Chapter 50: Nursing Management: Endocrine Problems

Chapter 50: Nursing Management: Endocrine Problems

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE
1. A patient with suspected acromegaly is seen at the clinic. To assist in making the
diagnosis, which question should the nurse ask?
a. “Have you had a recent head injury?”
b. “Do you have to wear larger shoes now?”
c. “Are you experiencing tremors or anxiety?”
d. “Is there any family history of acromegaly?”
ANS: B
Acromegaly causes an enlargement of the hands and feet. Head injury and family history
are not risk factors for acromegaly. Tremors and anxiety are not clinical manifestations of
acromegaly.
DIF: Cognitive Level: Application REF: 1255-1256
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
2. During 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.
ANS: D
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.
DIF: Cognitive Level: Application REF: 1256-1258
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
3. 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.
Test Bank 50-2
ANS: A
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.
DIF: Cognitive Level: Application REF: 1257-1258 TOP: Nursing Process:
Planning
MSC: NCLEX: Physiological Integrity
4. 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.
ANS: D
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.
DIF: Cognitive Level: Application REF: 1257-1259
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
5. 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.
ANS: B
Somatropin is injected subcutaneously on a daily basis, preferably in the evening. The
patient will need to continue on somatropin for life. If swelling or other adverse effects
occur, the health care provider should be notified. Growth hormone will increase blood
glucose levels.
DIF: Cognitive Level: Application REF: 1258-1259
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity