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Quizzes > Health & Medicine

RN Endocrine System Assessment Quiz

Quick, free quiz on normal endocrine assessment findings. Instant results.

Editorial: Review CompletedCreated By: Tess FlohrUpdated Aug 28, 2025
Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art illustration of thyroid pituitary adrenal glands and pancreas on sky blue background for nursing quiz

This quiz helps you practice endocrine system assessment and spot gaps before clinicals. Work through thyroid function, cortisol cues, and common findings in nursing care. After you finish, deepen review with the endocrine system quiz, focus on anatomy in the endocrine glands quiz, or build broader skills with nursing assessment questions.

What is the primary function of the thyroid gland?
Secrete cortisol
Control calcium levels
Produce insulin
Regulate metabolism
The thyroid gland produces T3 and T4 hormones that regulate basal metabolic rate, energy production, and heat generation in the body. It does not regulate calcium levels (that is the parathyroid gland), produce insulin (the pancreas does), or secrete cortisol (the adrenal cortex is responsible). Proper thyroid function is essential for metabolic homeostasis and influences multiple organ systems.
The hormone insulin is produced by which cells in the pancreas?
Alpha cells
Beta cells
Delta cells
PP cells
Insulin is synthesized and secreted by the beta cells located in the islets of Langerhans of the pancreas. Alpha cells secrete glucagon, delta cells secrete somatostatin, and PP cells secrete pancreatic polypeptide. Insulin plays a crucial role in glucose uptake and metabolism.
Which hormone is released in response to low blood calcium?
Calcitonin
Parathyroid hormone (PTH)
Antidiuretic hormone (ADH)
Aldosterone
When blood calcium levels fall, the parathyroid glands secrete parathyroid hormone (PTH), which increases calcium reabsorption from bone, enhances renal reabsorption of calcium, and stimulates activation of vitamin D. Calcitonin is released when calcium is high to lower levels. Aldosterone regulates sodium and potassium, and ADH controls water balance.
What is the target organ of antidiuretic hormone (ADH)?
Heart
Liver
Kidneys
Lungs
Antidiuretic hormone (ADH) acts primarily on the renal collecting ducts in the kidneys to increase water reabsorption and concentrate the urine. It does not directly affect the heart, liver, or lungs. Adequate ADH function helps maintain plasma osmolality and blood pressure.
Which gland is located at the base of the brain and often called the "master gland"?
Pineal gland
Adrenal gland
Thyroid gland
Pituitary gland
The pituitary gland, located in the sella turcica at the base of the brain, is termed the "master gland" because it secretes hormones that regulate other endocrine glands. The thyroid sits in the neck, the adrenals atop the kidneys, and the pineal is in the brain's epithalamus. Pituitary hormones include ACTH, TSH, GH, FSH, LH, prolactin, and ADH.
What is the normal range for fasting blood glucose in adults?
126-150 mg/dL
100-125 mg/dL
70-99 mg/dL
40-60 mg/dL
A fasting blood glucose level between 70 and 99 mg/dL is considered normal for most healthy adults. Levels from 100 to 125 mg/dL indicate impaired fasting glucose (prediabetes), and 126 mg/dL or higher on two occasions suggests diabetes. Hypoglycemia is blood glucose below 70 mg/dL.
Which hormone increases heart rate and blood pressure during the stress response?
Thyroxine (T4)
Glucagon
Epinephrine
Insulin
Epinephrine, released by the adrenal medulla during the fight-or-flight response, increases heart rate, cardiac output, and blood pressure. Thyroxine affects metabolism and heat production, insulin lowers blood glucose, and glucagon raises blood glucose. Epinephrine also dilates airways and redirects blood flow to muscles.
What is the primary role of growth hormone in the body?
Control calcium balance
Stimulate growth, cell reproduction, and regeneration
Regulate salt and water balance
Metabolize glucose and regulate blood sugar
Growth hormone (GH), secreted by the anterior pituitary, stimulates protein synthesis, cell division, and growth in tissues such as bone and muscle. It also has metabolic effects like increasing lipolysis. It does not directly control blood sugar (that is insulin/glucagon), calcium balance (PTH/calcitonin), or salt and water balance (aldosterone/ADH).
A patient presents with exophthalmos, heat intolerance, and weight loss. Which condition is most likely?
Hypothyroidism
Cushing's syndrome
Addison's disease
Graves' disease
Exophthalmos, heat intolerance, and weight loss are classic signs of hyperthyroidism due to Graves' disease, an autoimmune condition causing overproduction of thyroid hormones. Hypothyroidism causes cold intolerance and weight gain. Addison's affects adrenal cortisol, and Cushing's causes weight gain and skin changes.
A nurse reviewing lab results notes a patient's morning cortisol level is low. Which condition might this indicate?
Cushing's syndrome
Addison's disease
Diabetes insipidus
Hyperthyroidism
Low morning cortisol suggests adrenal insufficiency such as Addison's disease, where the adrenal cortex fails to produce sufficient cortisol. Cushing's has elevated cortisol, hyperthyroidism affects thyroid hormones, and diabetes insipidus involves ADH. Cortisol typically peaks in the morning in healthy individuals.
Which finding is most indicative of diabetes insipidus?
Hypertension
Hyperglycemia
Polyuria with low urine specific gravity
Polyphagia
Diabetes insipidus is characterized by insufficient ADH activity leading to excretion of large volumes of dilute urine (low specific gravity) and polydipsia. Polyphagia and hyperglycemia are associated with diabetes mellitus, and hypertension is not a hallmark of DI. Assessment of urine osmolality is diagnostic.
During an assessment, the nurse notes a buffalo hump and moon face. Which endocrine disorder causes these findings?
Addison's disease
Hyperthyroidism
Cushing's syndrome
Hypoparathyroidism
A buffalo hump and moon face are classic features of Cushing's syndrome, resulting from chronic cortisol excess. Addison's disease leads to hyperpigmentation and weight loss, hyperthyroidism causes weight loss and heat intolerance, and hypoparathyroidism presents with hypocalcemia symptoms. Cortisol's catabolic effects lead to fat redistribution.
A patient has hypoparathyroidism. Which electrolyte imbalance does the nurse expect?
Hypernatremia
Hypocalcemia
Hypercalcemia
Hypokalemia
Hypoparathyroidism results in decreased PTH secretion, leading to reduced calcium reabsorption in the kidneys and decreased bone resorption, causing hypocalcemia. Sodium and potassium are regulated by other hormones, and hypercalcemia would be seen in hyperparathyroidism. Hypocalcemia may present with neuromuscular irritability.
Which medication is first-line for thyroid hormone replacement in hypothyroidism?
Propylthiouracil
Levothyroxine
Insulin
Methimazole
Levothyroxine, a synthetic form of T4, is the standard first-line therapy for hypothyroidism to restore normal thyroid hormone levels. Methimazole and propylthiouracil are antithyroid drugs used for hyperthyroidism, and insulin is used for diabetes, not thyroid disorders. Dosing is titrated based on TSH levels.
In a dexamethasone suppression test, suppression of cortisol indicates what?
Cushing's disease
Normal adrenal function
Pheochromocytoma
Addison's disease
In a low-dose dexamethasone suppression test, dexamethasone should suppress ACTH and reduce cortisol in individuals with normal HPA axis function. Lack of suppression suggests Cushing's syndrome or disease. Addison's has low baseline cortisol, and pheochromocytoma involves catecholamines, not cortisol suppression.
A patient with primary hyperaldosteronism will exhibit which electrolyte abnormality?
Hypokalemia
Hyperglycemia
Hypoglycemia
Hyponatremia
Primary hyperaldosteronism (Conn's syndrome) causes excessive aldosterone secretion, leading to sodium retention, water retention, hypertension, and potassium excretion resulting in hypokalemia. Glucose levels are not directly affected, and sodium is elevated, not low. Recognizing this pattern is key in diagnosis.
How does growth hormone affect insulin sensitivity?
It has no effect on insulin sensitivity
It decreases insulin resistance
It increases insulin resistance
It only affects children, not adults
Growth hormone has anti-insulin effects, promoting lipolysis and hepatic glucose production, thereby increasing insulin resistance. This can lead to hyperglycemia if GH is in excess. GH's metabolic actions differ from its growth-promoting effects.
In primary hypothyroidism, what pattern of TSH and T4 levels is expected?
Low TSH and low T4
Low TSH and high T4
High TSH and high T4
High TSH and low T4
Primary hypothyroidism is due to thyroid gland failure, resulting in low T4 production and a compensatory rise in TSH from the pituitary. Secondary hypothyroidism (pituitary issue) shows low TSH and low T4. Elevated TSH with elevated T4 suggests hyperthyroidism, not hypothyroidism.
What is the mechanism of action of propylthiouracil in hyperthyroidism?
Stimulates iodine uptake by the thyroid
Inhibits thyroid peroxidase and T4 to T3 conversion
Enhances peripheral deiodination of T4
Blocks TSH receptors on thyroid cells
Propylthiouracil (PTU) inhibits thyroid peroxidase, reducing iodination of tyrosine residues in thyroglobulin, and also blocks peripheral conversion of T4 to the active T3. It does not block TSH receptors, enhance deiodination, or stimulate iodine uptake. PTU's dual action is beneficial in thyroid storm.
A 24-hour urine vanillylmandelic acid (VMA) test is used to diagnose which tumor?
Pheochromocytoma
Insulinoma
Cushing's adenoma
Pituitary adenoma
A 24-hour urine VMA test measures breakdown products of catecholamines (epinephrine and norepinephrine) and is diagnostic for pheochromocytoma. Insulinomas secrete insulin, Cushing's adenomas secrete cortisol, and pituitary adenomas may secrete various pituitary hormones. Elevated VMA indicates catecholamine excess.
Which hormone uses cyclic AMP as a second messenger in its target cells?
Thyroxine (T4)
Estrogen
Glucagon
Insulin
Glucagon binds to G protein - coupled receptors on hepatocytes, activating adenylate cyclase to convert ATP to cyclic AMP, which then activates protein kinase A. Insulin uses a tyrosine kinase receptor, estrogen uses nuclear receptors, and T4 acts via intracellular receptors. cAMP is a common second messenger for peptide hormones.
Elevated cortisol levels primarily inhibit release of which pituitary hormone?
Thyroid-stimulating hormone (TSH)
Adrenocorticotropic hormone (ACTH)
Growth hormone (GH)
Follicle-stimulating hormone (FSH)
High cortisol levels exert negative feedback on the hypothalamus and anterior pituitary, leading to reduced CRH and ACTH secretion. While cortisol can have minor effects on other pituitary hormones, its primary feedback target is ACTH. This feedback loop regulates adrenal cortisol production.
What is the mechanism of action of demeclocycline in treating SIADH?
Antagonizes ADH action at renal V2 receptors
Enhances insertion of aquaporins in the collecting duct
Inhibits ADH synthesis in the hypothalamus
Stimulates ADH release from the pituitary
Demeclocycline induces a reversible nephrogenic diabetes insipidus by inhibiting the action of ADH at the V2 receptors in the renal collecting ducts, reducing water reabsorption. It does not stimulate ADH release, enhance aquaporin insertion, or inhibit ADH synthesis. This mechanism corrects hyponatremia in SIADH.
Which receptor type mediates thyroid hormone action at the cellular level?
G protein - coupled receptors
Intracellular nuclear receptors regulating gene transcription
Cell membrane tyrosine kinase receptors
Ligand-gated ion channels
Thyroid hormones (T3 and T4) enter the cell, bind to nuclear thyroid hormone receptors, and modulate transcription of target genes. They do not act via cell surface tyrosine kinase, G protein - coupled receptors, or ion channels. This genomic mechanism explains their broad and sustained effects.
Which laboratory profile is characteristic of tertiary adrenal insufficiency?
Low ACTH, high cortisol, normal aldosterone
High ACTH, low cortisol, normal aldosterone
Low ACTH, low cortisol, low aldosterone
Low ACTH, low cortisol, normal aldosterone
Tertiary adrenal insufficiency arises from hypothalamic CRH deficiency leading to low ACTH and low cortisol, while renin-angiotensin regulation of aldosterone remains intact, so aldosterone is usually normal. Secondary insufficiency (pituitary disease) also shows low ACTH and cortisol but may slightly affect aldosterone. High ACTH would indicate primary adrenal failure.
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Study Outcomes

  1. Understand Endocrine Anatomy and Physiology -

    Recognize the structure and function of major endocrine glands and their hormones, providing a foundation for comprehensive endocrine system assessment.

  2. Analyze Physical Examination Techniques -

    Break down key steps in the physical examination of the endocrine system, including thyroid palpation and assessment of gland size, texture, and symmetry.

  3. Apply Hormone Regulation Concepts -

    Use knowledge of hormone feedback loops and cortisol regulation to interpret patient presentations and prioritize nursing interventions.

  4. Identify Clinical Signs of Endocrine Imbalance -

    Detect common manifestations of thyroid dysfunction, adrenal disorders, and sodium imbalance to inform differential diagnosis and care planning.

  5. Interpret Laboratory Values -

    Evaluate thyroid function tests, cortisol levels, and electrolyte panels, correlating lab results with clinical findings for accurate endocrine assessment nursing.

  6. Answer Endocrine Nursing Questions Confidently -

    Respond to targeted quiz questions on endocrine system assessment, reinforcing critical thinking and ensuring mastery of endocrine nursing assessment principles.

Cheat Sheet

  1. Thyroid Palpation & Lab Correlation -

    During an endocrine system assessment, palpate the thyroid for size, symmetry, and nodules, noting any enlargement or tenderness as part of your physical examination of endocrine system. Always correlate your findings with serum TSH (0.4 - 4.0 mIU/L) and free T4/T3 levels, remembering that an elevated TSH indicates primary hypothyroidism. A handy tip is to visualize TSH and T4 on a seesaw - when one goes up, the other typically goes down.

  2. Cortisol Diurnal Rhythm & Disorders -

    Assessing adrenal function in endocrine nursing assessment involves understanding cortisol's peak at 6 - 8 AM (5 - 25 μg/dL) and its nadir around midnight. Recognize Cushing's syndrome signs - moon face, hypertension, hyperglycemia - and contrast with Addison's disease symptoms like hyperpigmentation and hyponatremia. Use the "AM↑/PM↓" shorthand to remember cortisol's daily fluctuation.

  3. Aldosterone and Electrolyte Balance -

    In endocrine assessment nursing, evaluate the aldosterone effect by checking serum sodium (135 - 145 mEq/L) and potassium (3.5 - 5.0 mEq/L) levels; primary hyperaldosteronism often presents with hypertension and hypokalemia. Recall that aldosterone promotes sodium reabsorption and potassium excretion, contributing to fluid balance and blood pressure regulation. A simple mnemonic is "Salt Saver, Potassium Pusher" to remember this exchange.

  4. Growth Hormone Disorders & Physical Signs -

    During your physical examination of endocrine system, look for enlarged hands, feet, and jaw that suggest acromegaly, and note changes in ring or shoe size over time. Confirm with an oral glucose suppression test (GH should drop below 1 ng/mL); failure to suppress indicates excess GH secretion. Think "GROW" (Glucose test, Ring size, Overgrowth of tissues, Watch hormone levels) to streamline your endocrine nursing questions.

  5. Pituitary Hormones Mnemonic: FLAT PiG -

    Mastering an endocrine nursing assessment includes recalling anterior pituitary hormones: FSH, LH, ACTH, TSH (all tropic) followed by Prolactin and GH as "FLAT PiG." This mnemonic helps you systematically review pituitary function when faced with hypopituitarism or hyperpituitarism scenarios. Integrate this tool into your study routine to answer endocrine nursing questions with confidence.

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