Lewis Medical-Surgical Nursing 11th
Edition Test Bank- Chapter 49 Endocrine
Problems
1. A 45-year-old male patient with suspected acromegaly is seen at the
clinic.
in makingTo assist
the diagnosis, which question should the
nurse
a. Have ask?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? correct answers
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
2. A 42-year-old female patient is scheduled for transsphenoidal
hypophysectomy
treat to
a pituitary adenoma. During preoperative teaching, 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. avoid brushing teeth for at least 10 days after the
surgery.
d. be positioned flat with sandbags at the head postoperatively. correct
answers ANS:
C
To avoid disruption of the suture line, the patient should avoid brushing the
teethafter
days for 10 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
the on
sella turcica and decrease the risk for
headaches.
DIF: Cognitive Level: Apply
(application)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological
Integrity
3. The nurse is planning postoperative care for a patient who is being
admittedunit
surgical to the
form the recovery room after transsphenoidal resection of a
pituitary
Which tumor.action should be
nursing
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. correct
answers
After ANS: B
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
at patient
risk is
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
4. The nurse is assessing a 41-year-old African American male patient a
diagnosed
pituitary with causing panhypopituitarism. Assessment findings
tumor
consistent with
panhypopituitarism
include
a. high blood
pressure.
b. decreased facial
hair.
c. elevated blood
glucose.
d. tachycardia and cardiac palpitations. correct answers
ANS: B in male secondary sex characteristics such as decreased facial hair,
Changes
testicular
atrophy, diminished spermatogenesis, loss of libido, impotence, and
decreased
mass muscle with decreases in follicle stimulating hormone
are associated
(FSH) and
luteinizing hormone (LH). Fasting hypoglycemia and hypotension
occur in
panhypopituitarism as a result of decreases in adrenocorticotropic hormone d
(ACTH) an
cortisol. Bradycardia is likely due to the decrease in thyroid stimulating
and thyroid
hormone hormones associated with
(TSH)
panhypopituitarism.
DIF: Cognitive Level: Apply
(application)
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological
Integrity
5. 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
c. Blood day.
glucose levels may decrease when taking the medication. d. Stop
taking the if swelling of the hands or feet occurs. correct
medication
answers ANS:
Somatropin is B
injected subcutaneously on a daily basis, preferably in the
evening.will
patient The
need to continue on somatropin for life. If swelling or other
common
effects adverse
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
6. The nurse determines that demeclocycline (Declomycin) is effective for a
patient with
syndrome of inappropriate antidiuretic hormone (SIADH) based on
finding that the
patient
s
a. weight has
increased.
b. urinary output is
increased.
c. peripheral edema is
decreased.
d. urine specific gravity is increased. correct answers
ANS: B
Demeclocycline blocks the action of antidiuretic hormone (ADH) on the
renalincreases
and tubules urine output. An increase in weight or an increase in urine
specific gravity
Edition Test Bank- Chapter 49 Endocrine
Problems
1. A 45-year-old male patient with suspected acromegaly is seen at the
clinic.
in makingTo assist
the diagnosis, which question should the
nurse
a. Have ask?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? correct answers
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
2. A 42-year-old female patient is scheduled for transsphenoidal
hypophysectomy
treat to
a pituitary adenoma. During preoperative teaching, 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. avoid brushing teeth for at least 10 days after the
surgery.
d. be positioned flat with sandbags at the head postoperatively. correct
answers ANS:
C
To avoid disruption of the suture line, the patient should avoid brushing the
teethafter
days for 10 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
the on
sella turcica and decrease the risk for
headaches.
DIF: Cognitive Level: Apply
(application)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological
Integrity
3. The nurse is planning postoperative care for a patient who is being
admittedunit
surgical to the
form the recovery room after transsphenoidal resection of a
pituitary
Which tumor.action should be
nursing
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. correct
answers
After ANS: B
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
at patient
risk is
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
4. The nurse is assessing a 41-year-old African American male patient a
diagnosed
pituitary with causing panhypopituitarism. Assessment findings
tumor
consistent with
panhypopituitarism
include
a. high blood
pressure.
b. decreased facial
hair.
c. elevated blood
glucose.
d. tachycardia and cardiac palpitations. correct answers
ANS: B in male secondary sex characteristics such as decreased facial hair,
Changes
testicular
atrophy, diminished spermatogenesis, loss of libido, impotence, and
decreased
mass muscle with decreases in follicle stimulating hormone
are associated
(FSH) and
luteinizing hormone (LH). Fasting hypoglycemia and hypotension
occur in
panhypopituitarism as a result of decreases in adrenocorticotropic hormone d
(ACTH) an
cortisol. Bradycardia is likely due to the decrease in thyroid stimulating
and thyroid
hormone hormones associated with
(TSH)
panhypopituitarism.
DIF: Cognitive Level: Apply
(application)
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological
Integrity
5. 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
c. Blood day.
glucose levels may decrease when taking the medication. d. Stop
taking the if swelling of the hands or feet occurs. correct
medication
answers ANS:
Somatropin is B
injected subcutaneously on a daily basis, preferably in the
evening.will
patient The
need to continue on somatropin for life. If swelling or other
common
effects adverse
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
6. The nurse determines that demeclocycline (Declomycin) is effective for a
patient with
syndrome of inappropriate antidiuretic hormone (SIADH) based on
finding that the
patient
s
a. weight has
increased.
b. urinary output is
increased.
c. peripheral edema is
decreased.
d. urine specific gravity is increased. correct answers
ANS: B
Demeclocycline blocks the action of antidiuretic hormone (ADH) on the
renalincreases
and tubules urine output. An increase in weight or an increase in urine
specific gravity
