Adrenal Disorders (NCLEX) Exam Questions and
answers
1. A patient is diagnosed with pheochromocytoma. From your nursing knowledge, you know that the
patient will present with hypertension, sweating, and palpations due to excessive catecholamine
production from the?
A. Adrenal Cortex
B. Adrenal Zona Fasciculata
C. Adrenal Medulla
D. Adrenal Glomerulosa - ✅✅C. Adrenal Medulla
The adrenal medulla secretes catecholamines.
2. What cells are responsible for secreting catecholamines?
A. Chromaffin
B. Langerhans
C. Enkephalin
D. Parietal - ✅✅A. Chromaffin
3. A patient has excessive catecholamines in the urine. Which of the following signs and symptoms
would the patient NOT exhibit? SELECT-ALL-THAT-APPLY:
,A. Tachycardia
B. Anxiety
C. Hypoglycemia
D. Thermogenesis
E. Decreased Basal Metabolic Rate - ✅✅C. Hypoglycemia
E. Decreased Basal Metabolic Rate
The patient would have HYPERglycemia (not hypoglycemia) and INCREASED basal metabolic rate (not
decreased).
4. A patient is admitted with uncontrolled hypertension and the doctor suspects pheochromoctyoma.
On assessment, you note the blood pressure to be 196/120 and HR 130. The patient reports feeling very
anxious, sweaty, and having palpations. What do you expect the doctor will order to confirm a diagnosis
of pheochromocytoma?
A. Urinalysis
B. Urine culture
C. 24-hour urine
D. 8-hour urine - ✅✅C. 24-hour urine
A 24-hour urine is ordered to check for catecholamine and metanephrines (which are metabolites
formed when the body breaks down catecholamines).
5. Which statement is incorrect about pheochromocytoma?
A. This condition can be trigger by eating foods high in Tyramine such as hamburger meat and spinach.
,B. Monoamine oxidase inhibitors can trigger signs and symptoms of pheochromocytoma.
C. An adrenalectomy is the only surgical treatment for pheochromocytoma.
D. Patients with pheochromocytoma are at risk for hypertensive crisis. - ✅✅A. This condition can be
trigger by eating foods high in Tyramine such as hamburger meat and spinach.
This statement is incorrect because hamburger meat and spinach are not high in Tyramine....foods that
are aged, pickled, and fermented (cheeses, red wine, smoke/dried meat, bananas, sauerkraut,
chocolate) can trigger signs and symptoms of pheochromocytoma.
6. A patient is scheduled for a bilateral adrenalectomy. Preoperatively, the patient is ordered by the
doctor to take an alpha-adrenergic blocker. After administering a dose of this medication, what type of
side effect will you monitor the patient for?
A. Bradypnea
B. Hyperglycemia
C. Reflex tachycardia
D. Hypertension - ✅✅C. Reflex tachycardia
Alpha-adrenergic blockers (Cardura, Minipress, Hyrtin) block noradrenaline which reduces
catecholamine. This will help decrease blood pressure and prevent hypertensive crisis during surgery.
However, a side effect of this medication is reflex tachycardia due to the decrease in blood pressure.
The heart will try to compensate by increasing the heart rate.
7. In regards to question 6, you are also educating the patient about the post-opt care for a bilateral
adrenalectomy. Which statement by the patient indicates they understood your instructions?
A. "I will have to take mineralocorticoids daily for 2 years."
B. "I will have to take glucocorticoids and mineralocorticoids daily for 2 years."
C. "When I experience signs of stress I will have to take mineralocorticoids as needed."
, D. "I will have to take glucocorticoids and mineralocorticoids daily for life." - ✅✅D. "I will have to take
glucocorticoids and mineralocorticoids daily for life."
After a bilateral adrenalectomy, the patient will have to take glucocorticoids and mineralocorticoid for
life. If the patient was having a unilateral adrenalectomy they would have to take glucocorticoids for
approximately 2 years.
a client is admitted to the intensive care unit with suspected pheochromocytoma. the client's vital signs
are temperature of 99.6*F (37.5 C), blood pressure (BP) of 200/110 mm Hg, heart rate of 110/min, and
respirations of 20/min. the client is sweating profusely and reports a severe headache. which
prescription should the nurse implement first?
a. draw labs to assess electrolyte panel
b. give acetaminophen 650 mg by mouth as needed for headache
c. place a fan in the client's room
d. start nitroprusside infusion at 0.5mcg/kg/min - ✅✅d. start nitroprusside infusion at 0.5mcg/kg/min
hypertensive crisis puts the client at risk for stroke and so has the highest priority for treatment.
nitroprusside (nitropress, nipride) is a vasodilator given via infusion and can be titrated to keep the BP
within a desired parameter.
which nursing action would be appropriate to implement when a client has a diagnosis of
pheochromocytoma?
a. weigh the client
b. test the client's urine for glucose
c. monitor the blood pressure
d. palpate the client's skin to determine warmth - ✅✅c. monitor the blood pressure
Hypertension is the major symptom that is associated with pheochromocytoma. the blood pressure
status is monitored by taking the client's blood pressure. glycosuria, weight loss, and diaphoresis are
also clinical manifestations of pheochromocytoma, but hypertension is the major symptom.
a nurse is caring for a client with pheochromocytoma. the client is scheduled for an adrenalectomy.
during the preoperative period, the priority nursing action would be to monitor the:
answers
1. A patient is diagnosed with pheochromocytoma. From your nursing knowledge, you know that the
patient will present with hypertension, sweating, and palpations due to excessive catecholamine
production from the?
A. Adrenal Cortex
B. Adrenal Zona Fasciculata
C. Adrenal Medulla
D. Adrenal Glomerulosa - ✅✅C. Adrenal Medulla
The adrenal medulla secretes catecholamines.
2. What cells are responsible for secreting catecholamines?
A. Chromaffin
B. Langerhans
C. Enkephalin
D. Parietal - ✅✅A. Chromaffin
3. A patient has excessive catecholamines in the urine. Which of the following signs and symptoms
would the patient NOT exhibit? SELECT-ALL-THAT-APPLY:
,A. Tachycardia
B. Anxiety
C. Hypoglycemia
D. Thermogenesis
E. Decreased Basal Metabolic Rate - ✅✅C. Hypoglycemia
E. Decreased Basal Metabolic Rate
The patient would have HYPERglycemia (not hypoglycemia) and INCREASED basal metabolic rate (not
decreased).
4. A patient is admitted with uncontrolled hypertension and the doctor suspects pheochromoctyoma.
On assessment, you note the blood pressure to be 196/120 and HR 130. The patient reports feeling very
anxious, sweaty, and having palpations. What do you expect the doctor will order to confirm a diagnosis
of pheochromocytoma?
A. Urinalysis
B. Urine culture
C. 24-hour urine
D. 8-hour urine - ✅✅C. 24-hour urine
A 24-hour urine is ordered to check for catecholamine and metanephrines (which are metabolites
formed when the body breaks down catecholamines).
5. Which statement is incorrect about pheochromocytoma?
A. This condition can be trigger by eating foods high in Tyramine such as hamburger meat and spinach.
,B. Monoamine oxidase inhibitors can trigger signs and symptoms of pheochromocytoma.
C. An adrenalectomy is the only surgical treatment for pheochromocytoma.
D. Patients with pheochromocytoma are at risk for hypertensive crisis. - ✅✅A. This condition can be
trigger by eating foods high in Tyramine such as hamburger meat and spinach.
This statement is incorrect because hamburger meat and spinach are not high in Tyramine....foods that
are aged, pickled, and fermented (cheeses, red wine, smoke/dried meat, bananas, sauerkraut,
chocolate) can trigger signs and symptoms of pheochromocytoma.
6. A patient is scheduled for a bilateral adrenalectomy. Preoperatively, the patient is ordered by the
doctor to take an alpha-adrenergic blocker. After administering a dose of this medication, what type of
side effect will you monitor the patient for?
A. Bradypnea
B. Hyperglycemia
C. Reflex tachycardia
D. Hypertension - ✅✅C. Reflex tachycardia
Alpha-adrenergic blockers (Cardura, Minipress, Hyrtin) block noradrenaline which reduces
catecholamine. This will help decrease blood pressure and prevent hypertensive crisis during surgery.
However, a side effect of this medication is reflex tachycardia due to the decrease in blood pressure.
The heart will try to compensate by increasing the heart rate.
7. In regards to question 6, you are also educating the patient about the post-opt care for a bilateral
adrenalectomy. Which statement by the patient indicates they understood your instructions?
A. "I will have to take mineralocorticoids daily for 2 years."
B. "I will have to take glucocorticoids and mineralocorticoids daily for 2 years."
C. "When I experience signs of stress I will have to take mineralocorticoids as needed."
, D. "I will have to take glucocorticoids and mineralocorticoids daily for life." - ✅✅D. "I will have to take
glucocorticoids and mineralocorticoids daily for life."
After a bilateral adrenalectomy, the patient will have to take glucocorticoids and mineralocorticoid for
life. If the patient was having a unilateral adrenalectomy they would have to take glucocorticoids for
approximately 2 years.
a client is admitted to the intensive care unit with suspected pheochromocytoma. the client's vital signs
are temperature of 99.6*F (37.5 C), blood pressure (BP) of 200/110 mm Hg, heart rate of 110/min, and
respirations of 20/min. the client is sweating profusely and reports a severe headache. which
prescription should the nurse implement first?
a. draw labs to assess electrolyte panel
b. give acetaminophen 650 mg by mouth as needed for headache
c. place a fan in the client's room
d. start nitroprusside infusion at 0.5mcg/kg/min - ✅✅d. start nitroprusside infusion at 0.5mcg/kg/min
hypertensive crisis puts the client at risk for stroke and so has the highest priority for treatment.
nitroprusside (nitropress, nipride) is a vasodilator given via infusion and can be titrated to keep the BP
within a desired parameter.
which nursing action would be appropriate to implement when a client has a diagnosis of
pheochromocytoma?
a. weigh the client
b. test the client's urine for glucose
c. monitor the blood pressure
d. palpate the client's skin to determine warmth - ✅✅c. monitor the blood pressure
Hypertension is the major symptom that is associated with pheochromocytoma. the blood pressure
status is monitored by taking the client's blood pressure. glycosuria, weight loss, and diaphoresis are
also clinical manifestations of pheochromocytoma, but hypertension is the major symptom.
a nurse is caring for a client with pheochromocytoma. the client is scheduled for an adrenalectomy.
during the preoperative period, the priority nursing action would be to monitor the:
