Deck 44: Pituitary and Adrenal Disorders

Question 1

The nurse assessing a patient with Simmonds cachexia anticipates that the patient will exhibit:

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

Answer 1

Muscle wasting

Question 2

The nurse is aware that the large flattened features of the patient with acromegaly are caused by an excess of:

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

Answer 2

Growth hormone

Question 3

The family member of a patient who is in adrenal crisis asks why the IV cortisone is continued after the initial IV push of Solu-Cortef,which seemed to stop the symptoms.The nurse replies that:

A) Solu-Cortef has a very brief therapeutic period and needs a maintenance IV infusion to keep up the level.
B) IV infusions guarantee that Solu-Cortef will be absorbed.
C) Long-term IV infusions maintain adequate urine output.
D) IV cortisone supports peripheral perfusion and elevates the blood pressure.

Answer 3

Solu-Cortef has a very brief therapeutic period and needs a maintenance IV infusion to keep up the level.

Question 4

The hallmark findings expected when assessing a patient with Cushing syndrome are:

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 5

The nurse assesses a disturbance in body image when a woman with Addison disease says:

A) "Will I look like a zebra for the rest of my life?"
B) "I have found makeup to cover my rash."
C) "With this red face, I sure can't wear pink anymore."
D) "At last! I look like I have a suntan."

Question 6

The preoperative teaching for a patient scheduled for a transsphenoidal hypophysectomy should include the instruction that postoperatively,the patient should:

A) Avoid sneezing.
B) Drink through a straw.
C) Cough forcefully.
D) Wash mouth out with peroxide.

Question 7

The nurse includes in the discharge plan for a patient with Addison disease,"Risk for injury." 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 8

The patient with Addison disease asks why she must take hydrocortisone.The nurse clarifies that the drug will:

A) Increase cardiac output.
B) Regulate the excretion of potassium and sodium.
C) Decrease the level of cortisol.
D) Lower the blood sugar level.

Question 9

The patient with long-term asthma develops Cushing syndrome.The nurse explains that this condition is probably the result of:

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

Question 10

The patient believed to have acromegaly asks the purpose of the diagnostic glucose-tolerance test (GTT).The nurse responds by saying that:

A) "The doctor wants to know if you have either diabetes or acromegaly."
B) "The growth hormone will cause the glucose to be used up very quickly during the test."
C) "It measures the growth hormone in the presence of oral glucose levels at specified times."
D) "It tells whether your thyroid reacts to the high levels of sugar taken during this test."

Question 11

The nurse caring for a patient with Addison disease suspects adrenal crisis when the patient exhibits:

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

Question 12

On an intake physical examination,the nurse questions the patient with diabetes insipidus (DI)about the classic symptoms of that disease,which are:

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

Question 13

In drawing up a teaching plan for a patient with Addison disease,the nurse will include:

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

Question 14

The patient inquires about the purpose of the laboratory test to measure the serum level of adrenocorticotropic hormone (ACTH).The nurse responds that the laboratory test will determine if the:

A) Pituitary gland is sending the correct message to the adrenal glands.
B) Thyroid gland is not stimulating the production of ACTH.
C) Adrenal glands are not responding to produce cortisol.
D) Androgen metabolites are low or borderline.

Question 15

The care of a patient who underwent a hypophysectomy,during which the entire pituitary was removed,would include:

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 16

The nurse explains to a 14-year-old adolescent that because he has Addison disease,he will:

A) Not develop pubic hair.
B) Grow a heavy beard.
C) Become bald at an early age.
D) Have enlarged joints.

Question 17

The nurse is aware that the cardinal indication of a pheochromocytoma is:

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

Question 18

The nurse evaluates no need for further instruction for self-care for the patient with Cushing syndrome who states:

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 19

The patient states that he is confused because the physician told him that his DI is nephrogenic.The nurse explains that nephrogenic DI differs from neurogenic DI in that nephrogenic DI:

A) Will eventually resolve without medication.
B) Requires the nasal spray lypressin.
C) Does not respond to ADH.
D) Will require dialysis.

Question 20

The nurse making a care plan for a 10-year-old boy with hyperpituitarism identifies a disturbed self-image.The nursing diagnosis she would add to the nursing care plan would best be stated as "Disturbed self-image,related to":

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

Question 21

Discharge planning for the patient who underwent a hypophysectomy would be focused on:

A) Finding a support group
B) Nutritional maintenance
C) Education on self-care
D) Self-image improvement

Question 22

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

Question 23

The nurse takes into consideration that an addisonian crisis can be brought on by:

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

Question 24

The nurse clarifies that the drug,octreotide (Sandostatin),is a treatment for acromegaly and will:

A) Reverse the effects of acromegaly.
B) Be given on a daily basis by injection.
C) Increase insulin secretion causing hypoglycemia.
D) Suppress the growth hormone.

Question 25

Two days after a hypophysectomy the patient complains of a headache and nuchal rigidity.Based on these assessments the nurse should:

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 26

The patient with hypopituitarism must take medications for the rest of his or her life.The patient teaching plan would 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."

Question 27

When assessing the patient with a diagnosis of SIADH during an intake interview,the nurse expects that the patient will complain of:

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

Question 28

When the 18-year-old girl is diagnosed with adenoma of the anterior pituitary gland,the nurse assesses for the classic signs of this diagnosis,which are:

A) Cessation of menses
B) Milk production
C) Changing facial features
D) Excessive urine output
E) Weight gain

Question 29

The nurse caring for a patient with diabetes insipidus (DI)should be alert for the following and report these signs 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 30

The mother of a 6-foot,2-inch,16-year-old girl who is being treated for hyperpituitarism says,"I can't stand it that my beautiful daughter is a freak." The nurse's best response is:

A) "Gigantism is treatable."
B) "Her height could help her be a basketball star or a model."
C) "What is it about her height that makes her a freak?"
D) "All parents feel responsible when their children have problems."

Question 31

The nurse prepares the family for the altered appearance of the patient returning from stereotactic radiosurgery to see a _____________ ___________ in place.

Question 32

The nurse explains that growth hormone will be given to the child with hypopituitarism on a scheduled basis until the child reaches the height of ____________________.