Chapter 36: Care of Patients with Pituitary, Thyroid, Parathyroid, and Adrenal Disorders |DeWit: Medical-Surgical Nursing: Concepts & Practice, 3rd Edition

MULTIPLE CHOICE 1. Pituitary adenoma antagonizes insulin. This benign tumor results in which imbalance? a. Hyperinsulinism b. Hyperglycemia c. Hypopituitarism d. Hypoglycemia ANS: B The tumor interferes with the effectiveness of insulin, resulting in hyperglycemia. PTS:1 DIF: Cognitive Level: Comprehension REF: 855, Key Points OBJ:1 (clinical) TOP: Pituitary Tumor: Effects KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 2. A patient who had a hypophysectomy 3 days ago begins to have 3000 mL of urine output every shift and complains of thirst and a dry mouth. Which problem does the nurse suspect? a. Overreaction to diuretics b. Diabetes insipidus (DI) c. Diabetes mellitus d. Glucose intolerance ANS: B DI is a complication of a hypophysectomy. The posterior lobe of the pituitary gland controls urinary output; when this portion of the pituitary is removed or damaged, there is no secretion of antidiuretic hormone to stop excessive urine output. PTS: 1 DIF: Cognitive Level: Application REF: 835 OBJ: 4 (clinical) TOP: Hypophysectomy: Complication KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 3. A patient with central diabetes insipidus (DI) likely has which occurrence as part of his health history? a. Brain surgery to remove a tumor b. A kidney disorder c. Water addiction d. A thyroid disorder ANS: A Central DI is caused by insult to the pituitary that results from a brain injury or invasive brain surgery. Kidney disorders, water addiction, and thyroid disorders do not cause central DI. PTS:1 DIF: Cognitive Level: Comprehension REF: 837 OBJ:6 (clinical) TOP: DI: Central Type KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 4. The nurse is aware that the severe dehydration associated with diabetes insipidus (DI) can lead which serious electrolyte imbalance? a. Hypercalcemia b. Hypernatremia c. Hypocalcemia d. Hyperkalemia ANS: B The loss of potassium in the large volume of urine depletes the compensatory mechanisms and hypernatremia results. PTS:1 DIF: Cognitive Level: Comprehension REF: 837 OBJ:6 (clinical) TOP: DI: Complication KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 5. The nurse is educating a patient with a simple goiter. Which statement indicates that the patient needs additional instruction? a. “The lump on my throat is my enlarged thyroid.” b. “Treatment stops enlargement of the goiter.” c. “I am aware this goiter could develop into cancer.” d. “I’m glad my treatment will make this thing go away.”