Chapter 050

Topics: Calcium metabolism, Nursing, Hypothalamus Pages: 15 (4907 words) Published: December 5, 2014
Lewis: Medical-Surgical Nursing, 8th Edition
Chapter 50: Nursing Management: Endocrine Problems
Test Bank
MULTIPLE CHOICE
1. A patient with suspected acromegaly is seen at the clinic. To assist in making the

diagnosis, which question should the nurse ask?
a. “Have you had a recent head injury?”
b. “Do you have to wear larger shoes now?”
c. “Are you experiencing tremors or anxiety?”
d. “Is there any family history of acromegaly?”
ANS: B

Acromegaly causes an enlargement of the hands and feet. Head injury and family history are not risk factors for acromegaly. Tremors and anxiety are not clinical manifestations of acromegaly.
DIF: Cognitive Level: Application
TOP: Nursing Process: Assessment

REF: 1255-1256
MSC: NCLEX: Physiological Integrity

2. During preoperative teaching for a patient scheduled for transsphenoidal

hypophysectomy for treatment of a pituitary adenoma, the nurse instructs the patient about the need to
a. cough and deep breathe every 2 hours postoperatively.
b. remain on bed rest for the first 48 hours after the surgery. c. be positioned flat with sandbags at the head postoperatively. d. avoid brushing the teeth for at least 10 days after the surgery. ANS: D

To avoid disruption of the suture line, the patient should avoid brushing the teeth for 10 days after surgery. It is not necessary to remain on bed rest after this surgery. Coughing is discouraged because it may cause leakage of cerebrospinal fluid (CSF) from the suture line. The head of the bed should be elevated 30 degrees to reduce pressure on the sella turcica and decrease the risk for headaches.

DIF: Cognitive Level: Application
TOP: Nursing Process: Implementation

REF: 1256-1258
MSC: NCLEX: Physiological Integrity

3. Which nursing action will be included in the postoperative plan of care for a patient who

has had a transsphenoidal resection of a pituitary tumor?
a. Monitor urine output every hour.
b. Palpate extremities for dependent edema.
c. Check hematocrit hourly for first 12 hours.
d. Obtain continuous pulse oximetry for 24 hours.

Test Bank

50-2

ANS: A

After pituitary surgery, the patient is at risk for diabetes insipidus caused by cerebral edema and monitoring of urine output and urine specific gravity is essential. Hemorrhage is not a common problem. There is no need to check the hematocrit hourly. The patient is at risk for dehydration, not volume overload. The patient is not at high risk for problems with oxygenation, and continuous pulse oximetry is not needed. DIF: Cognitive Level: Application

Planning
MSC: NCLEX: Physiological Integrity

REF: 1257-1258

TOP: Nursing Process:

4. A patient is suspected of having a pituitary tumor causing panhypopituitarism. During

assessment of the patient, the nurse would expect to find
a. high blood pressure.
b. elevated blood glucose.
c. tachycardia and cardiac palpitations.
d. changes in secondary sex characteristics.
ANS: D

Changes in secondary sex characteristics are associated with decreases in follicle stimulating hormone (FSH) and luteinizing hormone (LH). Fasting hypoglycemia and hypotension occur in panhypopituitarism as a result of decreases in adrenocorticotropic hormone (ACTH) and cortisol. Bradycardia is likely due to the decrease in thyroidstimulating hormone (TSH) and thyroid hormones associated with panhypopituitarism. DIF: Cognitive Level: Application

TOP: Nursing Process: Assessment

REF: 1257-1259
MSC: NCLEX: Physiological Integrity

5. Which information will the nurse include when teaching a patient about use of

somatropin (Genotropin)?
a. The medication will improve vaginal dryness.
b. Inject the medication subcutaneously every day.
c. Blood glucose levels will decrease when taking the medication. d. Stop taking the medication if swelling of the hands or feet occurs. ANS: B

Somatropin is injected subcutaneously on a daily basis, preferably in the evening. The patient will need to continue on...
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