LEWIS MEDICAL SURGICAL NURSING 2026
PROFESSIONAL NURSING FINAL PAPER
REVISION QUESTIONS SOLUTIONS COMPLETE
SET
◉ During a preoperative teaching for a patient scheduled for
transsphenoidal hypophysectomy for treatment of a pituitary
adenoma, 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. be positioned flat with sandbags at the head postoperatively.
d. avoid brushing the teeth for at least 10 days after the surgery.
Answer: Answer: d. avoid brushing the teeth for at least 10 days
after the surgery.
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.
,◉ Which nursing action will be included in the postoperative plan of
care for a patient who has had a transsphenoidal resection of a
pituitary tumor?
a. Monitor urine output every hour.
b. Palpate extremities for dependent edema.
c. Check hematocrit hourly for first 12 hours.
d. Obtain continuous pulse oximetry for 24 hours.
Answer: Answer: a. Monitor urine output every hour.
After pituitary surgery, the patient is at risk for diabetes insipidus
caused by cerebral edema and 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.
◉ A patient is suspected of having a pituitary tumor causing
panhypopituitarism. During assessment of the patient, the nurse
would expect to find:
a. high blood pressure.
, b. elevated blood glucose.
c. tachycardia and cardiac palpitations.
d. changes in secondary sex characteristics.
Answer: Answer: d. changes in secondary sex characteristics.
Changes in secondary sex characteristics 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.
◉ Which information will the nurse include when teaching a patient
about use of somatropin (Genotropin)?
a. The medication will improve vaginal dryness.
b. Inject the medication subcutaneously every day.
c. Blood glucose levels will decrease when taking the medication.
d. Stop taking the medication if swelling of the hands or feet occurs.
Answer: Answer: b. Inject the medication subcutaneously every day.
Somatropin is injected subcutaneously on a daily basis, preferably in
the evening. The patient will need to continue on somatropin for life.
PROFESSIONAL NURSING FINAL PAPER
REVISION QUESTIONS SOLUTIONS COMPLETE
SET
◉ During a preoperative teaching for a patient scheduled for
transsphenoidal hypophysectomy for treatment of a pituitary
adenoma, 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. be positioned flat with sandbags at the head postoperatively.
d. avoid brushing the teeth for at least 10 days after the surgery.
Answer: Answer: d. avoid brushing the teeth for at least 10 days
after the surgery.
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.
,◉ Which nursing action will be included in the postoperative plan of
care for a patient who has had a transsphenoidal resection of a
pituitary tumor?
a. Monitor urine output every hour.
b. Palpate extremities for dependent edema.
c. Check hematocrit hourly for first 12 hours.
d. Obtain continuous pulse oximetry for 24 hours.
Answer: Answer: a. Monitor urine output every hour.
After pituitary surgery, the patient is at risk for diabetes insipidus
caused by cerebral edema and 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.
◉ A patient is suspected of having a pituitary tumor causing
panhypopituitarism. During assessment of the patient, the nurse
would expect to find:
a. high blood pressure.
, b. elevated blood glucose.
c. tachycardia and cardiac palpitations.
d. changes in secondary sex characteristics.
Answer: Answer: d. changes in secondary sex characteristics.
Changes in secondary sex characteristics 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.
◉ Which information will the nurse include when teaching a patient
about use of somatropin (Genotropin)?
a. The medication will improve vaginal dryness.
b. Inject the medication subcutaneously every day.
c. Blood glucose levels will decrease when taking the medication.
d. Stop taking the medication if swelling of the hands or feet occurs.
Answer: Answer: b. Inject the medication subcutaneously every day.
Somatropin is injected subcutaneously on a daily basis, preferably in
the evening. The patient will need to continue on somatropin for life.
