Chapter 45 Medical Surgical Nursing Preparation For Practice 2nd Edition By Osborn

Medical Surgical Nursing Preparation For Practice 2nd Ed By Osborn

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Chapter 45 Medical Surgical Nursing Preparation For Practice 2nd Edition By Osborn

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Question 1

Type: MCMA

A patient has had surgery to remove a tumor of the anterior pituitary. The nurse plans to assess for dysfunction associated with decreased levels of which hormones?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. Adrenocorticotropic hormone (ACTH)
  2. Thyroid-stimulating hormone (TSH)
  3. Gonadotropic hormones
  4. Antidiuretic hormone
  5. Somatostatin

Correct Answer: 1,2,3,5

Rationale 1: The anterior pituitary produces adrenocorticotropic hormone.

Rationale 2: The anterior pituitary produces thyroid-stimulating hormone.

Rationale 3: Gonadotropin-releasing hormone is released by the hypothalamus and stimulates the anterior pituitary to secrete the gonadotropic hormones, follicle-stimulating hormone and luteinizing hormone. If the anterior pituitary is damaged, this secretion cannot occur.

Rationale 4: Antidiuretic hormone is secreted by the posterior pituitary.

Rationale 5: Somatostatin inhibits growth hormone and thyroid-stimulating hormone release from the anterior pituitary. If the anterior pituitary is damaged, this release cannot take place.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 45-1

 

Question 2

Type: MCSA

A patient with hormone imbalance is demonstrating symptoms of dehydration and excessive urination. The nurse realizes that which hormone is most directly associated with these symptoms?

  1. Antidiuretic hormone (ADH)
  2. Adrenocorticotropic hormone (ACTH)
  3. Follicle stimulating hormone (FSH)
  4. Thyroid-stimulating hormone (TSH)

Correct Answer: 1

Rationale 1: Antidiuretic hormone decreases urine production by causing the renal tubules to reabsorb water from the urine and return it to the circulating blood. This patient is demonstrating excessive urination, which might indicate an alteration in this hormone.

Rationale 2: ACTH stimulates the production and release of adrenocortical hormones such as glucocorticoids, mineralocorticoids, and androgens. The effects of these hormones on water balance are not as direct as those of another hormone.

Rationale 3: FSH stimulates estrogen secretion and follicle maturation in females and spermatogenesis in males. It does not have a direct relationship to the patient’s symptoms.

Rationale 4: Thyroid-stimulating hormone stimulates thyroid function. Alteration in this hormone does not have as direct a relationship to the patient’s symptoms as another hormone does.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 45-2

 

Question 3

Type: MCSA

During an assessment, the nurse notes that the patient’s eyes are extremely wide open and bulging. The nurse would conduct additional assessment for which endocrine disorder?

  1. Hyperthyroidism
  2. Diabetes mellitus
  3. Hypofunction of the adrenal glands
  4. Hypofunction of the anterior pituitary gland

Correct Answer: 1

Rationale 1: Exophthalmos is protrusion of the eyeball(s). This finding is associated with Graves’ disease, which is a form of hyperthyroidism.

Rationale 2: This change in the eyeballs is not associated with diabetes mellitus.

Rationale 3: Decreased secretion from the adrenal glands does not result in changes in the structure of the eyeball.

Rationale 4: Protrusion of the eyeballs is not associated with inadequate pituitary function.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 45-4

 

Question 4

Type: MCSA

The nurse understands that an alteration in growth hormone can lead to changes in an individual’s physical stature. Which finding would cause the nurse to assess for high levels of growth hormone?

  1. Acromegaly
  2. Dwarfism
  3. Hirsutism
  4. Gynecomastia

Correct Answer: 1

Rationale 1: Acromegaly is a change in facial features caused by excessive growth hormone.

Rationale 2: Extremely short stature may indicate dwarfism, which is caused by insufficient growth hormone.

Rationale 3: Hirsutism, or abnormal hair growth, is associated with adrenal hormone excess.

Rationale 4: Gynecomastia, or development of breast tissue in men, is frequently associated with androgen therapy.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 45-4

 

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