Chapter 62: Care of Patients with Pituitary and Adrenal Gland Problems

Chapter 62: Care of Patients with Pituitary and Adrenal Gland Problems

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A nurse assesses clients for potential endocrine dysfunction. Which client is at greatest risk for a deficiency of gonadotropin and growth hormone?
   1. A 36-year-old female who has used oral contraceptives for 5 years
   2. A 42-year-old male who experienced head trauma 3 years ago
   3. A 55-year-old female with a severe allergy to shellfish and iodine
   4. A 64-year-old male with adult-onset diabetes mellitus

ANS:   B

Gonadotropin and growth hormone are anterior pituitary hormones. Head trauma is a common cause of anterior pituitary hypofunction. The other factors do not increase the risk of this condition.

DIF:     Applying/Application                         REF: 1267

KEY:   Pituitary disorder| health screening

MSC:   Integrated Process: Nursing Process: Assessment                 NOT: Client Needs Category: Safe and Effective Care Environment: Management of Care

2. A nurse plans care for a client with a growth hormone deficiency. Which action should the nurse include in this client’s plan of care?
   1. Avoid intramuscular medications.
   2. Place the client in protective isolation.
   3. Use a lift sheet to re-position the client.
   4. Assist the client to dangle before rising.

ANS:   C

In adults, growth hormone is necessary to maintain bone density and strength. Adults with growth hormone deficiency have thin, fragile bones. Avoiding IM medications, using protective isolation, and assisting the client as he or she moves from sitting to standing will not serve as safety measures when the client is deficient in growth hormone.

DIF:     Applying/Application                         REF: 1267

KEY:   Pituitary disorder| safety

MSC:   Integrated Process: Nursing Process: Implementation           NOT: Client Needs Category: Safe and Effective Care Environment: Safety and Infection Control

3. A nurse cares for a male client with hypopituitarism who is prescribed testosterone hormone replacement therapy. The client asks, “How long will I need to take this medication?” How should the nurse respond?
   1. “When your blood levels of testosterone are normal, the therapy is no longer needed.”
   2. “When your beard thickens and your voice deepens, the dose is decreased, but treatment will continue forever.”
   3. “When your sperm count is high enough to demonstrate fertility, you will no

longer need this therapy.”

1. “With age, testosterone levels naturally decrease, so the medication can be stopped

when you are 50 years old.”

ANS:           B

Testosterone therapy is initiated with high-dose testosterone derivatives and is continued until virilization is achieved. The dose is then decreased, but therapy continues throughout life. Therapy will continue throughout life; therefore, it will not be discontinued when blood levels are normal, at the age of 50 years, or when sperm counts are high.

DIF:            Applying/Application                         REF:    1268                 KEY: Pituitary disorder| medications                                                            MSC:   Integrated Process: Teaching/Learning NOT:                     Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

4. A nurse cares for a client after a pituitary gland stimulation test using insulin. The client’s post-stimulation laboratory results indicate elevated levels of growth hormone (GH) and adrenocorticotropic hormone (ACTH). How should the nurse interpret these results?
   1. Pituitary hypofunction
   2. Pituitary hyperfunction
   3. Pituitary-induced diabetes mellitus
   4. Normal pituitary response to insulin

ANS:           D

Some tests for pituitary function involve administering agents that are known to stimulate the secretion of specific pituitary hormones and then measuring the response. Such tests are termed stimulation tests. The stimulation test for GH or ACTH assessment involves injecting the client with regular insulin (0.05 to 1 unit/kg of body weight) and checking circulating levels of GH and ACTH. The presence of insulin in clients with normal pituitary function causes increased release of GH and ACTH.

DIF:            Applying/Application                         REF:    1275                 KEY: Pituitary disorder| laboratory values                                                                MSC:             Integrated Process: Nursing Process: Assessment                                               NOT: Client Needs Category: Physiological Integrity: Reduction of Risk Potential