Chapter 54: Endocrine Problems Lewis: Medical-Surgical
Nursing UPDATED ACTUAL Questions and CORRECT
Answers
1. A 40-yr-old patient with suspected acromegaly is seen ANS: B
at the clinic. To assist in making the diagnosis, which Acromegaly causes an enlargement of the hands and feet. Head injury and family
question should the nurse ask? history are not risk factors for acromegaly. Tremors and anxiety are not clinical
manifestations of acromegaly.
a. "Have you had a recent head injury?"
b. "Do you have to wear larger shoes now?" DIF: Cognitive Level: Apply (application)
c. "Is there a family history of acromegaly?" TOP: Nursing Process: Assessment
d. "Are you experiencing tremors or anxiety?" REF: 1157
MSC: NCLEX: Physiological Integrity
2. A patient is scheduled for transsphenoidal ANS: C
hypophysectomy to treat a pituitary adenoma. During To avoid disruption of the suture line, the patient should avoid brushing the teeth
preoperative teaching, the nurse instructs the patient for 10 days after surgery. It is not necessary to remain on bed rest after this
about the need to: 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
a. cough and deep breathe every 2 hours degrees to reduce pressure on the sella turcica and decrease the risk for
postoperatively. headaches.
b. remain on bed rest for the first 48 hours after the DIF: Cognitive Level: Apply (application)
surgery. TOP: Nursing Process: Implementation
c. avoid brushing teeth for at least 10 days after the REF: 1159
surgery.
d. be positioned flat with sandbags at the head
postoperatively.
3. The nurse is planning postoperative care for a patient ANS: B
who is being admitted to the surgical unit from the After pituitary surgery, the patient is at risk for diabetes insipidus caused by
recovery room after transsphenoidal resection of a cerebral edema. Monitoring of urine output and urine specific gravity is essential.
pituitary tumor. Which nursing action should be included? 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
a. Palpate extremities for edema. not at high risk for problems with oxygenation, and continuous pulse oximetry is
b. Measure urine volume every hour. not needed.
c. Check hematocrit every 2 hours for 8 hours.
d. Monitor continuous pulse oximetry for 24 hours. DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Planning
REF: 1159
MSC: NCLEX: Physiological Integrity
4. The nurse is assessing a male patient diagnosed with a ANS: B
pituitary tumor causing panhypopituitarism. Assessment Changes in male secondary sex characteristics such as decreased facial hair,
findings consistent with panhypopituitarism include: testicular atrophy, diminished spermatogenesis, loss of libido, impotence, and
a. high blood pressure. decreased muscle mass are associated with decreases in follicle-stimulating
b. decreased facial hair. hormone (FSH) and luteinizing hormone (LH). Fasting hypoglycemia and
c. elevated blood glucose. hypotension occur in panhypopituitarism as a result of decreases in
d. tachycardia and palpitations. adrenocorticotropic hormone (ACTH) and cortisol. Bradycardia is likely due to
the decrease in thyroid-stimulating hormone (TSH) and thyroid hormones
associated with panhypopituitarism.
, 5. Which information will the nurse include when teaching ANS: B
a 50-yr-old male patient about somatropin (Genotropin)? Somatropin is injected subcutaneously on a daily basis, preferably in the evening.
a.The medication will be needed for 3 to 6 months. The patient will need to continue on somatropin for life. If swelling or other
b. Inject the medication subcutaneously every day. common adverse effects occur, the health care provider should be notified.
c. Blood glucose levels may decrease when taking the Growth hormone will increase blood glucose levels.
medication.
d. Stop taking the medication if swelling of the hands or
feet occurs.
6. The nurse determines that demeclocycline is effective ANS: B
for a patient with syndrome of inappropriate antidiuretic Demeclocycline blocks the action of antidiuretic hormone (ADH) on the renal
hormone (SIADH) based on finding that the patient's tubules and increases urine output. An increase in weight or an increase in urine
a. weight has increased. specific gravity indicates that the SIADH is not corrected. Peripheral edema does
b. urinary output is increased. not occur with SIADH. A sudden weight gain without edema is a common clinical
c. peripheral edema is increased. manifestation of this disorder.
d. urine specific gravity is increased.
7. The nurse determines that additional instruction is ANS: A
needed for a patient with chronic syndrome of Patients with SIADH are at risk for hyponatremia, and a sodium supplement may
inappropriate antidiuretic hormone (SIADH) when the be prescribed. The other patient statements are correct and indicate successful
patient makes which statement? teaching has occurred.
a. "I need to shop for foods low in sodium and avoid
adding salt to food."
b. "I should weigh myself daily and report any sudden
weight loss or gain."
c. "I need to limit my fluid intake to no more than 1 quart
of liquids a day."
d. "I should eat foods high in potassium because diuretics
cause potassium loss."
8. A 56-yr-old patient who is disoriented and reports a ANS: B
headache and muscle cramps is hospitalized with When water is retained, the serum sodium level will drop below normal, causing
possible syndrome of inappropriate antidiuretic hormone the clinical manifestations reported by the patient. The hematocrit will decrease
(SIADH). The nurse would expect the initial laboratory because of the dilution caused by water retention. Urine will be more
results to include a(n) concentrated with a higher specific gravity. The serum chloride level will usually
a. elevated hematocrit. decrease along with the sodium level.
b. decreased serum sodium.
c. increased serum chloride.
d. low urine specific gravity.
9. An expected patient problem for a patient admitted to ANS: C
the hospital with symptoms of diabetes insipidus is Nocturia occurs as a result of the polyuria caused by diabetes insipidus. Edema,
a. excess fluid volume related to intake greater than excess fluid volume, and fluid retention are not expected.
output.
b. impaired gas exchange related to fluid retention in
lungs.
c. sleep pattern disturbance related to frequent waking
to void.
d. risk for impaired skin integrity related to generalized
edema.
Nursing UPDATED ACTUAL Questions and CORRECT
Answers
1. A 40-yr-old patient with suspected acromegaly is seen ANS: B
at the clinic. To assist in making the diagnosis, which Acromegaly causes an enlargement of the hands and feet. Head injury and family
question should the nurse ask? history are not risk factors for acromegaly. Tremors and anxiety are not clinical
manifestations of acromegaly.
a. "Have you had a recent head injury?"
b. "Do you have to wear larger shoes now?" DIF: Cognitive Level: Apply (application)
c. "Is there a family history of acromegaly?" TOP: Nursing Process: Assessment
d. "Are you experiencing tremors or anxiety?" REF: 1157
MSC: NCLEX: Physiological Integrity
2. A patient is scheduled for transsphenoidal ANS: C
hypophysectomy to treat a pituitary adenoma. During To avoid disruption of the suture line, the patient should avoid brushing the teeth
preoperative teaching, the nurse instructs the patient for 10 days after surgery. It is not necessary to remain on bed rest after this
about the need to: 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
a. cough and deep breathe every 2 hours degrees to reduce pressure on the sella turcica and decrease the risk for
postoperatively. headaches.
b. remain on bed rest for the first 48 hours after the DIF: Cognitive Level: Apply (application)
surgery. TOP: Nursing Process: Implementation
c. avoid brushing teeth for at least 10 days after the REF: 1159
surgery.
d. be positioned flat with sandbags at the head
postoperatively.
3. The nurse is planning postoperative care for a patient ANS: B
who is being admitted to the surgical unit from the After pituitary surgery, the patient is at risk for diabetes insipidus caused by
recovery room after transsphenoidal resection of a cerebral edema. Monitoring of urine output and urine specific gravity is essential.
pituitary tumor. Which nursing action should be included? 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
a. Palpate extremities for edema. not at high risk for problems with oxygenation, and continuous pulse oximetry is
b. Measure urine volume every hour. not needed.
c. Check hematocrit every 2 hours for 8 hours.
d. Monitor continuous pulse oximetry for 24 hours. DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Planning
REF: 1159
MSC: NCLEX: Physiological Integrity
4. The nurse is assessing a male patient diagnosed with a ANS: B
pituitary tumor causing panhypopituitarism. Assessment Changes in male secondary sex characteristics such as decreased facial hair,
findings consistent with panhypopituitarism include: testicular atrophy, diminished spermatogenesis, loss of libido, impotence, and
a. high blood pressure. decreased muscle mass are associated with decreases in follicle-stimulating
b. decreased facial hair. hormone (FSH) and luteinizing hormone (LH). Fasting hypoglycemia and
c. elevated blood glucose. hypotension occur in panhypopituitarism as a result of decreases in
d. tachycardia and palpitations. adrenocorticotropic hormone (ACTH) and cortisol. Bradycardia is likely due to
the decrease in thyroid-stimulating hormone (TSH) and thyroid hormones
associated with panhypopituitarism.
, 5. Which information will the nurse include when teaching ANS: B
a 50-yr-old male patient about somatropin (Genotropin)? Somatropin is injected subcutaneously on a daily basis, preferably in the evening.
a.The medication will be needed for 3 to 6 months. The patient will need to continue on somatropin for life. If swelling or other
b. Inject the medication subcutaneously every day. common adverse effects occur, the health care provider should be notified.
c. Blood glucose levels may decrease when taking the Growth hormone will increase blood glucose levels.
medication.
d. Stop taking the medication if swelling of the hands or
feet occurs.
6. The nurse determines that demeclocycline is effective ANS: B
for a patient with syndrome of inappropriate antidiuretic Demeclocycline blocks the action of antidiuretic hormone (ADH) on the renal
hormone (SIADH) based on finding that the patient's tubules and increases urine output. An increase in weight or an increase in urine
a. weight has increased. specific gravity indicates that the SIADH is not corrected. Peripheral edema does
b. urinary output is increased. not occur with SIADH. A sudden weight gain without edema is a common clinical
c. peripheral edema is increased. manifestation of this disorder.
d. urine specific gravity is increased.
7. The nurse determines that additional instruction is ANS: A
needed for a patient with chronic syndrome of Patients with SIADH are at risk for hyponatremia, and a sodium supplement may
inappropriate antidiuretic hormone (SIADH) when the be prescribed. The other patient statements are correct and indicate successful
patient makes which statement? teaching has occurred.
a. "I need to shop for foods low in sodium and avoid
adding salt to food."
b. "I should weigh myself daily and report any sudden
weight loss or gain."
c. "I need to limit my fluid intake to no more than 1 quart
of liquids a day."
d. "I should eat foods high in potassium because diuretics
cause potassium loss."
8. A 56-yr-old patient who is disoriented and reports a ANS: B
headache and muscle cramps is hospitalized with When water is retained, the serum sodium level will drop below normal, causing
possible syndrome of inappropriate antidiuretic hormone the clinical manifestations reported by the patient. The hematocrit will decrease
(SIADH). The nurse would expect the initial laboratory because of the dilution caused by water retention. Urine will be more
results to include a(n) concentrated with a higher specific gravity. The serum chloride level will usually
a. elevated hematocrit. decrease along with the sodium level.
b. decreased serum sodium.
c. increased serum chloride.
d. low urine specific gravity.
9. An expected patient problem for a patient admitted to ANS: C
the hospital with symptoms of diabetes insipidus is Nocturia occurs as a result of the polyuria caused by diabetes insipidus. Edema,
a. excess fluid volume related to intake greater than excess fluid volume, and fluid retention are not expected.
output.
b. impaired gas exchange related to fluid retention in
lungs.
c. sleep pattern disturbance related to frequent waking
to void.
d. risk for impaired skin integrity related to generalized
edema.
