Chapter 48: Pituitary and Adrenal Disorders
MULTIPLE CHOICE
1. What should preoperative teaching for a patient scheduled for a transsphenoidal
hypophysectomy include that the patient should do postoperatively? a. Avoid sneezing.
b. Drink through a straw.
c. Cough forcefully.
d. Wash mouth out with peroxide.
ANS: A
The patient should be taught to avoid sneezing, coughing, drinking through a straw, and using
a stringent mouthwash that might dislodge the graft.
DIF: Cognitive Level: Comprehension REF: p. 930|p. 934
OBJ: 1 TOP: Pituitary Surgery
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
2. What hormone causes the features of a patient with acromegaly?
a. Prolactin
b. Growth hormone
c. Thyroid-stimulating hormone
d. Adrenocorticotropic hormone
ANS: B
Excess growth hormone in an adult will cause the flat bones to grow because the adult has
little capacity for heightened growth. In a child, this same excess would cause giantism.
DIF: Cognitive Level: Knowledge REF: p. 930 OBJ: 1
TOP: Acromegaly KEY: Nursing Process Step: Assessment MSC:
NCLEX: Physiological Integrity: Physiological Adaptation
3. What are the classic symptoms of diabetes insipidus (DI)?
a. Diuresis, dehydration, and thirst
b. Dizziness, hypertension, and excitability
c. Stress incontinence, vomiting, and edema
d. Bradycardia, insomnia, and muscle cramps
ANS: A
Common signs and symptoms of DI are massive diuresis, dehydration, and thirst. Dehydration
is characterized by hypotension, tachycardia, dizziness, decreased skin turgor, weakness, and
possible fainting episodes.
DIF: Cognitive Level: Knowledge REF: p. 937 OBJ: 1
, TOP: Diabetes Insipidus KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
4. A patient states that he is confused because the physician told him that his diabetes insipidus
(DI) is nephrogenic. What should the nurse state when describing the difference between
nephrogenic DI and neurogenic DI?
a. Nephrogenic DI will eventually resolve without medication.
b. Nephrogenic DI requires the nasal spray lypressin.
c. Nephrogenic DI does not respond to ADH.
d. Nephrogenic DI will require dialysis.
ANS: C
Nephrogenic DI does not respond to ADH.
DIF: Cognitive Level: Comprehension REF: p. 936 OBJ: 1
TOP: Addison Disease KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
5. A 14-year-old adolescent male patient has been diagnosed with Addison disease. Which effect
of Addison disease should this patient be aware of? a. He will not develop pubic hair.
b. He will grow a heavy beard.
c. He will become bald at an early age.
d. He will have enlarged joints.
ANS: A
The boy with Addison disease will not grow facial, axillary, or pubic hair. Balding and
enlarged joints are not associated with Addison disease.
DIF: Cognitive Level: Comprehension REF: p. 940 OBJ: 1
TOP: Addison Disease KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
6. What is the cardinal indication of a pheochromocytoma?
a. Significant hypertension
b. Extreme nausea
c. Abdominal pain
d. Edema in the legs
ANS: A
The patient with a pheochromocytoma exhibits dangerously high hypertension. Hypertension
and its attendant symptoms are what bring the patient to the physician. The tumor is found
incidentally.
DIF: Cognitive Level: Knowledge REF: p. 947 OBJ: 1
TOP: Adrenal Tumor KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
MULTIPLE CHOICE
1. What should preoperative teaching for a patient scheduled for a transsphenoidal
hypophysectomy include that the patient should do postoperatively? a. Avoid sneezing.
b. Drink through a straw.
c. Cough forcefully.
d. Wash mouth out with peroxide.
ANS: A
The patient should be taught to avoid sneezing, coughing, drinking through a straw, and using
a stringent mouthwash that might dislodge the graft.
DIF: Cognitive Level: Comprehension REF: p. 930|p. 934
OBJ: 1 TOP: Pituitary Surgery
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
2. What hormone causes the features of a patient with acromegaly?
a. Prolactin
b. Growth hormone
c. Thyroid-stimulating hormone
d. Adrenocorticotropic hormone
ANS: B
Excess growth hormone in an adult will cause the flat bones to grow because the adult has
little capacity for heightened growth. In a child, this same excess would cause giantism.
DIF: Cognitive Level: Knowledge REF: p. 930 OBJ: 1
TOP: Acromegaly KEY: Nursing Process Step: Assessment MSC:
NCLEX: Physiological Integrity: Physiological Adaptation
3. What are the classic symptoms of diabetes insipidus (DI)?
a. Diuresis, dehydration, and thirst
b. Dizziness, hypertension, and excitability
c. Stress incontinence, vomiting, and edema
d. Bradycardia, insomnia, and muscle cramps
ANS: A
Common signs and symptoms of DI are massive diuresis, dehydration, and thirst. Dehydration
is characterized by hypotension, tachycardia, dizziness, decreased skin turgor, weakness, and
possible fainting episodes.
DIF: Cognitive Level: Knowledge REF: p. 937 OBJ: 1
, TOP: Diabetes Insipidus KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
4. A patient states that he is confused because the physician told him that his diabetes insipidus
(DI) is nephrogenic. What should the nurse state when describing the difference between
nephrogenic DI and neurogenic DI?
a. Nephrogenic DI will eventually resolve without medication.
b. Nephrogenic DI requires the nasal spray lypressin.
c. Nephrogenic DI does not respond to ADH.
d. Nephrogenic DI will require dialysis.
ANS: C
Nephrogenic DI does not respond to ADH.
DIF: Cognitive Level: Comprehension REF: p. 936 OBJ: 1
TOP: Addison Disease KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
5. A 14-year-old adolescent male patient has been diagnosed with Addison disease. Which effect
of Addison disease should this patient be aware of? a. He will not develop pubic hair.
b. He will grow a heavy beard.
c. He will become bald at an early age.
d. He will have enlarged joints.
ANS: A
The boy with Addison disease will not grow facial, axillary, or pubic hair. Balding and
enlarged joints are not associated with Addison disease.
DIF: Cognitive Level: Comprehension REF: p. 940 OBJ: 1
TOP: Addison Disease KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
6. What is the cardinal indication of a pheochromocytoma?
a. Significant hypertension
b. Extreme nausea
c. Abdominal pain
d. Edema in the legs
ANS: A
The patient with a pheochromocytoma exhibits dangerously high hypertension. Hypertension
and its attendant symptoms are what bring the patient to the physician. The tumor is found
incidentally.
DIF: Cognitive Level: Knowledge REF: p. 947 OBJ: 1
TOP: Adrenal Tumor KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
