Deck 41: Coordinating Care for Patients With Pituitary Disorders

Question 1

The nurse is reviewing discharge instructions with a patient being treated with desmopressin (DDAVP) for diabetes insipidus (DI). What should the nurse direct the patient to do regarding changes in body weight?
1)Decrease intake of fluids for a day.
2)Notify the healthcare provider.
3)Increase the intake of salty foods.
4)Take an extra dose of medication.

Answer 1

2

Question 2

The nurse provides teaching to a patient who is newly diagnosed with hypopituitarism. Which patient statement indicates that teaching was effective in relationship to medication management?
1)"I will take my medication each evening."
2)"I will take my medication each morning."
3)"I will take my medication only as needed."
4)"I will take my medication every other day."

Answer 2

2

Question 3

The nurse incorporates which information into the patient teaching for a patient with hypopituitarism?
1)"Avoid extremes in temperature."
2)"Minimize your exposure to people with infections."
3)"Increase foods containing high amounts of calcium."
4)"Increase rest periods throughout the day."

Answer 3

3

Question 4

Which clinical manifestation does the nurse associate with abnormal secretion of growth hormone in the patient with hyperpituitarism?
1)Elevated blood pressure
2)Increased serum glucose levels
3)Menstrual irregularities
4)Weight loss

Question 5

A patient with osteoarthritis develops syndrome of inappropriate antidiuretic hormone (SIADH). What information in the patient's history does the nurse correlate to the development of this disorder?
1)Male gender
2)Age 70 years
3)Use of NSAIDs
4)Use of diuretics

Question 6

In assessing a patient diagnosed with hypopituitarism, the nurse correlates the function of which additional structure to determine the root cause of this disorder?
1)Cerebellum
2)Cerebrum
3)Hypothalamus
4)Medulla

Question 7

What is the rationale for frequent mouth care in a patient after undergoing a transsphenoidal hypophysectomy for removal of a pituitary tumor?
1)Dry mucous membranes secondary to increased vasopressin (Pitressin) levels
2)Maintenance of nothing by mouth status
3)Mouth breathing because of nasal packing
4)Stomatitis caused by the hormone imbalance

Question 8

Which parameter does the nurse use to guide the effectiveness of intravenous fluid replacement in the patient with diabetes insipidus?
1)Skin turgor
2)Urine output total
3)Hemoglobin level
4)Serum sodium level

Question 9

A male patient presents to the clinic with complaints of changes in his facial features and enlarged, painful hands. The nurse correlates these clinical manifestations with a disorder of which hormone?
1)Testosterone
2)Growth hormone
3)Thyroid-stimulating hormone
4)Adrenocorticotropic hormone (ACTH)

Question 10

A patient with hypopituitarism is experiencing muscle weakness. Which referral should the nurse make to help this patient?
1)Home care
2)Physical therapy
3)Recreational therapy
4)Occupational therapy

Question 11

The nurse prioritizes which nursing diagnosis to guide care for the patient diagnosed with diabetes insipidus?
1)Fluid Volume Deficit
2)Alteration in Comfort
3)Body Image Disturbance
4)Sensory Perceptual Alteration

Question 12

A patient is being discharged after surgery for hyperpituitarism. The nurse incorporates which information to reduce the risk of postoperative complications?
1)Restrict fluids.
2)Avoid strain on the suture line.
3)Maintain bedrest for several days.
4)Expect clear nasal drainage to occur.

Question 13

The nurse recognizes that the patient with dysfunction of the posterior pituitary gland is at risk for which disorder?
1)Acromegaly
2)Osteoporosis
3)Diabetes insipidus
4)Type 1 diabetes mellitus

Question 14

A patient is demonstrating signs of hypopituitarism. The nurse monitors results from which diagnostic test for this disorder?
1)Magnetic resonance imaging (MRI)
2)Lumbar puncture
3)Cerebral angiogram
4)Carotid Doppler studies

Question 15

The nurse provides discharge instruction to a patient who had a transsphenoidal hypophysectomy. Which patient statement indicates a need for additional teaching?
1)"My neck will probably be stiff and sore for several days."
2)"I will call my provider if I am thirstier than normal."
3)"I should use a soft toothbrush to avoid irritating my incision."
4)"I won't bend at the waist until I see the provider at my follow-up appointment."

Question 16

The nurse correlates the action of which medication to the treatment of diabetes insipidus (DI)?
1)Pitocin
2)Synthroid
3)Vitamin D
4)Desmopressin (DDAVP)

Question 17

In providing care to a patient after a transsphenoidal hypophysectomy, the nurse notes that the patient's serum sodium level is 140 mEq/L (140 mmol/L). Which intravenous fluid prescription does the nurse question?
1)5% dextrose in water 0.45% sodium chloride
2)Lactated Ringer's (LR) solution 3.0.9% normal saline (NS) solution
4)0.45% sodium chloride (1/2 NS) solution

Question 18

The nurses assesses for which clinical manifestations in the patient being evaluated for hyperpituitarism?
1)Hair loss
2)Headaches
3)Hypoglycemia
4)Muscle cramps

Question 19

The nurse is reviewing medications prescribed for a patient with hypopituitarism. Which medications are indicated for the treatment of this disorder?
1)Diuretics
2)Antibiotics
3)Antihypertensives
4)Electrolyte supplements

Question 20

A patient with syndrome of inappropriate antidiuretic hormone (SIADH) is experiencing a headache and confusion. The nurse correlates which laboratory result to this clinical presentation of SIADH?
1)Sodium 125 mEq/L
2)Calcium 8.7 mEq/L
3)Potassium 5.5 mEq/L
4)Hematocrit 50%

Question 21

In assessing a patient admitted with diabetes insipidus (DI), which clinical manifestations does the nurse correlate with this diagnosis? Select all that apply.
1)Fatigue
2)Extreme thirst
3)Extreme hunger
4)Large amounts of urine output
5)Waking up to urinate during the night

Question 22

The nurse monitors for which clinical manifestation in the patient diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH)?
1)Hematocrit 40%
2)Serum sodium 148 mEq/L
3)Urine specific gravity 1.035
4)Serum potassium 3.9 mEq/L

Question 23

The nurse is calculating the fluid intake for a patient after a transsphenoidal hypophysectomy. The patient has received 75 mL/hour of intravenous fluids for the last 24 hours and consumed two 8-ounce cups of water. What is the total fluid intake?

Question 24

A patient's thyroid-stimulating hormone (TSH) is below normal. The nurse correlates which findings to this decreased hormone level? Select all that apply.
1)Weight gain
2)Thinning hair
3)Decreased bone density
4)Decreased muscle strength
5)Complaints of decreased libido

Question 25

The nurse monitors for which therapeutic response to the administration of demeclocycline in the patient being treated for syndrome of inappropriate antidiuretic hormone?
1)Increased heart rate
2)Decreased blood pressure
3)Increased mental status
4)Decreased urine output

Question 26

In reviewing laboratory results from a patient demonstrating clinical manifestations of diabetes insipidus (DI), which results does the nurse correlate with a definitive diagnosis? Select all that apply.
1)Hematocrit 52%
2)White blood cells 8000
3)Serum sodium 150 mEq/L
4)Urine specific gravity 1.002
5)Serum potassium 5.5 mEq/L

Question 27

In providing care to a patient who is newly diagnosed with acromegaly, which clinical manifestations does the nurse correlate with this disorder? Select all that apply.
1)A tongue that is coarse
2)Eyes that appear to bulge
3)An increase in perspiration
4)A hypertrophied thyroid gland
5)Hands that appear smaller than anticipated

Question 28

The nurse is preparing discharge teaching for a patient recovering from a transsphenoidal hypophysectomy for a pituitary tumor. What should the nurse emphasize in this teaching? Select all that apply.
1)Limit reading.
2)Avoid coughing.
3)Do not bend over.
4)Hold the nose when sneezing.
5)Avoid driving for several weeks.

Question 29

The nurse is reviewing orders written for a patient with syndrome of inappropriate antidiuretic hormone (SIADH). Which order should the nurse question?
1)No added salt diet
2)Fluid restriction 1 L/day
3)Intravenous fluids 0.9% normal saline 125 mL/hour
4)Furosemide (Lasix) 20 mg by mouth every day

Question 30

The nurse monitors the results of which laboratory studies in the patient diagnosed with hyperpituitarism? Select all that apply.
1)Calcium level
2)Growth hormone
3)Cortrosyn stimulation test
4)Follicle-stimulating hormone level (FSH)
5)Thyroid-stimulating hormone level (TSH)

Question 31

A patient admitted for an evaluation of a pituitary disorder has a serum sodium level of 118 mEq/L. What in the nursing priority at this time?
1)Apply wrist restraints
2)Implement seizure precautions
3)Prepare for nasogastric tube insertion
4)Plan for intermittent urinary catheterization