Chapter 46: Pituitary and Adrenal Disorders

Chapter 46: Pituitary and Adrenal Disorders

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A patient believed to have acromegaly asks the purpose of the diagnostic glucose tolerance test (GTT). What is the most accurate response by the nurse?

a.	“The doctor wants to know if you have either diabetes or acromegaly.”
b.	“The growth hormone will cause the glucose to be used up very quickly during the test.”
c.	“It measures the growth hormone in the presence of oral glucose levels at specified times.”
d.	“It tells whether your thyroid reacts to the high levels of sugar taken during this test.”

 

 

ANS:  C

The level of growth hormone will drop in the presence of oral glucose. In a patient with acromegaly, the growth hormone level drops dramatically. The GTT is the best diagnostic tool for acromegaly.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 1010-1011

OBJ:   2                    TOP:   Acromegaly   KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

2. 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. 1016           OBJ:   4

TOP:   Pituitary Surgery                             KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity: Basic Care and Comfort

 

3. What causes the large flattened 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. 1010           OBJ:   3

TOP:   Acromegaly   KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

4. What are the classic symptoms of diabetes insipidus (DI)?

a.	Diuresis, tachycardia, and weakness
b.	Dizziness, hypertension, and excitability
c.	Stress incontinence, vomiting, and edema
d.	Bradycardia, insomnia, and muscle cramps

 

 

ANS:  A

The hypovolemia from massive diuresis leads to decreased blood pressure, tachycardia, and weakness.

 

DIF:    Cognitive Level: Knowledge            REF:   p. 1019           OBJ:   1

TOP:   Diabetes Insipidus                           KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

5. A patient with Addison disease asks why she must take hydrocortisone. What should the nurse relay that the action of hydrocortisone is with Addison disease?

a.	Increases cardiac output
b.	Regulates the excretion of potassium and sodium
c.	Decreases the level of cortisol
d.	Lowers the blood sugar level

 

 

ANS:  B

Hydrocortisone helps regulate the excretion of potassium and sodium, the two electrolytes that control fluid distribution.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 1027           OBJ:   3

TOP:   Addison Disease                             KEY:  Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity: Pharmacological Therapies