritis caused by hyperglycemia Nephrosclerosis caused by hypotension PKD caused by hypertension According to the lesson, the glucose renal threshold is: 180 milligrams per deciliter 170 milligrams per deciliter 160 milligrams per deciliter 200 milligrams per deciliter In regard to a diabetic client with polyuria, these form when the liver breaks down FFAs into glucose for energy: Ketones Glucagons Amino Acids Globulins Polydipsia most specifically refers to: Excessive thirst Excessive hunger Excessive and profuse perspiration Excessive red blood cell production Kussmaul respiration may be best described as: Fast, deep breathing Slow, deep breathing Fast, shallow breathing Slow, shallow breathing Kussmaul respiration in a diabetic client, typically results from: Metabolic acidosis Metabolic alkalosis Polydipsia Polyuria The orange glow from the eyes' retina seen through an ophthalmoscope is called the: Red reflex Orange reflex Papilledema Optic disk When assessing a diabetic client for peripheral vascular disease, the nurse should: Palpate the peripheral pulses, check the color and temperature of the legs and feet, and look for skin breakdown Check the texture and temperature of the legs, feet and hands and look for signs of hematoma Check the texture and temperature of the legs, feet and hands and look for signs of atrophedema Palpate the peripheral pulses, check the texture, color and temperature of the legs and feet and look for skin acanthosis In a diabetes client, during an ophthalmoscopic examination, absence of an orange glow from the retina may signify: Diabetes-induced cataract Diabetic retinopathy Crystoid macular edema Diabetic glaucoma In a client with type 1 diabetes, a pH level of 7.26 usually indicates: Acidosis Bicarbonate loss Fibrosis Hypokalemia In a diabetic client, glucose builds up in the blood when: It cannot enter the cells due to the lack of insulin It cannot enter the cells due to the excess of insulin Excessive catecholamine production blocks its excretion Mucopolysaccharides accumulate in the renal tubules In regard to DKA, the conversion of FFAs into glucose creates: Ketones Amino acids Glucagon Glycogen Most specifically, this should be administered to a DKA client to move glucose into the cells for energy: Regular insulin Isotonic IV fluids Electrolytes, such as potassium Oral glucose During treatment for DKA, the nurse should check the client's blood glucose and electrolyte levels at least: Every hour, until the client's condition stabilizes Every 2 hours, until the client's condition stabilizes Every 3 hours, until the client's condition stabilizes Every 4 hours, until the client's condition stabilizes During the treatment of a DKA client, the nurse should monitor the client's vital signs every: 4 hours or more frequently 2 hours or more frequently 8 hours or more frequently 6 hours or more frequently All of the following are stated signs and symptoms of a critical fluid and electrolyte imbalance, except: Hypoactive bowel sounds Tetany Paresthesia Electrocardiogram changes All of the following are stated signs and symptoms of a critical fluid and electrolyte imbalance, except: Compressed QRS complex Disorientation Weight gain Bounding pulses To avoid the life-threatening consequences of fluid and electrolyte imbalance, the nurse should be able to do all of the following, except: Recommend reasonable alternative treatments and medications Detect signs and symptoms and assess the client thoroughly Interpret assessment findings to determine the probable cause Provide appropriate nursing care and medical interventions Focused assessment for tetany and paresthesia may include all of the following, except: Skin texture Vital signs Respiratory rate Breath sounds If tetany and paresthesia are suspected, the nurse should assess for harsh and musical breath sounds by: Auscultation Palpation Percussion Urea breath test In regard to tetany and paresthesia, harsh and musical breath sounds can indicate: Stridor Hamman's sign Kussmaul's breathing Biot's respiration According to the video, Chvostek's sign is characterized by: Brief muscular contractions of the cheek, upper lip and nose when the face is tapped Retentive muscular contractions of the cheek, upper lip and nose when the face is tapped Brief muscular contractions of the eye lid, lower lip and ears when the face is tapped Retentive muscular contractions of the eye lid, lower lip and ears when the face is tapped In regard to tetany, Chvostek's sign results from: Increased excitability of the facial nerve Decreased excitability of the trigeminal nerve Increased excitability of the accessory nerve Decreased excitability of the vagus nerve A cell's threshold potential is the: Minimum energy needed to depolarize the cell Minimum energy needed to repolarize the cell Cell membrane's electrical charge at rest Cell membrane's electrical charge in motion If a client suspected of having tetany displays Chvostek's sign, the nurse should further assess for Trousseau's sign. To elicit this sign, the nurse should: Wrap a blood pressure cuff around the client's upper arm, then inflate the cuff to a level just above the client's systolic pressure Wrap a blood pressure cuff around the client's lower arm, then inflate the cuff to a level just below the client's systolic pressure Wrap a blood pressure cuff around the client's upper arm, then inflate the cuff to a level just above the client's diastolic pressure Wrap a blood pressure cuff around the client's lower arm, then inflate the cuff to a level just below the client's diastolic pressure Trousseau's sign is evidenced by: Carpal spasms Hand and feet contractions Finger and toe contractions Astragal spasms In a client with hypocalcemia, Trousseau's sign is produced when: Reduced blood supply causes the nerve fibers to fire repeatedly Increased blood supply causes the nerve fibers to fire repeatedly Impulse formation and conduction in the cardiac conduction system is inhibited by ADH production Impulse formation and conduction in the cardiac conduction system is inhibited by excessive prothrombin and fibrinogen When testing the DTRs of a client, the nurse should: Hold the reflex hammer loosely, snap the wrist forward and strike the hammer against the tendon, and then quickly snap the wrist back Hold the reflex hammer firmly, snap the wrist forward and strike the hammer forcefully against the tendon, and then slowly snap the wrist back First inspect and palpate each tendon before striking it with a reflex hammer First inspect and apply a warm compress to each tendon for about 5 minutes before striking it with a reflex hammer On the DTRs briskness scale, a one plus (+) sign indicates: A weaker than normal or hypoactive reflex An extremely brisk or hyperactive reflex A brisker than expected but normal reflex The absence of a reflex In regard to DTRs, the sensory nerve is also known as the: Afferent nerve Splanchnic nerve Nervus ischiadicus Radial nerve Paresthesia can be best described as: Abnormal skin sensations, such as tingling and numbness A reduced sense of touch or sensation, or a partial loss of sensitivity to sensory stimuli An increased sensitivity to pain, which may be caused by damage to nociceptors An increased sensitivity to pain, which may be caused by damage to peripheral nerves Paresthesia can occur when: An acid-base or electrolyte imbalance causes sensory nerves to fire abnormally or be unusually excitable Sensory and motor nerves become less excitable because of a high blood potassium level Impulse formation and conduction in the cardiac conduction system is inhibited by ADH production The stimulation of refractory tissue is inhibited by ADH production In the blood, calcium helps convert: Prothrombin to thrombin and fibrinogen to fibrin Glycine to proline and fibrinogen to fibrin Plasmin to plasminogen and glycine to proline Plasmin to plasminogen and trypsin to trypsinogen To confirm hypocalcemia, the nurse should expect the physician to order: Blood tests and 12-lead ECG Urine tests and CBC Barium enema and stool tests ESR and ABG tests When hypocalcemia prolongs myocardial cell repolarization, the client's 12-lead ECG tracing may reveal: Prolonged ST segments and QT intervals Prolonged ST segments and PR intervals Depressed ST segments and prolonged QT intervals Depressed ST segments and QT intervals All of the following assessment findings may point to hypocalcemia, except: Impaired bleeding Hyperactive DTRs Chvostek's sign Trousseau's sign Hyperkalemia can produce bradycardia by, most specifically: Slowing impulse formation and conduction in the cardiac conduction system Making myocardial cell membranes less permeable to sodium Increasing the blood supply and then causing the nerve fibers to fire repeatedly Preventing the stimulation of refractory tissue Normally, cells in the SA node initiate impulses at: 60 to 100 beats per minute 40 to 80 beats per minute 80 to 120 beats per minute 50 to 110 beats per minute Cell depolarization occurs when: Sodium moves into the myocardial cell Potassium moves out of the myocardial cell Sodium moves out of the myocardial cell Potassium moves into the myocardial cell On the muscle strength scale, a grade of 0 denotes: No muscular contraction or limb movement Normal movement against gravity and full resistance Full movement against gravity and partial resistance Slight muscular contraction but no limb movement The arm muscle strength of a client with generalized weakness and ECG changes should be assessed by: Asking the client to flex and extend his/her arm against the nurse's arm resistance Asking the client to grip the nurse's hand as long as tolerated Asking the client to alternately extend his/her arms and balance a heavy object Asking the client to extend his/her arms and balance a light object simultaneously On the muscle strength scale, a grade of 2 denotes: Full movement in a supported limb Slight muscular contraction but no limb movement Full movement against gravity and partial resistance No muscular contraction or limb movement The leg muscle strength of a client with generalized weakness and ECG changes should be assessed through: Hip flexion and extension Ankle rotation Knee bending Leg raising Hyperkalemia is: An elevated blood potassium level An elevated blood sodium level A blood disorder consisting of an increase in the volume of circulating blood An elevated blood lipid level Muscle cell depolarization may occur when the blood potassium level of a hyperkalemia client continues to rise, which may result in: Paralysis Dementia Aphasias Dyslexia Normally, the kidneys help keep potassium at its optimum blood level by: Excreting excess potassium through the nephron's distal tubules and collecting ducts Dissolving excess potassium and then redistributing it in the circulating blood Producing vitamin D and erythropoietin, which promotes the excretion of excess potassium Reabsorbing glucose and amino acids, which dissolves excess potassium Hyperkalemia in a client with renal failure occurs when: Damaged nephrons cannot excrete potassium effectively Excessive production of ADH inhibits the excretion of potassium The kidneys cannot produce vitamin D and erythropoietin The kidneys cannot reabsorb glucose and amino acids According to the lesson, drug therapy for hyperkalemia often includes all of the following, except: Hydrochlorothiazide Sodium bicarbonate Cation-exchange resin Glucose and regular insulin In the brain, cellular swelling can lead to all of the following, except: Lacunar amnesia Cerebral edema Disorientation Decreased level of consciousness To correct dilutional hyponatremia, this forces excess fluid to move from the intravascular space into cells: Osmosis Homeostasis Plasmolysis Miosis Cerebral edema in a client with SIADH most specifically occurs when: Osmosis forces excess fluid to move from the intravascular space into cells Homeostasis forces excess fluid to move from the intravascular space into cells Plasmolysis forces excess fluid to move from the intravascular space into cells Miosis forces excess fluid to move from the intravascular space into cells The carotid arteries should not be palpated simultaneously because: Doing so can interrupt the blood flow to the brain Doing so may decrease the blood pressure and volume Doing so can cause cardiogenic shock Doing so may trigger nerve fibers to fire repeatedly On the pulse amplitude scale, a normal pulse should be denoted as: +2 +3 +5 +7 During palpation, pulses normally feel: Strong and their contours have a sharp upstroke with a gradual downstroke Strong and brisk and their contours have a gradual upstroke and downstroke Strong and their contours have a gradual downstroke and sharp upstroke Strong and brisk and their contours have a gradual upstroke and a sharp downstroke When assessing for jugular vein distention and estimating central venous pressure, the nurse should: Place his/her fingers on the sternal notch next to the second intercostal space, then use a centimeter ruler and a straight edge to measure the distance from the sternal notch to the highest visible level of the jugular vein pulsation Place the diaphragm of the stethoscope on the sternal notch next to the second intercostal space, then use a centimeter ruler and a straight edge to measure the distance from the second intercostal to the highest visible level of the sternal notch Place his/her fingers on the clavicle next to the first intercostal space, then use a centimeter ruler and a straight edge to measure the distance from the clavicle to the highest visible level of the jugular vein pulsation Place the bell of the stethoscope on the clavicle next to the second intercostal space, then use a centimeter ruler and a straight edge to measure the distance from the second intercostal to the highest visible level of the sternal notch In a client with hypervolemia, jugular vein distention may be produced when: The central venous pressure is increased The jugular venous pressure is decreased The portal venous pressure is increased The pulse pressure is decreased Hyperactive bowel sounds of a client with SIADH reflect: Increased peristalsis, which can occur with hunger, GI bleeding or hyponatremia Increased anastalsis, which can occur with hunger, GI bleeding or hyponatremia Increased peristalsis, which can occur with severe thirst, GI swelling or hypernatremia Increased anastalsis, which can occur with severe thirst, GI swelling or hypernatremia In regard to SIADH, this statement about ADH is most true: It makes the renal tubules more permeable It is secreted by the anterior pituitary gland and by the nerve endings in the hypothalamus It decreases urine flow by affecting the reabsorption of water by the spleen It may stimulate the adrenal cortex and the release of anterior pituitary gland secretions In regard to SIADH, this gland releases excess ADH: Posterior pituitary Anterior pituitary Adrenal Pyloric In a client with SIADH, dilutional hyponatremia and hypervolemia are produced when: The normal ratio of water molecules to sodium ions is disrupted in the intravascular space Potassium ions outnumber sodium ions in the circulating blood The normal ratio of calcium ions to sodium ions is disrupted in the intravascular space Sodium ions outnumber potassium ions in the circulating blood To confirm dilutional hyponatremia and hypervolemia, the nurse should expect the physician to order: Blood tests An ECG An EEG An ESR test A blood sodium level of 125 mEq/L reflects: Hyponatremia Hypervolemia Hypocalcemia Hypokalemia The plan of care for an SIADH client with hyponatremia and hypervolemia should include all of the following, except: Restricting the client's fluid intake to 400-600 ml/day Weighing the client daily Monitoring the client's level of consciousness frequently Evaluating the client's blood sodium level and osmolality at least once a day The endocrine gland that is located in the chest is the: Thymus Medulla Cortex Hypothalamus The adrenal (suprarenal) glands are located: At the top of the kidneys In the chest In the brain In the neck The pineal gland is located in the: Brain Neck Chest Stomach The hormones that do not enter general circulation are called: Locally acting hormones Growth hormones Follicle-stimulating hormones Luteinizing hormones The signaling used by cancer cells to trigger growth is called: Autocrine signaling Paracrine signaling Anterior signaling Posterior signaling In regard to the hormones' down-regulation, each target cell for a certain hormone has up to this number of receptors: 100000 10000 1000 1000000 The diameter of the pituitary is: 1 cm 1.5 cm 2 cm 2.5 cm This is also called the "master gland" because it controls all of the other endocrine glands: The pituitary gland The thyroid gland The adrenal gland The pineal gland The number of hormones secreted by the hypothalamus and pituitary glands is: 16 12 14 18 This hormone causes increased skin pigmentation: Melanocyte-stimulating hormone Lactogenic hormone Human growth hormone Luteinizing hormone These stimulate the thyroid gland to release thyroid hormones: Thyroid-stimulating hormones Autocrine hormones Human growth hormones Follicle-stimulating hormones This maintains muscle and skeletal size in an adult: Human growth hormone Thyroid-stimulating hormone Autocrine hormone Melanocyte-stimulating hormone This hormone raises blood volume, and thus blood pressure: Antidiuretic hormone Oxytocin Thyroid-stimulating hormone Follicle-stimulating hormone Another term for the posterior pituitary is the: Neurohypophysis Adenohypophysis Hypophysis Sella turcica This hormone enhances the strength of uterine contractions and stimulates the ejection of milk after delivery: Oxytocin Thyroid-stimulating hormone Follicle-stimulating hormone Antidiuretic hormone Drugs that depress the immune system and promote protein catabolism are called: Glucocorticoids Mineralcorticoids Aldosterones Androgens The adrenal glands are supplied abundantly by all of the following vessels, except: Middle suprarenal arteries of each renal artery Inferior phrenic arteries off the aorta Middle suprarenal arteries off the aorta Inferior suprarenal arteries of each renal artery Glucocorticoids in the adrenal cortex promote all of the following, except: Cell regeneration Protein catabolism Lipolysis Resistance to stress The result of adrenocortical insufficiency is most specifically: Addison's disease Lipolysis Cushing's syndrome Hypertension This is a disorder that results from excessive adrenal cortical function: Cushing's syndrome Addison's disease Adenomas Lipolysis The treatment for Addison's disease is usually: Steroid hormone replacement Adrenalin hormone replacement Oxytocin hormone replacement Thymus hormone replacement Hypersecretion by pheochromocytoma causes the disorder called: Paroxysmal hypertension High Blood Pressure Hypersecretion Hyperplasia Hormones in the adrenal medulla are produced in: Chromaffin cells Paneth cells Boettcher cells Stellate cells Stimulation of the adrenal medulla releases these hormones: Catecholamines Adrenocorticals Corticoids Cholecystokinins