Alterations of Hormonal Regulation

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Module 9 Exam

Chronic complications of DM include which of the following?

A) Peripheral neuropathies
B) End-stage renal disease
C) Coronary artery disease
D) All of the above

D) All of the above

Microvascular and macrovascular disease can lead to peripheral neuropathies, end-stage renal disease (nephropathy), and coronary artery disease.

Damage to the posterior pituitary caused by a cerebrovascular accident (stroke) results in _____ diabetes insipidus (DI).

A) vascular
B) nephrogenic
C) psychogenic
D) neurogenic

D) neurogenic

When DI develops from injury to the CNS, it is called "neurogenic" DI.

When evaluating the kidney function of an individual with diabetes insipidus (DI), the nurse would observe:

A) high volume urine output.
B) high urine osmolarity.
C) blood in the urine.
D) protein in the urine.

A) high volume urine output.

In DI, the kidneys are unable to conserve water in the distal and collecting tubules, resulting in the production of large volumes of dilute urine.

Gestational diabetes can occur:

A) during fetal development.
B) in early childhood.
C) during pregnancy.
D) in older adults.

C) during pregnancy.

Gestational diabetes is the development of glucose intolerance in women during pregnancy.

The symptom of polyuria in diabetes mellitus (DM) is caused by:

A) a reduced AHD response caused by insulin deficiency.
B) the loss of protein across the glomerular membrane.
C) the production of ketones.
D) increased glucose in the urine.

D) increased glucose in the urine.

When glucose levels in the blood are greater than 300 mg/dL, glucose is excreted in the urine. The presence of glucose in the urine filtrate draws water into the tubules, causing an "osmotic diuresis."

Which of the following is a serious complication of SIADH?

A) Permanent neurological damage
B) Renal failure
C) Myocardial infarction
D) Panhypopituitarism

A) Permanent neurological damage

Hyponatremia in SIADH can lead to severe, irreversible neurological damage.

Syndrome of inappropriate diuretic hormone (SIADH) results in excessive:

A) renal retention of sodium and water.
B) renal retention of sodium without water retention.
C) renal retention of water without sodium retention.
D) renal excretion of water without sodium retention.

C) renal retention of water without sodium retention.

Elevated ADH secretion in SIADH stimulates increased water reabsorption in the distal and collecting tubules.

Classic symptoms of diabetes insipidus (DI) include all of the following except:

A) hypertension.
B) dehydration.
C) low urine osmolarity.
D) thirst.

A) hypertension.

Absence of ADH secretion in DI leads to increased urine output, volume depletion, and hypotension.

The pathophysiology of type 1 diabetes mellitus (DM) involves:

A) autoimmune destruction of pancreatic beta cells.
B) production of antibodies against insulin.
C) type IV hypersensitivity against pancreatic islet cells.
D) all of the above.

D) all of the above.

The insulin deficiency that results in type 1 DM is caused by three factors: (1) the production of antibodies that destroy the beta cells in the pancreatic islets of Langerhans, (2) the production of antibodies against insulin, and (3) cell-mediated destruction of the islet cells.

Neurological symptoms of SIADH are related to:

A) hypotension and cellular dehydration.
B) decreased serum sodium concentrations.
C) increased serum osmolarity.
D) hypokalemia.

B) decreased serum sodium concentrations.

ADH secretion in SIADH causes a dilutional hyponatremia and decreased serum osmolarity.

The development of an acute metabolic acidosis from insulin deficiency is due to which of the following processes?

A) Protein catabolism with ammonia release
B) Anaerobic metabolism of glucose
C) Fatty acid metabolism with ketone production
D) Renal failure

C) Fatty acid metabolism with ketone production

An insulin deficiency will increase the release and utilization of fatty acids as fuel. Metabolizing fatty acids liberates acidic molecules called ketones.

A new diagnosis of type 1 diabetes is based on:
A) random serum glucose levels.
B) fasting plasma glucose levels and glucose tolerance tests.
C) genetic testing.
D) the presence of symptoms only.

B) fasting plasma glucose levels and glucose tolerance tests.

The suspicion of diabetes-based clinical manifestations can be confirmed by evaluating fasting plasma glucose levels and conducting glucose tolerance tests.

Alterations in lipid and protein metabolism lead to chronic complications of DM through which of the following processes?

A) Activation of protein kinase C
B) Induction of the polyol pathway
C) Glycosylation
D) All of the above

D) All of the above

Hyperglycemia activates protein kinase C, induction of the polyol pathway, and glycosylation.

Signs and symptoms common to both type 1 and type 2 diabetes mellitus (DM) include all of the following except:

A) polyphagia.
B) weight loss.
C) polydipsia.
D) polyuria.

B) weight loss.

Weight loss is a symptom of type 1 DM. Most individuals with type 2 DM are obese.

What effect does the presence of advanced glycosylation end products (AGEs) have in diabetes?

A) Increased ketone formation
B) Tissue injury
C) Dawn phenomenon
D) Reduction of chronic complications

B) Tissue injury

AGEs cause tissue injury through a variety of mechanisms, including the production of free radicals and the induction of microvascular/macrovascular disease.

Signs and symptoms that a person with type 1 diabetes has administered too much insulin include:

A) Kussmaul respirations and acetone breath.
B) dizziness and confusion.
C) abdominal cramping and nausea.
D) pain at the site of injection.

B) dizziness and confusion.

Dizziness and confusion, combined with tachycardia, palpations, and visual disturbances are signs of hypoglycemia related to overadministration of insulin.

The purpose of monitoring glycosylated hemoglobin levels in persons with diabetes is to:

A) check for hyperlipidemia.
B) detect acute complications of diabetes.
C) monitor long-term serum glucose control.
D) measure fasting glucose levels.

C) monitor long-term serum glucose control.

Monitoring hemoglobin A1c levels in a person with diabetes provides a measure of glucose control during the life span of the red blood cells being evaluated.

Hyperglycemia and lipid abnormalities in type 2 diabetes mellitus (DM) are a result of:

A) production of inactive insulin.
B) glucagon deficiency.
C) insulin resistance.
D) glycogen excess.

C) insulin resistance.

Type 2 DM is caused by cellular resistance to the physiologic effects of insulin.

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