Chapter 57: Concepts of Care for Patients
with Pituitary and Adrenal Gland Problems
Ignatavicius: Medical-Surgical Nursing, 10th Edition
MULTIPLE CHOICE
1. The nurse is caring for a client who is diagnosed with diabetes insipidus (DI). For
what common complication will the nurse monitor?
a. Hypertension
b. Bradycardia
c. Dehydration
d. Pulmonary embolus
ANS: C
The client who has DI has fluid loss through excessive urination. Decreased fluid
volume, or dehydration, is manifested by tachycardia, hypotension, and possibly
elevated temperature. Pulmonary embolism (PE) could possible as a clot in the lower
extremity (caused by dehydration) could fragment and travel to the lungs.
DIF: Understanding TOP: Integrated Process: Nursing Process: Assessment
KEY: DI, Assessment MSC: Client Needs Category:
Physiological Integrity: Physiological Adaptation
2. A client is being treated for diabetes insipidus (DI) with synthetic vasopressin
(desmopressin). What is the priority health teaching that the nurse provides regarding
drug therapy?
a. The need to check the client’s urinary specific gravity.
b. The need to take blood pressure at least twice a day.
, c. The need to monitor blood glucose every day.
d. The need to weigh every day and report weight gain.
ANS: D
The client with DI who takes lifelong hormone replacement will need to report
significant weight gain to monitor for water toxicity. Water toxicity causes headache,
vomiting, and acute confusion.
DIF: Applying TOP: Integrated Process: Teaching/Learning
KEY: DI, Drug therapy MSC: Client Needs Category:
Physiological Integrity: Pharmacological and Parenteral Therapies
3. A nurse cares for a client with adrenal hyperfunction. The client screams at her
husband, bursts into tears, and throws her water pitcher against the wall. She then tells
the nurse, “I feel like I am going crazy.” How would the nurse respond?
a. “I will ask your doctor to order a mental health consult for you.”
b. “You feel this way because of your hormone levels.”
c. “Can I bring you information about support groups?”
d. “I will close the door to your room and restrict visitors.”
ANS: B
Hypercortisolism can cause the client to have neurotic or psychotic behaviors. The
client needs to know that these behavior changes do not reflect a true mental or
behavioral health disorder and will resolve when therapy results in lower and steadier
blood cortisol levels. The client needs to understand this effect and does not need a
psychiatrist, support groups, or restricted visitors at this time.
DIF: Applying TOP: Integrated Process: Teaching/Learning
KEY: Hypercortisolism, Coping MSC: Client Needs Category:
Psychosocial Integrity
with Pituitary and Adrenal Gland Problems
Ignatavicius: Medical-Surgical Nursing, 10th Edition
MULTIPLE CHOICE
1. The nurse is caring for a client who is diagnosed with diabetes insipidus (DI). For
what common complication will the nurse monitor?
a. Hypertension
b. Bradycardia
c. Dehydration
d. Pulmonary embolus
ANS: C
The client who has DI has fluid loss through excessive urination. Decreased fluid
volume, or dehydration, is manifested by tachycardia, hypotension, and possibly
elevated temperature. Pulmonary embolism (PE) could possible as a clot in the lower
extremity (caused by dehydration) could fragment and travel to the lungs.
DIF: Understanding TOP: Integrated Process: Nursing Process: Assessment
KEY: DI, Assessment MSC: Client Needs Category:
Physiological Integrity: Physiological Adaptation
2. A client is being treated for diabetes insipidus (DI) with synthetic vasopressin
(desmopressin). What is the priority health teaching that the nurse provides regarding
drug therapy?
a. The need to check the client’s urinary specific gravity.
b. The need to take blood pressure at least twice a day.
, c. The need to monitor blood glucose every day.
d. The need to weigh every day and report weight gain.
ANS: D
The client with DI who takes lifelong hormone replacement will need to report
significant weight gain to monitor for water toxicity. Water toxicity causes headache,
vomiting, and acute confusion.
DIF: Applying TOP: Integrated Process: Teaching/Learning
KEY: DI, Drug therapy MSC: Client Needs Category:
Physiological Integrity: Pharmacological and Parenteral Therapies
3. A nurse cares for a client with adrenal hyperfunction. The client screams at her
husband, bursts into tears, and throws her water pitcher against the wall. She then tells
the nurse, “I feel like I am going crazy.” How would the nurse respond?
a. “I will ask your doctor to order a mental health consult for you.”
b. “You feel this way because of your hormone levels.”
c. “Can I bring you information about support groups?”
d. “I will close the door to your room and restrict visitors.”
ANS: B
Hypercortisolism can cause the client to have neurotic or psychotic behaviors. The
client needs to know that these behavior changes do not reflect a true mental or
behavioral health disorder and will resolve when therapy results in lower and steadier
blood cortisol levels. The client needs to understand this effect and does not need a
psychiatrist, support groups, or restricted visitors at this time.
DIF: Applying TOP: Integrated Process: Teaching/Learning
KEY: Hypercortisolism, Coping MSC: Client Needs Category:
Psychosocial Integrity
