ADULT HEALTH NURSING III 2026 EXAMPREP
PRACTICE SET SOLUTION QUESTIONS WITH
FULL ANSWERS
◉ Pituitary surgery. Answer: -for DI or SIADH surgeries caused by
tumors
-assess for drainage, visual acuity
-notify HCP for excessive bleeding or CSF drainage
-check clear drainage with a urine dipstick for glucose and protein-
*glucose greater than 30mg/dl indicated CSF leak. risk for
meningitis
-assess for supraorbital headache: resolves in 72 hours, keep HOB
30 degrees or more. caused by CSF in sinuses
◉ Cushing syndrome. Answer: CAUSES
-glucocorticoids, mineralcorticoids, androgens
-medulla hormones- catecholamines= adrenaline, noradrenalin,
dopamine
-*iatrogenic admin of exogenous corticosteroids
-ACTH secrreting pituitary adenoma, adrenal tumors, too much
ACTH production by tumors
MANIFESTATIONS
,-moon face, thin and reddened skin, wt gain, centripetal obesity,
buffalo hump
-purplish-red striae below skin surface on abdomen, breast,
buttocks
-excess glucocorticoids: hyperglycemia, muscle wasting, weakness,
loss of bone matrix, osteoporosis, back pain. loss of collagen, think
skin, easily bruises, delay in wound healing
-mineralcorticoid excess: hypokalemia, hypertension
-adrenal androgen excess: severe acne, gynecomastia, hirsutism
-polyuria
-awkward gait
-enlarged clitoris
DIAGNOSTICS
-plasma ACTH lo, normal, or elevated, depending on underlying
cause
-hypokalemia (decreased K+), alkalosis with ACTH syndrome and
adrenal carcinoma
-increased glucose
-dyslipidemia, granulocytosis, lymphycytopenia, eosinopenia
-*calcium in urine
◉ Cushing syndrome *nursing care. Answer: -tx based on cause
-surgery, removal of ACTH secreting tumors
,-discontinue corticosteroid therapy, decreased dose gradually
ASSESS
-negative feelings, amenorrhea, impotence, decreased libido
-anxiety, emotional lability, psychosis
-** signs of inflammation, infection, thromboembolism: cjest pain,
dyspnea, tachypnea, sudden chest pain
MANAGEMENT
-high protein diet
-correct hypokalemia
-comfort and emotional support
-post surgery: *high doses of corticosteroids (hydrocortisone) IV
during and several days after surgery
>risk for glycemic control, infection, delayed wound healing
-monitor for acute renal insufficiency: vomiting, weakness,
dehydration, hypotension, painful joints, pruritis, peeling skin
-*taper dose of corticosteroids slowly!
-prevent infection, avoid extreme temps, wear medic alert bracelet
◉ Addison's disease. Answer: CAUSES
-lack of glucocorticoids, lack of ACTH, lack of androgens
-autoimmune or antibodies destroy adrenal cortex
-TB, amyloidosis, fungal infections, AIDS, metastatic cancer
, MANIFESTATIONS
-anorexia, nausea, weakness, fatigue, wt loss. disease advanced
before diagnosed
-abdominal pain, diarrhea, headache, orthostatic hypotension, salt
craving, joint pain
-*hyperpigmentation and bronze colored skin
◉ Addisons cont.. Answer: TRIGGERS
-stress (infection, surgery, psychologic distress)
-sudden withdrawal of corticosteroid hormone therapy
-adrenal surgery
-sudden pituitary destruction
MANIFESTATIONS
-hypotension, tachycardia
-dehydration
-decreased sodium, increased potassium, decreased glucose
-fever, weak, confusion, diarrhea, pain (in lower back or legs), severe
vomiting
-shock and circulatory collapse
DIAGNOSTIC TESTS
-*ACTH stimulation test to diagnose insufficiency
PRACTICE SET SOLUTION QUESTIONS WITH
FULL ANSWERS
◉ Pituitary surgery. Answer: -for DI or SIADH surgeries caused by
tumors
-assess for drainage, visual acuity
-notify HCP for excessive bleeding or CSF drainage
-check clear drainage with a urine dipstick for glucose and protein-
*glucose greater than 30mg/dl indicated CSF leak. risk for
meningitis
-assess for supraorbital headache: resolves in 72 hours, keep HOB
30 degrees or more. caused by CSF in sinuses
◉ Cushing syndrome. Answer: CAUSES
-glucocorticoids, mineralcorticoids, androgens
-medulla hormones- catecholamines= adrenaline, noradrenalin,
dopamine
-*iatrogenic admin of exogenous corticosteroids
-ACTH secrreting pituitary adenoma, adrenal tumors, too much
ACTH production by tumors
MANIFESTATIONS
,-moon face, thin and reddened skin, wt gain, centripetal obesity,
buffalo hump
-purplish-red striae below skin surface on abdomen, breast,
buttocks
-excess glucocorticoids: hyperglycemia, muscle wasting, weakness,
loss of bone matrix, osteoporosis, back pain. loss of collagen, think
skin, easily bruises, delay in wound healing
-mineralcorticoid excess: hypokalemia, hypertension
-adrenal androgen excess: severe acne, gynecomastia, hirsutism
-polyuria
-awkward gait
-enlarged clitoris
DIAGNOSTICS
-plasma ACTH lo, normal, or elevated, depending on underlying
cause
-hypokalemia (decreased K+), alkalosis with ACTH syndrome and
adrenal carcinoma
-increased glucose
-dyslipidemia, granulocytosis, lymphycytopenia, eosinopenia
-*calcium in urine
◉ Cushing syndrome *nursing care. Answer: -tx based on cause
-surgery, removal of ACTH secreting tumors
,-discontinue corticosteroid therapy, decreased dose gradually
ASSESS
-negative feelings, amenorrhea, impotence, decreased libido
-anxiety, emotional lability, psychosis
-** signs of inflammation, infection, thromboembolism: cjest pain,
dyspnea, tachypnea, sudden chest pain
MANAGEMENT
-high protein diet
-correct hypokalemia
-comfort and emotional support
-post surgery: *high doses of corticosteroids (hydrocortisone) IV
during and several days after surgery
>risk for glycemic control, infection, delayed wound healing
-monitor for acute renal insufficiency: vomiting, weakness,
dehydration, hypotension, painful joints, pruritis, peeling skin
-*taper dose of corticosteroids slowly!
-prevent infection, avoid extreme temps, wear medic alert bracelet
◉ Addison's disease. Answer: CAUSES
-lack of glucocorticoids, lack of ACTH, lack of androgens
-autoimmune or antibodies destroy adrenal cortex
-TB, amyloidosis, fungal infections, AIDS, metastatic cancer
, MANIFESTATIONS
-anorexia, nausea, weakness, fatigue, wt loss. disease advanced
before diagnosed
-abdominal pain, diarrhea, headache, orthostatic hypotension, salt
craving, joint pain
-*hyperpigmentation and bronze colored skin
◉ Addisons cont.. Answer: TRIGGERS
-stress (infection, surgery, psychologic distress)
-sudden withdrawal of corticosteroid hormone therapy
-adrenal surgery
-sudden pituitary destruction
MANIFESTATIONS
-hypotension, tachycardia
-dehydration
-decreased sodium, increased potassium, decreased glucose
-fever, weak, confusion, diarrhea, pain (in lower back or legs), severe
vomiting
-shock and circulatory collapse
DIAGNOSTIC TESTS
-*ACTH stimulation test to diagnose insufficiency
