Chapter 49: Endocrine Problems Lewis: Medical-Surgical Nursing, 10th Edition

1. A 40-yr-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) REF: 1157 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity 2. A 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: 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. DIF: Cognitive Level: Apply (application) REF: 1159 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity 3. 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 hou