CHAPTER 49 ENDOCRINE PROBLEMS MEDICAL
SURGICAL NURSING ACTUAL PAPER 2026
SOLUTIONS GRADED A+
◉ 2. A patient is scheduled for transsphenoidal hypophysectomy to
treat a pituitary adenoma. During preoperative teaching, 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. avoid brushing teeth for at least 10 days after the surgery.
d. be positioned flat with sandbags at the head postoperatively.
Answer: ANS: C
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: Apply (application)
TOP: Nursing Process: Implementation
REF: 1159
,◉ 3. The nurse is planning postoperative care for a patient who is
being admitted to the surgical unit from the recovery room after
transsphenoidal resection of a pituitary tumor. Which nursing action
should be included?
a. Palpate extremities for edema.
b. Measure urine volume every hour.
c. Check hematocrit every 2 hours for 8 hours.
d. Monitor continuous pulse oximetry for 24 hours. Answer: ANS: B
After pituitary surgery, the patient is at risk for diabetes insipidus
caused by cerebral edema. 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: Apply (application)
TOP: Nursing Process: Planning
REF: 1159
MSC: NCLEX: Physiological Integrity
, ◉ 4. The nurse is assessing a male patient diagnosed with a pituitary
tumor causing panhypopituitarism. Assessment findings consistent
with panhypopituitarism include:
a. high blood pressure.
b. decreased facial hair.
c. elevated blood glucose.
d. tachycardia and palpitations. Answer: ANS: B
Changes in male secondary sex characteristics such as decreased
facial hair, testicular atrophy, diminished spermatogenesis, loss of
libido, impotence, and decreased muscle mass 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.
◉ 5. Which information will the nurse include when teaching a 50-
yr-old male patient about somatropin (Genotropin)?
a.The medication will be needed for 3 to 6 months.
b. Inject the medication subcutaneously every day.
c. Blood glucose levels may decrease when taking the medication.
d. Stop taking the medication if swelling of the hands or feet occurs.
Answer: ANS: B
SURGICAL NURSING ACTUAL PAPER 2026
SOLUTIONS GRADED A+
◉ 2. A patient is scheduled for transsphenoidal hypophysectomy to
treat a pituitary adenoma. During preoperative teaching, 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. avoid brushing teeth for at least 10 days after the surgery.
d. be positioned flat with sandbags at the head postoperatively.
Answer: ANS: C
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: Apply (application)
TOP: Nursing Process: Implementation
REF: 1159
,◉ 3. The nurse is planning postoperative care for a patient who is
being admitted to the surgical unit from the recovery room after
transsphenoidal resection of a pituitary tumor. Which nursing action
should be included?
a. Palpate extremities for edema.
b. Measure urine volume every hour.
c. Check hematocrit every 2 hours for 8 hours.
d. Monitor continuous pulse oximetry for 24 hours. Answer: ANS: B
After pituitary surgery, the patient is at risk for diabetes insipidus
caused by cerebral edema. 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: Apply (application)
TOP: Nursing Process: Planning
REF: 1159
MSC: NCLEX: Physiological Integrity
, ◉ 4. The nurse is assessing a male patient diagnosed with a pituitary
tumor causing panhypopituitarism. Assessment findings consistent
with panhypopituitarism include:
a. high blood pressure.
b. decreased facial hair.
c. elevated blood glucose.
d. tachycardia and palpitations. Answer: ANS: B
Changes in male secondary sex characteristics such as decreased
facial hair, testicular atrophy, diminished spermatogenesis, loss of
libido, impotence, and decreased muscle mass 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.
◉ 5. Which information will the nurse include when teaching a 50-
yr-old male patient about somatropin (Genotropin)?
a.The medication will be needed for 3 to 6 months.
b. Inject the medication subcutaneously every day.
c. Blood glucose levels may decrease when taking the medication.
d. Stop taking the medication if swelling of the hands or feet occurs.
Answer: ANS: B
