CHAPTER 49: ENDOCRINE PROBLEMS -
LEWIS'S MEDICAL SURGICAL
NURSING. EXAM 2025 QUESTIONS AND
ANSWERS
A 45-year-old male 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 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.
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,A 42-year-old female patient is scheduled for transsphenoidal hypophysectomy to treat 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. - ANS 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.
The nurse is planning postoperative care for a patient who is being admitted to the surgical unit
form the
recovery room after transsphenoidal resection of a pituitary tumor. Which nursing action
should be included?
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,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 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.
The nurse is assessing a 41-year-old African American male patient diagnosed with a pituitary
tumor
causing panhypopituitarism. Assessment findings consistent with panhypopituitarism include
a. high blood pressure.
b. decreased facial hair.
c. elevated blood glucose.
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, d. tachycardia and cardiac palpitations. - ANS 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 as a result of decreases in adrenocorticotropic hormone (ACTH) and
cortisol. Bradycardia
is likely due to the decrease in thyroid stimulating hormone (TSH) and thyroid hormones
associated with
panhypopituitarism.
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.
4 Copyright ©2025 FYNDLAY ALL RIGHTS RESERVED.
LEWIS'S MEDICAL SURGICAL
NURSING. EXAM 2025 QUESTIONS AND
ANSWERS
A 45-year-old male 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 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.
1 Copyright ©2025 FYNDLAY ALL RIGHTS RESERVED.
,A 42-year-old female patient is scheduled for transsphenoidal hypophysectomy to treat 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. - ANS 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.
The nurse is planning postoperative care for a patient who is being admitted to the surgical unit
form the
recovery room after transsphenoidal resection of a pituitary tumor. Which nursing action
should be included?
2 Copyright ©2025 FYNDLAY ALL RIGHTS RESERVED.
,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 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.
The nurse is assessing a 41-year-old African American male patient diagnosed with a pituitary
tumor
causing panhypopituitarism. Assessment findings consistent with panhypopituitarism include
a. high blood pressure.
b. decreased facial hair.
c. elevated blood glucose.
3 Copyright ©2025 FYNDLAY ALL RIGHTS RESERVED.
, d. tachycardia and cardiac palpitations. - ANS 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 as a result of decreases in adrenocorticotropic hormone (ACTH) and
cortisol. Bradycardia
is likely due to the decrease in thyroid stimulating hormone (TSH) and thyroid hormones
associated with
panhypopituitarism.
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.
4 Copyright ©2025 FYNDLAY ALL RIGHTS RESERVED.
