Wk. 4 - Adrenal Cortex Disorders Practice Questions

Which is a primary physiologic function of cortisol? a) Stimulates sodium retention in the kidney b) Promotes gluconeogenesis and stress adaptation c) Directly lowers serum potassium d) Increases calcium absorption in the gut

B

Which hormone stimulates the adrenal cortex to secrete cortisol? a) CRH b) ACTH c) ADH d) TSH

B

True or False: Cortisol secretion follows a circadian rhythm, with highest levels in the early morning.

True

Which component of the HPA axis directly releases CRH? a) Anterior pituitary b) Posterior pituitary c) Hypothalamus d) Adrenal medulla

C

Which of the following are physiologic effects of glucocorticoids? (Select all that apply) a) Increased protein catabolism b) Increased lipolysis c) Enhanced inflammatory response d) Mood and cognition effects e) Reduced peripheral glucose use

A,B,D,E

Which best describes the action of aldosterone? a) Retains sodium and water, excretes potassium b) Stimulates cortisol synthesis c) Increases glucose uptake into cells d) Suppresses immune response

A

The most common cause of Cushing syndrome overall is: a) Pituitary adenoma b) Long-term corticosteroid therapy c) Adrenal carcinoma d) Ectopic ACTH secretion

B

Which are expected clinical manifestations of Cushing syndrome? (Select all that apply) a) Buffalo hump b) Moon face c) Purple striae d) Hypoglycemia e) Osteoporosis

A,B,C,E

Which metabolic finding is consistent with Cushing syndrome? a) Hypotension b) Hypoglycemia c) Hyperkalemia d) Hyperglycemia

D

Which nursing intervention is priority for a patient with iatrogenic Cushing syndrome? a) Encourage abrupt cessation of corticosteroids b) Gradually taper corticosteroid dose per provider c) Restrict fluid intake d) Increase dietary potassium

B

True or False: Mood changes, such as irritability and insomnia, may be manifestations of Cushing syndrome.

True

Collaborative care for endogenous Cushing syndrome may include (Select All That apply): a) Transsphenoidal resection of pituitary adenoma b) IV hydrocortisone replacement c) Adrenalectomy for adrenal tumor d) Medical therapy with ketoconazole e) Sodium restriction and potassium supplements

A,D,E

Which is a major patient teaching point for long-term corticosteroid therapy? a) Take with meals in the evening to mimic cortisol rhythm b) Stop abruptly if infection develops c) Carry a steroid identification card d) Avoid calcium and vitamin D supplementation

C

Long-term side effects of corticosteroid therapy include (Select All That Apply): a) Osteoporosis b) Increased infection risk c) Skin thinning d) Bradycardia e) Hyperglycemia

A,B,C,E

What is the primary reason corticosteroids must be tapered after long-term use? a) To prevent rebound hypoglycemia b) To avoid adrenal insufficiency c) To prevent Cushing syndrome d) To reduce infection risk

B

Which timing is best for taking daily corticosteroid therapy? a) Before bedtime b) Early morning with food c) Before strenuous exercise d) At midnight

B

True or False: Steroid-sparing agents may be used to reduce systemic corticosteroid burden in chronic diseases.

True

Patient education for long-term corticosteroid therapy should include (Select All that Apply): a) Report weight gain and edema b) Monitor blood glucose c) Avoid abrupt discontinuation d) Expect improved wound healing e) Engage in weight-bearing exercise

A,B,C,E

Hydrocortisone (Solu-Cortef) is the drug of choice for: a) Addisonian crisis b) Hyperaldosteronism c) Cushing syndrome d) Hypoparathyroidism

A

Which is a significant side effect of hydrocortisone at high doses? a) Hypoglycemia b) Immunosuppression c) Hypotension d) Bradycardia

B

Which best describes the action of fludrocortisone (Florinef)? a) Stimulates cortisol secretion b) Promotes sodium retention and potassium excretion c) Increases gluconeogenesis d) Blocks aldosterone receptors

B

Nursing considerations for a patient taking fludrocortisone include (Select All That Apply): a) Monitor blood pressure b) Monitor for edema c) Restrict sodium intake in all patients d) Check serum potassium regularly e) Weigh daily

A,B,D,E

True or False: Hydrocortisone provides only glucocorticoid activity and no mineralocorticoid effect.

False

Which is the most common cause of Addison’s disease in the U.S.? a) Pituitary tumor b) Adrenal carcinoma c) Autoimmune adrenal destruction d) Tuberculosis

C

Which electrolyte imbalance is most characteristic of primary adrenal insufficiency? a) Hypernatremia and hypokalemia b) Hyponatremia and hyperkalemia c) Hypercalcemia and hypophosphatemia d) Hypocalcemia and hypermagnesemia

B

Manifestations of Addison’s disease may include (Select All That Apply): a) Bronze hyperpigmentation b) Salt craving c) Hypotension d) Hyperglycemia e) Weight loss

A,B,C,E

During adrenal crisis, which treatment is priority? a) Oral fludrocortisone b) IV hydrocortisone and IV fluids c) Immediate adrenalectomy d) Potassium restriction

B

Primary hyperaldosteronism leads to which two electrolyte abnormalities? a) Hyponatremia and hypokalemia b) Hypernatremia and hyperkalemia c) Hypernatremia and hypokalemia d) Hyponatremia and hyperkalemia

C

Which manifestations are consistent with hyperaldosteronism? (Select all that apply) a) Resistant hypertension b) Muscle weakness c) Polyuria d) Hyponatremia e) Paresthesias

A,B,C,E

Which treatment is recommended for bilateral adrenal hyperplasia with hyperaldosteronism? a) Adrenalectomy b) Spironolactone or eplerenone c) IV hydrocortisone d) Potassium restriction

B