LEWIS MEDICAL-SURGICAL NURSING
11TH EDITION TEST BANK- CHAPTER
49 ENDOCRINE PROBLEMS
QUESTIONS & ELABORATED
COMPLETE SOLUTIONS
1. A 45-year-old male patient with suspected acromegaly is seen at the clinic. To assist
in making the diagnosis, which question should the nurse ask?
a. Have you had a recent head injury?
b. Do you have to wear larger shoes now?
c. Is there a family history of acromegaly?
d. Are you experiencing tremors or anxiety? - Correct Answer ✔✔ ANS: B
Acromegaly causes an enlargement of the hands and feet. Head injury and family
history are not risk factors for acromegaly. Tremors and anxiety are not clinical
manifestations of acromegaly.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
2. A 42-year-old female 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. - Correct 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 MSC: NCLEX: Physiological Integrity
3. The nurse is planning postoperative care for a patient who is being admitted to the
surgical unit form 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. - Correct 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 MSC: NCLEX: Physiological Integrity
4. The nurse is assessing a 41-year-old African American 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 cardiac palpitations. - Correct 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.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
5. Which information will the nurse include when teaching a 50-year-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. - Correct Answer ✔✔ ANS: B
Somatropin is injected subcutaneously on a daily basis, preferably in the evening. The
patient will need to continue on somatropin for life. If swelling or other common adverse
effects occur, the health care provider should be notified. Growth hormone will increase
blood glucose levels.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
6. The nurse determines that demeclocycline (Declomycin) is effective for a patient with
syndrome of inappropriate antidiuretic hormone (SIADH) based on finding that the
patients
a. weight has increased.
b. urinary output is increased.
c. peripheral edema is decreased.
d. urine specific gravity is increased. - Correct Answer ✔✔ ANS: B
11TH EDITION TEST BANK- CHAPTER
49 ENDOCRINE PROBLEMS
QUESTIONS & ELABORATED
COMPLETE SOLUTIONS
1. A 45-year-old male patient with suspected acromegaly is seen at the clinic. To assist
in making the diagnosis, which question should the nurse ask?
a. Have you had a recent head injury?
b. Do you have to wear larger shoes now?
c. Is there a family history of acromegaly?
d. Are you experiencing tremors or anxiety? - Correct Answer ✔✔ ANS: B
Acromegaly causes an enlargement of the hands and feet. Head injury and family
history are not risk factors for acromegaly. Tremors and anxiety are not clinical
manifestations of acromegaly.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
2. A 42-year-old female 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. - Correct 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 MSC: NCLEX: Physiological Integrity
3. The nurse is planning postoperative care for a patient who is being admitted to the
surgical unit form 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. - Correct 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 MSC: NCLEX: Physiological Integrity
4. The nurse is assessing a 41-year-old African American 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 cardiac palpitations. - Correct 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.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
5. Which information will the nurse include when teaching a 50-year-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. - Correct Answer ✔✔ ANS: B
Somatropin is injected subcutaneously on a daily basis, preferably in the evening. The
patient will need to continue on somatropin for life. If swelling or other common adverse
effects occur, the health care provider should be notified. Growth hormone will increase
blood glucose levels.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
6. The nurse determines that demeclocycline (Declomycin) is effective for a patient with
syndrome of inappropriate antidiuretic hormone (SIADH) based on finding that the
patients
a. weight has increased.
b. urinary output is increased.
c. peripheral edema is decreased.
d. urine specific gravity is increased. - Correct Answer ✔✔ ANS: B
