Deck 48: Pituitary and Adrenal Disorders

Question 1

A patient with hypopituitarism must take medications for the rest of his or her life.What should the patient teaching plan include?

A) "Constipation must be prevented because straining increases intracranial pressure."
B) "You must become familiar with the signs and symptoms of inadequate or excessive hormone replacement."
C) "It is not necessary to wear a medical alert bracelet or necklace."
D) "Your self-image is important.Take positive steps to improve your appearance."

Answer 1

"You must become familiar with the signs and symptoms of inadequate or excessive hormone replacement."

Question 2

What is the cardinal indication of a pheochromocytoma?

A) Significant hypertension
B) Extreme nausea
C) Abdominal pain
D) Edema in the legs

Answer 2

Significant hypertension

Question 3

What should a nurse include when planning education to a patient with Addison disease?

A) Discontinue hormonal replacement therapy if the patient becomes nauseated or has diarrhea.
B) Decrease medication if the patient is under stress or is being treated for an infection.
C) Wear a medical alert tag and carry emergency dexamethasone.
D) Begin a vigorous exercise program to overcome weakness and muscle wasting.

Answer 3

Wear a medical alert tag and carry emergency dexamethasone.

Question 4

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

A) Diuresis, dehydration, and thirst
B) Dizziness, hypertension, and excitability
C) Stress incontinence, vomiting, and edema
D) Bradycardia, insomnia, and muscle cramps

Question 5

A nurse is caring for a patient with diabetes insipidus (DI).Which signs should the nurse report that indicate a change in condition?

A) Dropping blood pressure
B) Light clear urine
C) Moist mucous membranes
D) Excessive thirst
E) Large urine output

Question 6

What hormone causes the features of a patient with acromegaly?

A) Prolactin
B) Growth hormone
C) Thyroid-stimulating hormone
D) Adrenocorticotropic hormone

Question 7

A patient with long-term asthma develops Cushing syndrome.What is the cause of this condition?

A) Taking corticosteroids for many years
B) Abruptly withdrawing cortisone therapy
C) Lacking ACTH, related to the pituitary gland
D) Poorly functioning adrenal glands

Question 8

What should a nurse include when caring for a patient after a hypophysectomy, during which the entire pituitary was removed?

A) Maintaining strict intake and output fluids
B) Keeping the patient flat in bed for the first 24 hours
C) Withholding analgesics to assess the level of consciousness
D) Providing mouth care with thorough cleansing of the oral cavity

Question 9

Which findings are expected when assessing a patient with Cushing syndrome?

A) Edema of the trunk, extremities, and face
B) Wasting of the abdomen with thick, calloused skin
C) Excess adipose tissue in the trunk, slender extremities, and moon face
D) High levels of potassium and low levels of sodium, weakness, and wasting

Question 10

A 6-foot, 2-inch, 16-year-old girl who is being treated for hyperpituitarism says, "I can't stand it that I look like a freak." What is the nurse's best response?

A) "Gigantism is treatable."
B) "Your height could help you be a basketball star or a model."
C) "What is it about your height that makes you a freak?"
D) "Your height is something you will have to get used to."

Question 11

Two days after a hypophysectomy a patient complains of a headache and nuchal rigidity.What action should the nurse take based on these assessments?

A) Medicate with the prescribed analgesic.
B) Report suspected meningitis to the head nurse.
C) Closely monitor the patient's blood pressure.
D) Elevate the head of the bed to 45 degrees.

Question 12

Which statement by a patient diagnosed with Cushing syndrome leads a nurse to conclude that teaching has been effective?

A) "I know I should add salt to everything I eat."
B) "I make a point to avoid excessive exposure to sun."
C) "I avoid being exposed to anyone with an infection."
D) "I am careful to wear well-fitting shoes."

Question 13

A nurse is assessing a patient with Simmonds cachexia.What symptom should the nurse anticipate the patient will exhibit?

A) High body temperature
B) Ruddy complexion
C) Silky body hair
D) Muscle wasting

Question 14

A nurse making a care plan for a 10-year-old boy with hyperpituitarism identifies an altered body image.What should the nurse relate this nursing diagnosis to?

A) Lack of facial hair
B) Excessive height
C) Small genitalia
D) Skin eruptions on the face

Question 15

A 14-year-old adolescent male patient has been diagnosed with Addison disease.Which effect of Addison disease should this patient be aware of?

A) He will not develop pubic hair.
B) He will grow a heavy beard.
C) He will become bald at an early age.
D) He will have enlarged joints.

Question 16

A nurse is caring for a patient diagnosed with Addison disease.Which signs and symptoms should lead the nurse to suspect an adrenal crisis?

A) Hypertension and abdominal pain
B) Confusion and tachycardia
C) Bradycardia and nausea
D) Widening pulse pressure and shortness of breath

Question 17

A nurse includes in the discharge plan for a patient with Addison disease, "Potential for injury." What should measures to deal with this include?

A) Arranging for uncluttered floor space
B) Rising slowly from a lying position
C) Keeping the room well lit
D) Providing instructions in the use of a walker

Question 18

What can bring on an addisonian crisis?

A) Sudden atmospheric temperature change
B) Hyperglycemia
C) Infection
D) Change of altitude

Question 19

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.

Question 20

A patient states that he is confused because the physician told him that his diabetes insipidus (DI)is nephrogenic.What should the nurse state when describing the difference between nephrogenic DI and neurogenic DI?

A) Nephrogenic DI will eventually resolve without medication.
B) Nephrogenic DI requires the nasal spray lypressin.
C) Nephrogenic DI does not respond to ADH.
D) Nephrogenic DI will require dialysis.

Question 21

What symptoms should a nurse expect a patient with the diagnosis of SIADH to report during an intake interview? (Select all that apply.)

A) Headache
B) Hypotension
C) Weight gain
D) Muscle cramps
E) Weakness

Question 22

A nurse noting a peaked T wave on the electrocardiogram (ECG)of a patient with Addison disease recognizes this complex as suggestive of ______.

Question 23

An 18-year-old girl is diagnosed with adenoma of the pituitary gland.What signs of this diagnosis should the nurse assess? (Select all that apply.)

A) Cessation of menses
B) Milk production
C) Excess body hair
D) Excessive urine output
E) Weight loss

Question 24

A nurse prepares a family for the altered appearance of the patient returning from stereotactic radiosurgery to see a(n)______ in place.