Lewis's Chapter 49- Endocrine Problems Test Bank, Chapter 47-
Assessment of Endocrine System Lewis- Medical-Surgical Nursing,
10th Edition (Latest
... [Show More] Update 2022 Solved)
A 40-year-old 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. "Is there a family history of acromegaly?"
d. "Are you experiencing tremors or anxiety?" - 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: Apply (application)
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
A patient is scheduled for transsphenoidal hypophysectomy to treat a pituitary
adenoma. What
should the nurse include in preoperative teaching?
a. Cough and deep breathe every 2 hours postoperatively.
b. Remain on bed rest for the first 48 hours postoperatively.
c. Avoid brushing teeth for at least 10 days after the surgery.
d. You will be positioned flat with a cervical collar after surgery. - ANS: C
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. A cervical collar is not needed.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
The nurse is planning postoperative care for a patient who is being admitted to the
surgical
unit from the recovery room after transsphenoidal resection of a pituitary tumor. Which
nursing action should be included?
a. Palpate extremities for edema.
b. Measure urine volume every hour.
c. Check hematocrit every 2 hours for 8 hours.
d. Monitor continuous pulse oximetry for 24 hours. - ANS: B
After pituitary surgery, the patient is at risk for diabetes insipidus caused by cerebral
edema.
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: Apply (application) TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity
The nurse is assessing a male patient diagnosed with a pituitary tumor causing
panhypopituitarism. Which assessment finding is consistent with panhypopituitarism?
a. High blood pressure
b. Decreased facial hair
c. Elevated blood glucose
d. Intermittent tachycardia - ANS: B
Changes in male secondary sex characteristics such as decreased facial hair, testicular
atrophy,
diminished spermatogenesis, loss of libido, impotence, and decreased muscle mass are
associated with decreases in follicle-stimulating hormone (FSH) and luteinizing
hormone
(LH). Fasting hypoglycemia and hypotension occur in panhypopituitarism because of
decreases in adrenocorticotropic hormone (ACTH) and cortisol. Bradycardia is due to
the
decrease in thyroid-stimulating hormone (TSH) and thyroid hormones associated with
panhypopituitarism.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
Which information will the nurse include when teaching a 50-year-old male patient about
somatropin (Genotropin)?
a. The medication will be needed for 3 to 6 months.
b. Inject the medication subcutaneously every day.
c. Blood glucose levels may decrease when taking the medication.
d. Stop taking the medication if swelling of the hands or feet occurs. - ANS: B
Somatropin is injected subcutaneously daily, preferably in the evening. The patient will
need
to continue on somatropin for life. If swelling or other common adverse effects occur,
the
health care provider should be notified. Growth hormone will increase blood glucose
levels.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
Which finding indicates to the nurse that demeclocycline is effective for a patient with
syndrome of inappropriate antidiuretic hormone (SIADH)?
a. Weight has increased.
b. Urinary output is increased.
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