CHAPTER 49: ENDOCRINE PROBLEMS LEWIS: MEDICAL-SURGICAL
NURSING, 10TH EDITION EXAM QUESTIONS AND ANSWERS
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)
TOP: Nursing Process: Assessment
REF: 1157
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)
TOP: Nursing Process: Implementation
REF: 1159
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 hour.
c. Check hematocrit every 2 hours for 8 hours.
d. Monitor continuous pulse oximetry for 24 hours.
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.
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 pituitary tumor causing
panhypopituitarism. Assessment findings consistent with panhypopituitarism
include:
a. high blood pressure.
b. decreased facial hair.
, c. elevated blood glucose.
d. tachycardia and palpitations.
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.
5. Which information will the nurse include when teaching a 50-yr-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.
d. Stop taking the medication if swelling of the hands or feet occurs.
ANS: B
Somatropin is injected subcutaneously on a daily basis, preferably in the evening. The
patient will need to continue on somatropin for life. If swelling or other common adverse
effects occur, the health care provider should be notified. Growth hormone will increase
blood glucose levels.
6. The nurse determines that demeclocycline 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 increased.
d. urine specific gravity is increased.
ANS: B
Demeclocycline blocks the action of antidiuretic hormone (ADH) on the renal tubules
and increases urine output. An increase in weight or an increase in urine specific gravity
NURSING, 10TH EDITION EXAM QUESTIONS AND ANSWERS
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)
TOP: Nursing Process: Assessment
REF: 1157
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)
TOP: Nursing Process: Implementation
REF: 1159
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 hour.
c. Check hematocrit every 2 hours for 8 hours.
d. Monitor continuous pulse oximetry for 24 hours.
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.
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 pituitary tumor causing
panhypopituitarism. Assessment findings consistent with panhypopituitarism
include:
a. high blood pressure.
b. decreased facial hair.
, c. elevated blood glucose.
d. tachycardia and palpitations.
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.
5. Which information will the nurse include when teaching a 50-yr-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.
d. Stop taking the medication if swelling of the hands or feet occurs.
ANS: B
Somatropin is injected subcutaneously on a daily basis, preferably in the evening. The
patient will need to continue on somatropin for life. If swelling or other common adverse
effects occur, the health care provider should be notified. Growth hormone will increase
blood glucose levels.
6. The nurse determines that demeclocycline 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 increased.
d. urine specific gravity is increased.
ANS: B
Demeclocycline blocks the action of antidiuretic hormone (ADH) on the renal tubules
and increases urine output. An increase in weight or an increase in urine specific gravity
