Medical Surgical Nursing Test Bank Questions and Answers Complete Study Guide

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Man  TOTALITY ADRENAL CORTEX
 Suprasystem Glucocorticoids/Steroids
o Individual, family, community, society  Gluconeogenesis (formation of new glucose from fats and
 Subsystem proteins)  increased CHON catabolism (breakdown)  (-)
nitrogen balance (catabolism>anabolism)
Stress Response/SMR (Sympatho-medullary Response/ SAMR o Positive nitrogen balance (more protein
(Sympatho-adreno-medullary response)/GAS (General Adaptation anabolism)
Response) Mineralocorticoid/Aldosterone
 Diaphoresis  Fluid and sodium retention
 Increased B o Oliguria <400 ml /24 hrs.
 Increased PR o Anuria <100 ml /24 hrs.
 Increased rate/depth resp.  Potassium excretion
 Pallor
 Cold clammy NEUROHYPOPHYSEAL (Hypophysis Cerebri/Sella Turcica)
 Weight loss Anterior (Adenohypophysis)
 Weakness  TSH
 Anorexia  ACTH
 Diarrhea  FSH
 Constipation  LH
 Urinary frequency  MSH (Melanocyte-Stimulating Hormone)
 Oiguria  SH (Somatotrophic Hormone)
 Anuria
 GH
 Transient hyperglycemia
Posterior (Neurohypophysis)
 Increased in visual acuity
 ADH
 Oxytocin
 Hypothalamus
o Sympatho-adrenal medullary
ENDOCRINE
o Adreno-cortical
Hypoactivity
o Neurohypophyseal
 Congenital absence of glands
Adrenal glands  Surgical removal of gland
 On top of kidneys  Idiopathic atrophy of glands
 Adrenal medulla Hyperactivity
o Inner portion  Tumor within or outside the gland
o Secretes catecholamines:  Failure of kidneys to secrete hormones
EPINEPHRINE/ADRENALINE  Failure of liver to deactivate of hormones
 Vasodilator (coronary artery, cerebral
artery, peripheral blood vessels) DECREASED APG ACTIVITY
 Vasoconstrictor (peripheral arterioles) Pituitary dwarfism
 Glycogenolysis (breakdown of  Dwarf (doubled size of infant)
glycogen in liver) Frohlicks Syndrome
NOREPINEPHRINE/NORADRENALINE  Dwarf, obese, mentally retarded, genital atrophy
 Vasoconstrictor Simmonds disease/ Pituitary Cachexia
 Wizened old man, mental lethargy, teeth start to fall,
ADRENAL MEDULLA amenorrhea, absence of spermatogenesis
Epi/Norepi (Sympathetic/Adrenergic)
 Dilated coronary arteries  increased myocardial INCREASED APG ACTIVITY
perfusion  increased myocardial contraction  Gigantism
increased PR  Before closure of epiphyseal line
 Dilated peripheral blood vessels  Rapid growth of long bones
 Relaxation of smooth muscular bronchioles o Prolongation/elongation of long bones
bronchodilation  increased rate/depth respiration Acromegaly
 Constricted peripheral arterioles  increased  After closure of epiphyseal line
peripheral resistance  increased BP  Increased in bone thickness and hypertrophy of soft tissues
 Constricted arteries of skin  decreased blood supply o Enlargement of cartilages
 pallor  Nose
 Increased glycogenolysis  transient hyperglycemia  Ears
 Sweat glands  stimulation o Enlargement of larynx
 GIT  decreased gastric secretion  decreased  Deepened voice
gastric motility o Progmathism/protrusion of jaw
 No urine  Separation of teeth
o Urinary bladder muscles relaxes o Thickening of lips and oral mucous membrane
o Urinary sphincter  close o Lengthening of chin
 Pupils  dilation  increased visual acuity o Broad hands/spade-like fingers
o Enlargement of visceral organs




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MEDICAL SURGICAL NURSING.pdf MEDICAL SURGICAL NURSING.pdf MEDICAL SURGICAL NURSING.pdf

,MEDICAL SURGICAL NURSING.pdf MEDICAL SURGICAL NURSING.pdf MEDICAL SURGICAL NURSING.pdf

..MEDICAL SURGICAL NURSING, featuring verified solutions for nursing students. This 2025 updated! 2
 Management  Calcium gluconate
o Cobalt therapy
 Radiation o Given with vit. D (tachysterol)
o Surgical removal  Dihydrotachysterol
 Hypophysectomy  Hytakerol
o Inhibit production of growth hormone  Calciferol
(subcutaneously)  Calcifediol
o Somatostatin  Calcidiol
 Sandostatin ADRENAL CORTEX
 Octreotide/actreotide 1. Glucocorticoid/steroid – gluconeogenesis
 Fat  increased lipolysis  abnormal fat distribution
DIABETES INSIPIDUS  CHON  increased CHON catabolism  tissue
 Disorder in water metabolism  decreased ADH  prevent starvation & muscle wasting
renal tubules reabsorption of water  polyuria = 5-29 L/24 2. Mineralocorticoid/aldosterone
hrs.  Polydipsia  diluted (decreased specific gravity = 3. Androgen
1.010-1.025)  increased Na (135-145 mEq/L)
 All electrolyte testing do not require NPO Cushing’s
 Increased GMA

ADH  Increased 3S
o Oily preparations (Deep IM)  lipodystrophy (rotate o Sugar
route of administration)  Hyperglycemia
 Pitressin Tannate  Moon facies
 Vasopressin – vasoconstrictor  HPN  Buffalo hump
o Nasal sprays (clear nasal passages)  Truncal obesity
 Desmopressin Acetate o Salt
 Lypressin  Fluid retention  Increased BP
 Anti-lipidemic  Hypernatremia
o Clofibrate/Atromid S/Clo 5  Hypokalemia
o Sex
SIADH  Virilism
 Increased ADH  Masculinization
 Fluid retention  Hirsutism
o Increased IV volume (hypervolemia)  Management
 Increased BP o Cobalt therapy
 Increased renal perfusion  o Adrenalectomy
enhance/increased GFR/ increased o Cortisol inhibitors
UO  no leg edema  Aminogluthetemide
o Electrolyte dilution  Dilutional hyponatremia   Trilostane
fluid move into the cell  Metyrapone
 Cerebral edema  Increased ICP  Metotane
 Cellular overhydration Addison’s
 Management  Decreased GMA
o Hypophysectomy  Decreased 3S
o Inhibit production of ADH o Sugar
 Demeclocyline/Declomycin PO  Hypoglycemia
 Stimulate anterior pituitary gland 
Parathormone increased ACTH  MSH  tan
 Promote reabsorption of Ca in the renal tubules and complexion  bronze-skinned
excretion of P, essential for blood coagulation, regulate o Salt
cardiac rhythmicity  Decreased IV volume  hypotension
Hypoparathyroidism  Hyponatremia
 Hypocalcemia = hyperphosphatemia  Hyperkalemia  myocardial irritability
o 4.5-5.5 mEq/L  altered electrical conduction 
o 8-11 mg/dL dysrhythmias  heart arrest
o High calcium diet o Sex
 Tetany  Management
o (+) Chvostek – tap the Facial nerve (below the o Steroids
temporals)  muscle twitching of face
o Trousseau – occlude blood flow of an extremity Conns/Primary aldosteronism
for 1-2 minutes  carpopedal spasm  Adenoma of adrenal cortex (benign)
 Management  Hyperactivity
o Can be given sea foods but not milk, dairy Pheochromocytoma
products and egg (rich in phosphorus) so check  Adenoma of adrenal medulla (benign)
levels of phosphorus if among the choices, all is  Hyperactivity
with calcium  5H
o Calcium preparations (after meals) o Hypertension
 Calcium carbonate o Headache
 Calcium Lactate o Hyperglycemia
 Calcium Chloride 10% o Hypermetabolism
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MEDICAL SURGICAL NURSING.pdf MEDICAL SURGICAL NURSING.pdf MEDICAL SURGICAL NURSING.pdf

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o Hyperhidrosis o E.g. 11am PO RAI 131 6 millicuries  24 hr.
 Management urine  1pm scanner
o Cobalt therapy  N: 0.9%-2.4 millicuries
o Surgical removal of adrenal medullary  Low: 0.67
 Assessment  High: 3.6
o VMA (Vanillylmandellic Acid) o Directly proportional to uptake
 Level of catecholamine o Inversely proportional to urine
 Blood 0.2-0.9 mg%  Thyroid Scan
 Urine 0.2-7 mg/24 hrs. o Evaluate RAI 131 stored by thyroid gland to
determine size, shape, location of thyroid gland
Thyroid glands
 Isthmus – connects the two lobes of the thyroid glands HYPOTHYROIDISM
 Thyroid hormones  Onset of symptoms
o T3 – tri-iodothyronine o Cretinism - childhood
o T4 – Thyroxine o Myxedema - adulthood
o Thyrocalcitonin  Cause
 Plasma iodide + tyrosine (amino acid) = thyroglobulin o Primary – failure of thyroid gland to secrete T3 T4
(storage form)  T3, T4 o Secondary – failure of anterior pituitary gland to
o Level of hormones are related to feedback secrete TSH
mechanism  S/sx
o Stunted growth
Anterior pituitary gland  trophic hormone  target organ o Delayed onset of puberty
 TSH  thyroid gland  T3 T4 o Low VS
 ACTH  Adrenal cortex  SSS o Mentally sluggish
o Cold intolerant
Assessments o Hypometabolic = weight gain
 PBI (Protein Bound Iodine)  Management
o Evaluate amount of iodine attached to the protein o Supplement thyroid extract
molecule of the blood  Proloid
o 4-8 ug %  Cytomel
o No intake of iodine for 3-4 days  Synthroid
 Sea foods  Euthroid
 Iodized salt  Thyrolar
 Cough syrup  Thyrax
 Salicylate (ASA)  Ectroxine
 Estrogenic preparations  Thyroxine
 Dyes  Levo-thyronine
 T3 T4 Determination  Lio-thyronine
o T3 70-170 ug %
 More potent than T4 HYPERTHYROIDISM
 Will not bind with iodine  Grave’s/Basedoue/Parry’s disease/ Thyroitoxicosis/Toxic
 Can readily/penetrate a cell to Goiter
stimulate metabolism  Theories:
o T4 4.7-11 ug % o LATS (Long-acting thyroid stimulator)
o No special preparations  Gammaglobulin
 TSH Test  Cause iodine accumulation and
o 0.4-6.11 ug/ml thyroid hyperplasia
o Decreased T3 T4  APG  stimulate TSH  Triad Symptoms
o Increased T3 T4  APG  inhibit TSH  Goiter
o Inversely proportional to thyroid function  Eye signs
 BMR  Hyperthyroidism
o Evaluate O2 consumption when at rest o Elevated T3 T4
o NPO 12 hrs. and good night sleep o EPS
o  Anterior pituitary gland will release an
 TBMR exophthalmos producing substance
o Theoretical basal metabolic rate  Exophthalmos (protrusion
o 20-30 of eyeball)
o Pulse pressure + PR/min – 111  Proptosis (downward
o Not definitive displacement of eyeball)
 RAIU (Radioactive Iodine Uptake)  Lid lag
o Evaluate amount of radioactive iodine 131  Infrequent blinking
accumulated by the thyroid gland and excreted  Fixed stare
by the kidneys  Peri-orbital edema
o No intake of iodine  Von Graefe (failure of
o Uptake = 15-40% eyelids to follow movement
o Urine = 40-80% of eyes when the patient
o PO RAI 131 cocktail (with brassy taste)  24 hr. looks down)
urine  2-4 hr. scanner
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MEDICAL SURGICAL NURSING.pdf MEDICAL SURGICAL NURSING.pdf MEDICAL SURGICAL NURSING.pdf

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 Dalyrimple sign (infrequent  Turn to sides
blinking and fixed stare)  Promote adequate nutrition and fluid and electrolytes
o S/sx o As soon as fully awake and with gag reflex
Increased T3 T4  (Elevation of palate and contraction of
 Diarrhea pharyngeal muscle)
 Voracious increase T3 T4 (Grave’s)  Promote adequate bowel-bladder elimination
 Over-excitability SNS (no o 6-8 hrs. after surgery
management sought) o If not within 6-8 hrs., palpate presence of bladder
o Diaphoresis distention
o Tremors  Encourage early ambulation
o Nervousness o Shorten convalescence period
o Palpitation o Boost patient’s moral
o Constipation o Get out of bed as soon as VS are stable
o Simple goiter/Endemic goiter/ Iodine-deficiency  Support the head and neck to prevent
goiter/ Non-toxic goiter flexion and hyperextension
o Goiter – enlargement of thyroid gland  Complications
 Hormone levels o Tetany
 May be normal,  Occurs upon accidental removal of
above/below normal parathyroid glands
because goiter is simply o 2 recurrent laryngeal nerves
enlargement  Hoarseness (edema of glottis)
Treatment Modalities  Aphonia
 Anti-thyroid preparation o Bleeding
 Prevent synthesis T3 T4 by blocking utilization of  Failure to tie/ligate the bleeders
iodine  Check for dampness at the nape
 Example  Check for feeling of choking
o Tapazole/methimazole  Evaluate VS
o PTU (Propylthiouracil)  Rapid, weak, feeble,
 Differential count thready pulse
o Neomercazole/Carbimazole  Rapid but shallow
 Adverse effects (prolonged use) respiration
o Agranulocytosis – infection o Respiratory obstruction
 Fever  Secondary to bleeding
 Complaint of sore throat  Accumulation of tracheo-bronchial
 Dyspnea secretion
 Iodine Preparation  Laryngospasm
 Lugol’s solution/KISS (Potassium Iodide  Laryngeal edema
Saturated Solution) o Thyroid crises/storm
o Reduce vascularity  High anxiety level pre-op
o Increase firmness of gland  Increased T3 TT4  anti-thyroid
o Promote storage of T3 T4 preparation for 3 months  euthyroid
 Adrenergic-blocking state, normal T3 T4  operation 
 Control symptoms of over-excitability of post-op stress, infection  increased
SNS T3 T4 (over-excitability of SNS)
 RAI 131  Fever with tachycardia
 Surgery  Anti-thyroid preparation
 Management
DIABETES MELLITUS
o High caloric diet
Assessments
o No colas/caffeinated beverages
o Monitor weight  FPG, RBS, PPBS, OGTT, Hgt
o Provide physical mental rest
o Provide calm/restful environment HHNK Coma/HHNS
o Elevate head to promote drainage and reduce  Hyperglycemia  hyperosmolar diuresis  glycosuria &
peri-orbital edema polyuria  ECF dehydration  cerebral dehydration 
CNS depression  HHNK
Surgeries DKA
 Sistrunk’s – thyroglossal cyst  Increased lipolysis  increased oxidation of fatty acids 
 Radical/Total thyroidectomy hyperlipidemia & ketone bodies  DKA
o Collar-line/Curvilinear Dawn’s phenomenon
 Partial/Sub-total thyroidectomy – 5/6 of 2 lobes  Normal blood sugar before night time  shoots up
hyperglycemia at the dawn
 Thyroid lobectomy
Somogyi/Rebound Hyperglycemia
 Isthmusectomy
 Maybe normal bood sugar before the client sleeps  blood
sugar depletes at around 2 am  shoots up at around 3 am
Post-thyroidectomy management
due to the counter hormone secreted in the body
 Promote patent airway
o Position Semi-Fowler’s
Rapid Short Intermediate Long/Slow
o Not High-Fowler’s – cause strain on neck muscle
(10-15 (6-8 hrs.)
which causes tension on suture line (bleeding)
min.)
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MEDICAL SURGICAL NURSING.pdf MEDICAL SURGICAL NURSING.pdf MEDICAL SURGICAL NURSING.pdf