You catch glucose, thyroid, and steroid problems from the labs and symptoms in the stem. Five of the 15 questions include the correct answer and rationale. The other ten keep answers in the study hub. Continue with the LPN exams exam guide or more LPN exams practice questions.
Five endocrine questions with answers
Cover the key. Write the first action. Then open the rationale and name why the other choices fail.
Question 1
Which of the following statements regarding pituitary hormones is false?
A. The hypothalamus makes oxytocin and antidiuretic hormone, which are transported to the posterior pituitary for storage.
B. Antidiuretic hormone, released by the posterior pituitary, causes urine volume to increase and blood volume to decrease.
C. Luteinizing hormone, an anterior pituitary hormone, triggers ovulation of an egg from the ovary and causes the ruptured follicle to produce progesterone and some estrogens.
D. Hyposecretion of follicle-stimulating hormone or luteinizing hormone leads to sterility in both males and females.
Show answer and rationale
Correct answer: B — Antidiuretic hormone, released by the posterior pituitary, causes urine volume to increase and blood volume to decrease.
Step 1: Antidiuretic hormone (ADH) is released by the posterior pituitary, and its main function is to increase water reabsorption in the kidneys, leading to decreased urine volume and increased blood volume.
Step 2: If ADH causes urine volume to increase and blood volume to decrease, it would be counterproductive to its known physiological role.
Step 3: Therefore, Choice B is false as it contradicts the established function of ADH.
Summary:
- Choice A is true because oxytocin and antidiuretic hormone are indeed produced in the hypothalamus and stored in the posterior pituitary.
- Choice C is true as luteinizing hormone does trigger ovulation and stimulates the production of progesterone and some estrogens.
- Choice D is true because hyposecretion of follicle-stimulating hormone or luteinizing hormone can lead to infertility in both males and females.
Question 2
A 21-year-old previously healthy man has noticed blood in his urine for the past 2 days. He reports no dysuria, frequency, or hesitancy of urination. On physical examination, there are no abnormal findings. Laboratory findings show a serum urea nitrogen level of 39 mg/dL and creatinine level of 4.1 mg/dL. A renal biopsy specimen is obtained; the immunofluorescence pattern of staining with antibody against human IgG is shown in the figure. Which of the following serologic findings is most likely to be present in this patient?
A. Anti-glomerular basement membrane antibody
B. Anti-streptolysin O antibody
C. C3 nephritic factor
D. Hepatitis B surface antibody
Show answer and rationale
Correct answer: A — Anti-glomerular basement membrane antibody
The linear pattern of staining shown in the figure indicates the presence of anti-glomerular basement membrane antibodies (directed against the noncollagenous domain of the a3 chain of type IV collagen). Such antibodies are typically seen in Goodpasture syndrome, a form of rapidly progressive glomerulonephritis (GN) that has a bimodal pattern of occurrence in younger and older men. The anti-streptolysin O titer is increased in poststreptococcal GN, which typically has a granular pattern of immune complex deposition. The C3 nephritic factor can be a marker for dense deposit disease. Some cases of membranous nephropathy are associated with hepatitis B virus infection, but the immune complex deposition is granular, not linear. HIV infection can lead to a nephropathy that resembles FSGS, in which IgM and C3 are deposited in the mesangial areas of affected glomeruli.
Question 3
A floor nurse pages you about a patient who is having chest pain. You order an electrocardiogram and rush to see the patient. He describes the pain as tight pressure and is demonstrably sweating and gasping for air. The ECG comes back with acute ST-segment elevations in inferior leads, and you diagnose a myocardial infarction. You start giving the patient oxygen and give him sublingual nitroglycerin and morphine for pain. You also give him another medication, which you have read may prolong his survival in this situation. What class of medication is it?
A. β-Blocker
B. α-Agonist
C. Muscarinic agonist
D. Neuromuscular blocker
Show answer and rationale
Correct answer: A — β-Blocker
The correct answer is A: β-Blocker. β-Blockers are indicated in the management of myocardial infarction as they help reduce myocardial oxygen demand by decreasing heart rate, blood pressure, and contractility. This results in less strain on the heart muscle and can improve survival outcomes. Additionally, β-blockers can prevent arrhythmias and reduce the risk of recurrent infarction. In this scenario, where the patient is experiencing an acute myocardial infarction with ST-segment elevations, the use of a β-blocker is crucial in managing the condition and improving the patient's prognosis.
Summary of other choices:
B: α-Agonist - Not indicated in the management of myocardial infarction.
C: Muscarinic agonist - Not indicated in the management of myocardial infarction.
D: Neuromuscular blocker - Not indicated in the management of myocardial infarction.
Question 4
A 56-year-old woman is found on health screening to have a blood pressure of 168/109 mm Hg. No other physical examination findings are noted. Urinalysis shows a pH of 7.0; specific gravity, 1.020; 1+ proteinuria; and no blood, glucose, or ketones. The ANA and ANCA test results are negative. The serum urea nitrogen level is 51 mg/dL, and the creatinine level is 4.7 mg/dL. The hemoglobin A1c concentration is within the reference range. An abdominal ultrasound scan shows bilaterally and symmetrically small kidneys with no masses. What is her most likely diagnosis?
A. Amyloidosis
B. Autosomal dominant polycystic kidney disease
C. Chronic glomerulonephritis
D. Microscopic polyangiitis
Show answer and rationale
Correct answer: C — Chronic glomerulonephritis
Chronic glomerulonephritis (GN) may follow specific forms of acute GN. In many cases, however, it develops insidiously with no known cause. With progressive glomerular injury and sclerosis, both kidneys become smaller, and their surfaces become granular. Hypertension often develops because of renal ischemia. Regardless of the initiating cause, these 'end-stage' kidneys appear morphologically identical. They have sclerotic glomeruli, thickened arteries, and chronic inflammation of interstitium. Because the patient's ANA and ANCA test results are negative, vasculitis is unlikely. Polycystic kidney disease and amyloidosis would cause the kidney size to increase, not decrease. The normal hemoglobin A1c concentration indicates that the patient does not have diabetes mellitus. Nodular glomerulosclerosis is typical of diabetes mellitus with an elevated hemoglobin A1c.
Question 5
Insulin, cortisol, thyroxine, and oxytocin:
A. are hypothalamic-releasing hormones.
B. are secreted by the adenohypophysis.
C. increase blood glucose levels.
D. are hormones.
Show answer and rationale
Correct answer: D — are hormones.
Rationale:
1. Insulin, cortisol, thyroxine, and oxytocin are all hormones produced by various glands in the body.
2. Insulin is produced by the pancreas, cortisol by the adrenal glands, thyroxine by the thyroid gland, and oxytocin by the hypothalamus and released by the pituitary gland.
3. Each of these hormones plays a different role in the body, such as regulating blood glucose levels, metabolism, stress response, and reproductive functions.
4. Therefore, the correct answer is D: they are all hormones.
Summary:
A: Incorrect. Hypothalamic-releasing hormones are specific hormones that stimulate the release of other hormones from the pituitary gland.
B: Incorrect. Adenohypophysis secretes different hormones, not these specific ones.
C: Incorrect. Insulin, for example, decreases blood glucose levels, while cortisol increases blood glucose levels.
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Question 6
The posterior pituitary gland receives hormone messages from the hypothalamus via ________.
A. a capillary network
B. neurons that extend from the hypothalamus to the pituitary
C. Schwann cells
D. both a and b
Correct answer:
The correct answer is B: neurons that extend from the hypothalamus to the pituitary. The hypothalamus produces hormones that are stored and released by the posterior pituitary gland. This communication is facilitated by specialized neurons that extend from the hypothalamus to the pituitary, forming the hypothalamic-pituitary axis. These neurons release hormones into the bloodstream, which then reach the posterior pituitary gland and stimulate the release of its stored hormones. Choice A is incorrect because the posterior pituitary does not directly receive messages through a capillary network. Choice C is incorrect as Schwann cells are responsible for myelinating peripheral nerves, not hormone communication. Choice D is incorrect because while the hypothalamus communicates with the pituitary gland through neurons, it does not involve a capillary network.
Which of the following structures connects the hypothalamus and the adenohypophysis?
A. Islets of Langerhans
B. Portal capillaries
C. Corpus callosum
D. Medulla oblongata
Correct answer:
The correct answer is B: Portal capillaries. The hypothalamus and adenohypophysis are connected by a system of blood vessels called the hypothalamic-pituitary portal system, which includes portal capillaries. These capillaries carry releasing and inhibiting hormones from the hypothalamus to the adenohypophysis to regulate the secretion of pituitary hormones. The other choices are incorrect because:
A: Islets of Langerhans are clusters of cells in the pancreas involved in insulin and glucagon production, not connected to the hypothalamus or adenohypophysis.
C: The corpus callosum is a structure that connects the two cerebral hemispheres and is not related to the hypothalamus or adenohypophysis.
D: The medulla oblongata is part of the brainstem responsible for autonomic functions and is not involved in connecting the hypothalamus and adenohypophysis.
A 66-year-old female with a long history of heavy smoking presents to her doctor with complaints of shortness of breath and chronic coughing that has been present for about 2 years and has been worsening in frequency. The doctor decides to prescribe a bronchodilator agent that has minimal cardiac side effects, since the patient also has an extensive cardiac history. Which medication did the doctor likely prescribe?
A. Albuterol
B. Prazosin
C. Atenolol
D. Ipratropium
Correct answer:
The correct answer is D: Ipratropium. Ipratropium is an anticholinergic bronchodilator that has minimal cardiac side effects. It is commonly used to treat chronic obstructive pulmonary disease (COPD) and asthma. In this case, the patient's history of heavy smoking, shortness of breath, and chronic coughing suggests a respiratory condition like COPD. Albuterol (choice A) is a short-acting beta-agonist bronchodilator that can have cardiac side effects such as palpitations and increased heart rate. Prazosin (choice B) is an alpha-blocker used for hypertension and has no bronchodilator effects. Atenolol (choice C) is a beta-blocker used for hypertension and can worsen bronchospasm in patients with respiratory conditions. Therefore, the doctor likely prescribed Ipratropium to address the patient's respiratory symptoms while minimizing cardiac side effects.
Your patient is diagnosed with myasthenia gravis, and she is given a prescription for pyridostigmine. Which of the following best summarizes the drug’s mechanism of action?
A. Blocks muscarinic receptors, so that acetylcholine preferentially stimulates skeletal muscle
B. Inhibits reuptake of acetylcholine by motor nerves
C. Inhibits skeletal muscle activation at rest so that the muscles are less susceptible to fatigue during exercise
D. Inhibits breakdown of acetylcholine, thereby improving activation of skeletal muscle by acetylcholine
Correct answer:
The correct answer is D: "Inhibits breakdown of acetylcholine, thereby improving activation of skeletal muscle by acetylcholine."
Rationale:
1. Pyridostigmine is an acetylcholinesterase inhibitor, which means it blocks the breakdown of acetylcholine.
2. In myasthenia gravis, there is a decrease in acetylcholine receptor sites, leading to muscle weakness.
3. By inhibiting the breakdown of acetylcholine, pyridostigmine increases the availability of acetylcholine at the neuromuscular junction, improving muscle activation.
4. This mechanism helps alleviate muscle weakness in myasthenia gravis patients.
Summary:
A: Incorrect. Pyridostigmine does not block muscarinic receptors or change the preference of acetylcholine stimulation.
B: Incorrect. Pyridostigmine does not inhibit reuptake of acetylcholine; it acts by inhibiting its breakdown
Which of the following glands can be classified as an endocrine and exocrine gland?
A. Thyroid
B. Thymus
C. Pancreas
D. Pituitary
Correct answer:
The correct answer is C: Pancreas. The pancreas is both an endocrine and exocrine gland. It secretes digestive enzymes (exocrine function) into the small intestine to aid in digestion, and it also releases hormones like insulin and glucagon (endocrine function) into the bloodstream to regulate blood sugar levels.
Rationale:
1. The thyroid gland (choice A) is solely an endocrine gland responsible for producing hormones that regulate metabolism.
2. The thymus gland (choice B) is primarily an endocrine gland involved in immune function, producing hormones that regulate T cell development.
3. The pituitary gland (choice D) is known as the master gland and is purely endocrine, controlling various hormonal functions in the body.
In summary, the pancreas uniquely exhibits both endocrine and exocrine functions, making it the correct choice.
Propranolol is useful in the treatment of all of the following conditions EXCEPT:
A. Hypertension
B. Anxiety
C. Heart block
D. Angina of effort
Correct answer:
Propranolol is a non-selective beta-blocker that slows the heart rate and reduces blood pressure. Heart block refers to a condition where the electrical signals in the heart are delayed or blocked. Propranolol can worsen heart block by further slowing down the heart rate, making it inappropriate for this condition. Therefore, the correct answer is C.
A: Propranolol is used to treat hypertension by reducing blood pressure.
B: Propranolol is effective in managing anxiety symptoms by blocking the physical manifestations of anxiety, such as rapid heart rate.
D: Propranolol is beneficial in treating angina of effort by reducing the workload of the heart and improving blood flow to the heart muscle.
In summary, the other choices (A, B, D) are correct uses of propranolol, making C the exception due to its potential to worsen heart block.
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.
Correct answer:
The correct answer is A: Note the time of the client's first void and collect urine for 24 hours. This is correct because for a 24-hour urine specimen collection, it is essential to start by noting the exact time of the first void and then collect all subsequent urine voided over the next 24 hours, including the final void at the same time the collection started. This ensures accurate measurement of substances in the urine over a full 24-hour period.
Choice B is incorrect because the preservative should be added to the container at the beginning, not the end, to maintain the integrity of the specimen. Choice C is incorrect because the 24-hour collection starts with the first void, not the first morning urine. Choice D is incorrect as missing even one urine sample during the 24-hour collection can compromise the accuracy of the results.
An autopsy study is performed involving persons with gross pathologic findings of bilaterally small kidneys (<100 g) that have a coarsely granular surface appearance. Microscopic examination shows sclerotic glomeruli, a fibrotic interstitium, tubular atrophy, arterial thickening, and scattered lymphocytic infiltrates. Which of the following clinical findings was most likely reported in these patients' medical histories?
A. Hemoptysis
B. Hypertension
C. Lens dislocation
D. Pharyngitis
Correct answer:
These findings describe end-stage renal disease, the appearance of which can be similar regardless of the cause (e.g. vascular disease or glomerular disease). The characteristics of progressive renal damage include glomerulosclerosis (starting with focal segmental glomerulosclerosis) and tubulointerstitial fibrosis. With advanced renal destruction, hypertension almost always supervenes, even if it was absent at the onset of renal disease. Many such cases are referred to as chronic glomerulonephritis (GN), for want of a better term. Hemoptysis occurs in Goodpasture syndrome that involves lungs as well as kidneys. Lens dislocation is a feature of Alport syndrome, from thinning of the anterior lens capsule. Pharyngitis with group A streptococcal infection may precede postinfectious GN. A skin rash might have preceded the postinfectious GN.
What is the most critical need for the child with newly diagnosed cretinism?
A. Thyroidectomy
B. Administration of a radioactive cocktail of 131I (radioactive iodine)
C. Replacement dose of thyroid hormones
D. Replacement dose of calcitonin
Correct answer:
The correct answer is C: Replacement dose of thyroid hormones. In newly diagnosed cretinism, there is a deficiency of thyroid hormones, leading to developmental delays and other health issues. Administering replacement thyroid hormones is crucial to normalize hormone levels and support proper growth and development. Thyroidectomy (choice A) is not necessary in this case as the goal is to supplement the missing hormones. Option B, the administration of radioactive iodine cocktail, is used to treat hyperthyroidism, not hypothyroidism. Choice D, replacement dose of calcitonin, is not relevant as calcitonin is involved in calcium regulation, not thyroid hormone production. Thus, the most critical need for the child with newly diagnosed cretinism is the replacement dose of thyroid hormones to address the underlying hormonal deficiency.
A common second messenger used in signaling pathways of water-soluble hormones is
A. tRNA.
B. ATP.
C. cAMP.
D. PTH.
Correct answer:
The correct answer is C: cAMP. Water-soluble hormones, such as adrenaline or glucagon, bind to cell surface receptors and activate a signaling cascade that often involves cAMP as a second messenger. Upon hormone binding, the receptor activates adenylyl cyclase, which converts ATP to cAMP. cAMP then activates protein kinase A, leading to phosphorylation of target proteins, ultimately affecting cellular responses.
Explanation for incorrect choices:
A: tRNA is involved in protein synthesis, not in signaling pathways of water-soluble hormones.
B: ATP is used as an energy source in various cellular processes, but it is not a second messenger in hormone signaling pathways.
D: PTH (parathyroid hormone) is a hormone involved in calcium regulation and does not act through cAMP signaling in the same manner as water-soluble hormones.
LPN exams endocrine practice questions, set 3 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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