©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
Lewis Medical-Surgical Nursing 11th Edition Test
Bank- Chapter 49 Endocrine Problems Questions and
Answers
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? - Ans:✔✔-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:
Page 1/35
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
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. - Ans:✔✔-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.
Page 2/35
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
d. Monitor continuous pulse oximetry for 24 hours. - Ans:✔✔-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. - Ans:✔✔-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
Page 3/35
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
(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. - Ans:✔✔-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
Page 4/35
FIRST PUBLISH OCTOBER 2024
Lewis Medical-Surgical Nursing 11th Edition Test
Bank- Chapter 49 Endocrine Problems Questions and
Answers
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? - Ans:✔✔-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:
Page 1/35
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
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. - Ans:✔✔-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.
Page 2/35
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
d. Monitor continuous pulse oximetry for 24 hours. - Ans:✔✔-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. - Ans:✔✔-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
Page 3/35
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
(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. - Ans:✔✔-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
Page 4/35
