Ch 57 - Pituitary and Adrenal Gland Problems

which medication would the nurse plan to administer to a patient diagnosed with hyperaldosteronism? (select all) a. insulin b. dextrose c. potassium supplement d. kayexalate e. spironolactone

c. potassium supplement e. spironolactone

Which finding in a patient with syndrome of inappropriate antidiuretic hormone (SIADH) is a priority to report to the health care provider? a. lethargy b. dependent edema c. serum sodium of 115 mEq/L d. intake of 1100 mL, output of 1250 mL

c. serum sodium of 115 mEq/L

Which syndrome is the result of pituitary infarction after postpartum hemorrhage? a. conn syndrome b. cushing syndrome c. sheehan syndrome d. schwartz-bartter syndrome

c. sheehan syndrome

Which medication instruction would the nurse provide to a patient who is prescribed cortisone for treatment of hypofunction of the adrenal gland? a. take the drug on alternate days b. take the evening dose of the drug just before going to bed c. take the drug with meals or a snack d. take the drug in divided doses, three times a day

c. take the drug with meals or a snack

Which medication teaching does the nurse provide for a patient with acromegaly who is prescribed bromocriptine therapy? a. a side effect of this drug is diarrhea b. bromocriptine is given on an empty stomach c. the drug must be stopped during pregnancy d. you will receive a starting dose of 7.5 mg/day

c. the drug must be stopped during pregnancy

Which clinical manifestation is found in a patient with deficiency of growth hormone? a. weight gain b. slowed cognition c. low estrogen levels d. decreased bone density e. increased serum cholesterol level

d. decreased bone density e. increased serum cholesterol level

C)Which assessment finding would the nurse identify as a sign of infection in a patient who underwent an adrenalectomy? a. skin breakdown b. crackles and wheezes c. breakdown of oral mucosa d. increase of 1°F (or 0.5°C) in body temperature

d. increase of 1°F (or 0.5°C) in body temperature

Which manifestation does the nurse expect to find in a patient diagnosed with diabetes insipidus (DI)? a. excessive hunger b. reduced fluid intake c. highly concentrated urine d. increased urinary frequency

d. increased urinary frequency

Which is a secondary cause of adrenal insufficiency? (select all) a. tuberculosis b. pituitary tumors c. hypophysectomy d. autoimmune diseases e. abrupt discontinuiation of corticosteroids

b. pituitary tumors c. hypophysectomy e. abrupt discontinuiation of corticosteroids secondary causes of adrenal insufficiency include pituitary tumors, hypophysectomy, and abrupt discontinuation of corticosteroid therapy. Primary causes include TB and autoimmune diseases

The nurse suspects which condition when. the patient's laboratory reports indicate a serum cortisol level of 4 mcg/dL? a. graves disease b. adrenal gland hypofunction c. Cushing disease d. syndrome of inappropriate antidiuretic hormone (SIADH)

b. adrenal gland hypofunction

The nurse expects which laboratory finding in a patient with hyperaldosteronism? a. elevated blood pH b. low serum sodium levels c. urine specific gravity of 1.005 d. elevated serum potassium levels

a. elevated blood pH

Which finding indicates the possibility of syndrome of inappropriate antidiuretic hormone (SIADH)? (select all) a. full and bounding pulse b. decreased plasma volume c. decreased urine osmolarity d. elevated urine sodium level e. decreased serum sodium level

a. full and bounding pulse d. elevated urine sodium level e. decreased serum sodium level

Which assessment finding is consistent with a diagnosis of hyperaldosteronism? (select all) a. headache b. dehydration c. muscle weakness d. profuse diaphoresis e. intermittent hypertension

a. headache b. dehydration c. muscle weakness

Which clinical manifestation would the nurse expect to find in a patient with hyperaldosteronism? (Select all) a. headache b. muscle weakness c. fatigue d. hypotension e. hyperkalemia

a. headache b. muscle weakness c. fatigue also: hypertension, dilutional hypokalemia (both from fluid retention)

A male patient with hypopituitarism is receiving sex steroid replacement therapy with androgens. The nurse recognizes that which assessment finding indicates effective treatment? (select all) a. increased libido b. increase muscle mass c. increased bone strength d. increased estrogen levels e. increased serum cholesterol levels

a. increased libido b. increase muscle mass c. increased bone strength

Which medication would the nurse anticipate administering to a patient who is experiencing an addisonian crisis with laboratory results of potassium 5.4 mEq/L, sodium 130 mEq/L, calcium 8.0 mg/dL, and blood glucose 70 mh/dL? (select all) a. insulin b. dextrose c. aldactone d. H2 histamine blocker e. loop diuretic

a. insulin b. dextrose d. H2 histamine blocker e. loop diuretic

Which symptom indicates decreased adrenocorticotropic hormone (ACTH) in the body? a. malaise b. increased thirst c. decreased libido d. intolerance to cold

a. malaise

Which manifestation does the nurse expect in a patient with syndrome of inappropriate antidiuretic hormone (SIADH)? (select all) a. water retention b. dependent edema c. full, bounding pulse d. decreased urine sodium level e. decreased sodium serum level

a. water retention c. full, bounding pulse e. decreased sodium serum level

Which finding would the nurse identify as contributing to the potential for infection int he patient with hypercortisolism? a. increased serum sodium level b. decreased lymphocyte count c. increased blood glucose level d. decreased serum potassium level

b. decreased lymphocyte count

The nurse instructs a patient who takes bromocriptine to treat acromegaly that which side effect requires immediate medical attention? (select all) a. constipation b. dizziness c. chest pain d. nausea e. watery nasal discharge

b. dizziness c. chest pain e. watery nasal discharge

Which intervention does the nurse provide when a patient with diabetes insipidus experiences dry lips, mucous membranes, and poor skin turgor? a. offer a lemon-based mouthwash b. encourage fluids c. perform a 24-hour urine test d. withhold desmopressin

b. encourage fluids

Which question by the nurse is a priority when a patient who has been on long-term corticosteroid treatment reports fatigue, nausea, and salt cravings? a. have you been using salt substitutes b. have you stopped taking your corticosteroid c. do you have any notable swelling in your abdomen d. do you have any abnormal swelling on your upper back and shoulder

b. have you stopped taking your corticosteroid

The nurse monitors. for which condition in a patient with adrenal gland hypofunction? a. hypertension b. hyperkalemia c. hyperglycemia d. hypernatremia

b. hyperkalemia

Which other assessment finding does the nurse anticipate in a patient diagnosed with adrenocorticotropic hormone imbalance who reports weight gain and moon face? a. galactorrhea b. hypertension c. hypoglycemia d. heat intolerance

b. hypertension

Which laboratory result indicates that fluid restrictions have bene effective in treating syndrome of inappropriate antidiuretic hormone (SIADH)? a. decreased hematocrit b. increased serum sodium c. decreased serum osmolality d. increased urine specific gravity

b. increased serum sodium

recognizing that a patient with cushing disease is at risk for injury, which intervention would the nurse include in the patient's plan of care? a. provide a low-calorie diet b. instruct the patient to use an electric razor c. encourage the patient to walk independently d. avoid the use of histamine receptor blockers

b. instruct the patient to use an electric razor

Which medication is used for the treatment of Cushing disease? a. kayexalate b. metyrapone c. hydrocortisone d. phenoxxybenzamine

b. metyrapone

Which intervention is appropriate for a patient with a pituitary tumor who has developed syndrome of inappropriate antidiuretic hormone (SIADH)? (select all) a. restrict sodium b. restrict fluid intake c. assess liver function d. administer tolvaptan e. administer desmopressin

b. restrict fluid intake c. assess liver function d. administer tolvaptan

Which laboratory value would the nurse recognize as consistent with a patient diagnosis of adrenal insufficiency? a. calcium: 8 mg/dL b. sodium: 128 mEq/L c. potassium: 2.5 mEq/L d. bicarbonate: 20 mEq/L

b. sodium: 128 mEq/L

The nurse questions which prescription. that is listed on the plan of. care for a patient with hyperpituitarism? a. octreotide b. vasopressin c. pegvisomant d. bromocriptine

b. vasopressin

Which action would the nurse take first when a patient with Cushing disease reports a weight loss of 5 lb? a. encourage an increased intake of fluids b. weigh the patient c. check the specific gravity of the urine d. auscultate the lungs for crackles

b. weigh the patient

which is a sign of syndrome of inappropriate antidiuretic hormone (SIADH)? a. edema b. weight gain c. hypernatremia d. increased appetite

b. weight gain

Which assessment finding is consistent with this diagnosis of thyroid-stimulating hormone (TSH) deficiency? (Select all) a. headache b. weight gain c. scalp alopecia d. slowed cognition e. postural hypotension

b. weight gain c. scalp alopecia d. slowed cognition

Which assessment finding in a patient with diabetes insipidus (DI) being treated with drug therapy is a priority for the nurse to report to health care provider? a. pulse of 102 beats/min b. weight gain of 2.4lb in 1 day c. serum sodium of 147 mEq/dL d. intake of 1200 mL, output of 1050 mL

b. weight gain of 2.4lb in 1 day

Which condition results from excessive secretion of vasopressin even when plasma osmolarity is low or normal? a. Cushing syndrome b. Sheehan syndrome c. Schwartz-Bartter syndrome d. Waterhouse-Friderichsen syndrome

c. Schwartz-Bartter syndrome aka syndrome of inappropriate antidiuretic hormone secretion. (SIADH) - excessive vasopressin or antidiuretic hormone is secreted even when plasma osmolarity is low or normal.

After reviewing the inpatient assignments, the nurse determines that which patient should be assessed first? a. a patient with adrenal insufficiency who is vomiting and reports fatigue b. a patient with adrenal hypofunction who is scheduled tot receive prednisone c. a patient with Conn syndrome who experiences a blood pressure of 210/106 mm Hg and tremors d. a patient diagnosed with Cushing disease who has a potassium level of 5.4 mEq/L and a calcium level of 8.0 mg/dL

c. a patient with Conn syndrome who experiences a blood pressure of 210/106 mm Hg and tremors

After reviewing the laboratory reports of a patient with hypercortisolism, the nurse identifies that which finding should be reported immediately to the primary health care provider? a. a serum calcium level decrease from 10.5 - 9 mg/dL b. a serum cortisol level increase from 10 - 23 mcg/dL c. a serum sodium level increase from 138 - 154 mEq/L d. a serum potassium level decrease from 4.8 - 3.6 mEq/L

c. a serum sodium level increase from 138 - 154 mEq/L

After reviewing the patient assignment, the nurse determines that which patient should be assessed first? a. a patient with diabetes insipidus (DI) whose serum potassium is 3.3 mEq/L b. a patient with diabetes insipidus (DI) who experienced a weight gain of 2 lb in 24 hours c. a. patient with syndrome of inappropriate antidiuretic hormone (SIADH) whose serum sodium is 114 mEq/L d. a patient with syndrome of inappropriate antidiuretic hormone (SIADH) with an intake of 1000 mL and an output of 900 mL

c. a. patient with syndrome of inappropriate antidiuretic hormone (SIADH) whose serum sodium is 114 mEq/L

Which intervention does the nurse expect to find in a plan of care for a patient who has developed syndrome of inappropriate antidiuretic hormone (SIADH)? a. restrict salt intake b. administer octreotide c. administer conicaptan d. encourage fluid intake

c. administer conicaptan

Which nursing action is a priority when caring for a patient with adrenal insufficiency who reports palpitations and who has laboratory results of potassium 5.9 mEq/dL, sodium 128 mEq/dL, and calcium 8.0 mg/dL? a. increase IV fluids b. weigh the patient daily c. assess the patient's cardiac rhythm d. evaluate the patient's potassium intake

c. assess the patient's cardiac rhythm

When a patient with hyperpituitarism is prescribed bromocriptine, the nurse recalls that, by stimulating dopamine receptors in the brain, the medication has which effect? a. increases the risk for depression b. decreases the risk for cerebrovascular diseae c. inhibits the release of prolactin (PRL) d. stimulates the release of growth hormone (GH)

c. inhibits the release of prolactin (PRL)

When performing an assessment 1 day after a patient underwent a hypophysectomy, the nurse identifies that which finding has an immediate implication for the patient's care? a. urine specific gravity of 1.016 b. dry lips and oral mucosa on examination c. patient report of a headache and stiff neck d. nasal drainage that tests negative for glucose

c. patient report of a headache and stiff neck

Which intervention would the nurse include in a plan of care that addresses the risk for infection in a patient who is immobile and immunosuppressed because of hypercortisolism? a. performing pulmonary hygiene every 6 hours b. changing the patient's position every 8 hours c. recording the body temperature every 4 hours d. checking for the presence of breath sounds every 12 hours

c. recording the body temperature every 4 hours

When assessing a patient's elimination pattern, the nurse identifies that which finding needs further evaluation to rule out the possibility of diabetes insipidus (DI)? a. the specific gravity of the urine is 1.005 b. the first morning sample of urine is pale yellow and clear c. the patient reports excessive thirst and increased frequency of urination d. the total. urine output is slightly less than the total fluid intake in 24 hours

c. the patient reports excessive thirst and increased frequency of urination

weight gain, intolerance to cold, lethargy, and menstrual abnormalities are symptoms of deficiency in which pituitary hormone? a. gonadotropins b. growth hormone (GH) c. thyroid-stimulating hormone (TSH) d. adrenocorticotropic hormone (ACTH)

c. thyroid-stimulating hormone (TSH)

Which is a nursing priority for a patient who presents to the emergency department with a history of adrenal insufficiency and with laboratory results of sodium 130 mEq/L, potassium 5.6 mEq/L, and glucose 72 mg/dL? a. give spironolactone 100 mg daily b. obtain arterial blood gases to assess for peaked T waves c. initiate H2 blocker therapy with ranitidine for ulcer prophylaxis d. administer insulin and dextrose in normal saline to shift K+ into the cells

d. administer insulin and dextrose in normal saline to shift K+ into the cells

To prevent increased intracranial pressure. (ICP) after a hypophysectomy, the nurse instructs the patient to take which precaution? a. bend at the waist to pick up objects b. perform deep-breathing exercises c. cover the mouth when coughing and sneezing d. consume high-fiber foods and drink plenty of fluids

d. consume high-fiber foods and drink plenty of fluids

Assessment findings of a patient who presents to the hospital include a moonface, hypertension, petechiae, and truncal obesity. The manifestations are related to increased adrenocorticotropic hormone (ACTH) levels. Which medication does the nurse expect to be prescribed. a. tolvaptan b. desmopressin c. hydrocortisone d. crypoheptadine

d. crypoheptadine

The nurse teaches a patient that which criterion is used to monitor the effectiveness of therapy for syndrome of inappropriate antidiuretic hormone (SIADH)? a. muscle spasms b. increasing heart rate c. dry mucous membranes d. daily weight gain of more than 2 lb

d. daily weight gain of more than 2 lb

The nurse monitors for which risk in a patient who has growth hormone (GH).deficiency? a. double vision b. decreased height c. growth retardation d. decreased bone strength

d. decreased bone strength

The nurse expects which assessment finding in a patient with syndrome of inappropriate antidiuretic hormone (SIDAH)? a. decrease in body weight b. increase in urinary volume c. decrease in blood pressure d. increase in urinary osmolarity

d. increase in urinary osmolarity SIDAH, water retention leads to increase in urine osmolarity and decrease in plasma osmolarity. body weight may increase due to water retention. water retention may lead to decrease in urinary volume. increase in BP because. of water retention

To avoid increasing intracranial pressure (ICP), which intervention does the nurse implement for a patient who has undergone a hypophysectomy? a. place the patient in the Trendelenburg position b. encourage the patient to cough and deep breath c. instruct the patient to blow the nose for postnasal drip d. instruct the patient not to strain during a bowel movement

d. instruct the patient not to strain during a bowel movement

During the immediate postoperative period, which instruction does the nurse provide to a patient who underwent a hypophysectomy? a. use a soft toothbrush rather than dental floss b. anticipate postnasal drip for the first 24-hours c. cough gently and deep breathe every 2 hours d. keep the head of the bed elevated

d. keep the head of the bed elevated

Which is the cause of nephrogenic diabetes insipidus? a. defects in the hypothalamus or pituitary gland b. tumors in or near the hypothalamus. or pituitary gland c. use of drugs that affect the response of kidneys to antidiuretic hormone d. lack of response of the kidney tubules to the actions of antidiuretic hormone

d. lack of response of the kidney tubules to the actions of antidiuretic hormone

when making patient assignments for the medical-surgical unit, the nursing team leader determines that which patient is best to assign to a registered nurse (RN) who has floated from the pediatric unit? a. patient experiencing an addisonian crisis who is receiving IV hydrocotrisone b. patient admitted with syndrome of inappropriate antidiuretic hormone (SIADH) secondary to lung cancer c. patient being discharged after a unilateral adrenalectomy to remove an adrenal tumor d. patient with Cushing disease who has elevated blood glucose and requires frequent administration of insulin

d. patient with Cushing disease who has elevated blood glucose and requires frequent administration of insulin

After receiving a change-of-shift report about four patients, which patient would the nurse attend to first? a. patient with hyperaldosteronism who has a serum potassium of 3.4 mEq/L b. patient with pituitary adenoma who is reporting a severe headache c. patient with diabetes insipidus who has a dose of desmopressin due d. patient with acute adrenal insufficiency who has a blood glucose level of 36 mg/dL

d. patient with acute adrenal insufficiency who has a blood glucose level of 36 mg/dL

Which change would the nurse expect to find in a patient with hypercortisolism upon physical assessment? a. excessively dry skin b. muscle artophy c. absence of hair on the body d. presence of fat pads on the shoulders

d. presence of fat pads on the shoulders

Which skin change would the nurse expect to find in a patient with hypercortisolism? a. thick skin b. smooth, thin skin c. hypopigmentation d. reddish-purple striae

d. reddish-purple striae

Which teaching does the nurse provide to a patient who has undergone nasal hypophysectomy? a. report any postnasal drip after surgery b. brush your teeth twice every day after surgery c. cough slowly at the end of a deep-breathing exercise d. perform deep-breathing exercises every 15 minutes after surgery

a. report any postnasal drip after surgery

Which is a key assessment finding in a patient suspected of having diabetes insipidus? (Select all) a. tachycardia b. hemodilution c. increased thirst d. dry mucous membranes e. high specific urine gravity

a. tachycardia c. increased thirst d. dry mucous membranes

Which is a primary cause of adrenal insufficiency? (Select all) a. tuberculosis b. hemorrhage c. renal failure d. pituitary tumors e. autoimmune disease

a. tuberculosis b. hemorrhage e. autoimmune disease

Which is a common side effect of spironolactone therapy for hyperaldosteronism? a. urticaria b. hypokalemia c. constipation d. hypernatremia

a. urticaria side effects: urticaria, hives, diarrhea increased risk for hyperkalemia - avoid potassium supplements and foods rich in potassium, and hyponatremia

which condition contraindicates androgen therapy? a. HTN b. prostate cancer c. bronchial asthma d. diabetes mellitus

b. prostate cancer

The nurse expects which assessment finding in a patient who presents to the emergency department with symptoms consistent with a diagnosis of nephrogenic diabetes inspidisu (DI)? (select all) a. hypotension b. hypoglycemia c. breast atrophy d. intolerance to cold e. low vasopressin level

a. hypotension e. low vasopressin level

The nurse identifies that which finding in a patient who is 4 hours posthypophysectomy should be reported to the health care provider immediately? a. increased swallowing b. dry mucous membranes c. blood-tinged nasal drainage d. urine specific gravity of 1.028

a. increased swallowing sign of cerebrospinal fluid leakage

Which symptom is associated with vasopressin hormone deficiency? a. increased thirst b. decreased bone density c. decreased urinary output d. increased urine specific gravity of the urine

a. increased thirst

Which treatment modality would the nurse expect the health care provider to prescribe for a patient with hyperaldosteronism? A. adrenalectomy B. fluid restriction C. glucocorticoids D. fludrocortisone

A. adrenalectomy surgical removal of adrenal gland - performed for patients with hyperaldosteronism

Which laboratory finding is consistent with a patient diagnosed with hyperaldosteronism? (Select all) A. arterial pH 7.48 B. serum sodium 148 mEq/L C. serum calcium 8.9 mg/dL D. serum glucose 358 mg/dL E. serum potassium 5.3 mEq/L

A. arterial pH 7.48 B. serum sodium 148 mEq/L Hyperaldosteronism - alkalotic and hypernatremia

For which reason would the nurse who is caring for a patient with acute adrenal insufficiency place the patient on a telemetry monitor? A. hyperkalemia B. hypocalcemia C. hyponatremia D. hyperphosphatemia

A. hyperkalemia

Which musculoskeletal problem would the nurse expect to find in a patient with Cushing disease? A. striae B. osteoporosis C. osteoarthritis D. rheumatoid arthritis

B. osteoporosis excess cortisol levels deplete calcium from the bones, causing weakness and osteoporosis

Which disorder causes the adrenal cortex to secrete too much cortisol? A. graves disease B. turner syndrome C. cushing disease D. Hashimoto disease

C. cushing disease when the adrenal cortex produces too much cortisol, this can lead to Cushing disease.

Which finding in a patient with syndrome of inappropriate antidiuretic hormone (SIADH) is a priority to report to the health care provider? A. lethargy B. dependent edema C. serum sodium of 115 mEq/L D. intake of 1100mL, output of 1250 mL

C. serum sodium of 115 mEq/L SIADH = increased risk for hyponatremia, can lead to seizures and coma

Which finding does the nurse expect to assess in a patient with deficient growth hormone (GH)? A. weight gain B. intolerance to cold C. decreased body hair D. pathologic fractures

D. pathologic fractures deficiency of GH leads to decreased muscle mass and decreased bone strength which increases the risk for pathologic fractures

Which parameter is elevated in a patient with adrenal insufficiency? A. sodium level B. glucose level C. cortisol level D. potassium level

D. potassium level adrenal insufficiency will have decreased secretion of aldosterone - aids urinary potassium excretion

After reviewing inpatient assignments, the nurse determines that which patient should be assessed first? a. a patient with adrenal gland hypofunction who is experiencing loss of aldosterone b. a patient with adrenal insufficiency who has received a prescription for cortisol c. a patient with Cushing disease who has a sodium level of 147 mEq/dL d. a patient with Conn syndrome who is scheduled for surgery and has a potassium level of 4.0 mEq/L

a. a patient with adrenal gland hypofunction who is experiencing loss of aldosterone

which clinical finding would the nurse expect to find in a patient with Cushing disease? a. acne b. hirsutism c. leukocytosis d. buffalo humo e. vaginal bleeding

a. acne b. hirsutism d. buffalo humo

Which clinical finding would the nurse expect in a patient with reduced aldosterone secretion? a. hyperkalemia b. hypervolemia c. hypernatremia d. hyperglycemia

a. hyperkalemia

The nurse expects a prescription for which medication for a patient with diabetes insipidus secondary to lithium overdose? a. tolvaptan b. prednisone c. desmopressin d. dopamine hydrochloride

c. desmopressin

which hormonal hyperfunctioning can result in truncal obesity? a. growth hormone b. follicle-stimulating hormone c. thyroid-stimulating hormone d. adrenocorticotropic hormone

d. adrenocorticotropic hormone

Which pituitary condition is decreased production of all hormones from the anterior pituitary? A. panhypopituitarism B. pituitary hypofunction C. selective hypopituitarism D. secondary pituitary dysfunction

A. panhypopituitarism panhypopituitarism is an extremely rare condition in which a person has a decreased production of all of the pituitary hormones.

Which serum laboratory finding is most important to monitor in a patient with diabetes insipidus (DI)? A. sodium B. glucose C. potassium D. liver function

A. sodium inability of kidneys to respond to ADH leads to increased sodium levels

Which laboratory test would the nurse expect to be prescribed for a patient who is admitted to the hospital with acute adrenal insufficiency? (Select all) A. sodium B. cortisol C. albumin D. potassium E. liver function

A. sodium B. cortisol D. potassium low sodium, low salivary cortisol levels, low fasting blood glucose, elevated potassium, increased BUN

To allow for appropriate dose adjustments, which medication instruction would the nurse provide to a patient who receives a prescription for oral hydrocortisone to treat adrenal insufficiency? a. report if you experience mood swings b. report if you experience irritability c. report if you have difficulty sleeping d. report if you have an abrupt increase in your body weight

d. report if you have an abrupt increase in your body weight

the nurse provides information to a patient about which condition that may occur when taking demsopressin nasal spray to treat diabetes insipidus? a. anuria b. drowsiness c. weight gain d. sensation of chest tightness

d. sensation of chest tightness

In addition to increased. cortisol levels, the nurse expects which laboratory result in a patient who is suspected to have Cushing disease? a. lymphocyte count of 55% b. blood glucose level of 75 mg/dL c. serum calcium level of 11.2 mg/dL d. serum sodium level of 155 mmol/L

d. serum sodium level of 155 mmol/L

Which instruction about taking divided doses of prednisone would the nurse provide to a patient with adrenal hypofunction? a. take one-third in the morning, afternoon, and night b. take one-third in the morning and two thirds at night c. take half in the morning and half at night d. take two-thirds in the morning and one-third in the later afternoon

d. take two-thirds in the morning and one-third in the later afternoon

which is the nurse's best response when a patient with Cushing disease begins to laugh loudly and inappropriately, causing the family in the room to be uncomfortable? a. medication is available to help with this b. I need to check the patient's cortisol level c. don't mind this. the disease is causing this d. the disease can sometimes affect emotional responses

d. the disease can sometimes affect emotional responses

Which is a common finding of acromegaly? a. acne b. moon face c. fine tremors d. thickened lips

d. thickened lips

Which medication teaching does the nurse provide for a patient who is prescribed nasal spray desmopressin for diabetes insipidus? a. maintain a fluid intake of 4L/day when taking the drug b. maintain a record of weekly weight gain or loss c. sit upright and breathe deeply when inhaling the drug d. ulceration of the mucous membranes may occur with intranasal use

d. ulceration of the mucous membranes may occur with intranasal use

The nurse instructs a patient who is taking fludrocortisone for adrenal hypofunction to report which symptom to the health care provider? a. anxiety b. nausea c. insomnia d. weight gain

d. weight gain

How does the drug desmopressin decrease urine output in a patient with diabetes insipidus (DI)? a. increases cardiac output b. increases blood pressure c. blocks reabsorption of sodium d. works as an antidiuretic hormone (ADH) in the kidneys

d. works as an antidiuretic hormone (ADH) in the kidneys

When the nurse is planning care for a patient diagnosed with acute adrenal insufficiency, which hormone deficit will guide the interventions? (Select all) A. cortisol B. prolactin C. androgen D. aldosterone E. growth hormone

A. cortisol D. aldosterone patient with acute adrenal insufficiency will have severe deficits of cortisol and aldosterone.

Which electrolyte imbalance is the most common in the patient with diabetes insipidus (DI)? A. increased serum sodium B. decreased serum sodium C. increased serum potassium D. decreased serum potassium

A. increased serum sodium DI is a water loss problem caused by either an antidiuretic hormone (ADH) deficiency or an inability of the kidneys to respond to ADH - result is the excretion of large volumes of dilute urine because the distal kidney tubules and collecting ducts do not reabsorb water

A patient suspected of having Cushing disease is scheduled for dexamethasone suppression testing. Which statement by the patient indicates the need for further teaching? A. my blood will be drawn over 3 days B. for 24 hours, my urine will be collected C. this test will show whether i have high cortisol levels D. i will be given set doses of dexamethasone

A. my blood will be drawn over 3 days patient will not have blood drawn. 24-hour urine collection follows drug admin. dexamethasone suppression testing can screen for hypercortisolism and may take place overnight or over 3-day period. Set doses of dexamethasone are given

Which intervention would the nurse delegate to the assistive personnel (AP) when caring for a patient who is hospitalized with suspected Cushing disease? A. assess skin turgor and mucous membranes for hydration status B. discuss dietary restrictions needed for 24-hour urine testing C. plan ways to control the environment to avoid stimulating the patient D. remind the patient to avoid drinking coffee and changing positions suddenly

D. remind the patient to avoid drinking coffee and changing positions suddenly drinking caffeinated beverages and changing position suddenly are not safe for a patient with a potential adrenal gland tumor because of the effects of catecholamines

Which medication is contraindicated for a patient diagnosed with acute adrenal insufficiency and hyperkalemia? a. furosemide b. spironolactone c. insulin with dextrose d. sodium polystyrene sulfonate

b. spironolactone

Which manifestation would the nurse anticipate finding in a patient diagnosed with Cushing disease? a. acne b. moon face c. weight loss d. hypotension e. hyperglycemia f. elevated cortisol level

a. acne b. moon face e. hyperglycemia f. elevated cortisol level

Which discharge medication instruction would the nurse provide to a patient who receives a prescription for an exogenous glucocorticoid to treat hypercortisolism? (select all) a. adhere to the drug regimen b. use proper hygiene and avoid crowds c. monitor body weight once a week d. report a weight gain of more than 5 lb in a week e. receive an influenza vaccination

a. adhere to the drug regimen b. use proper hygiene and avoid crowds e. receive an influenza vaccination

which manifestation does the nurse anticipate finding in a female patient diagnosed with deficient gonadotropins? a. anovulation b. menorrhagia c. breast atrophy d. decreased libido e. high estrogen levels

a. anovulation c. breast atrophy d. decreased libido

Which intervention would the nurse delegate to the assistive personnel (AP) who if providing care to a patient with Cushing disease? a. assist with personal hygiene and skin care b. monitor for signs and symptoms of fluid retention c. develop a plan of care to minimize the risk for infection d. instruct the patient on the reasons to avoid overeating

a. assist with personal hygiene and skin care

The nurse monitors for which indication of fluid overload in the patient with syndrome of inappropriate antidiuretic hormone (SIADH) who is receiving IV hypertonic solution? a. crackles in the lungs b. increased urine output c. absence of peripheral edema d. absence of neurologic changes

a. crackles in the lungs

The nurse asks about which history when evaluating a female patient with a suspected diagnosis of adrenal hypofunction? a. menstrual changes related to weight loss b. radiation to the abdomen or head c. salt intake d. anorexia e. anticoagulant therapy f. change in activity level

a. menstrual changes related to weight loss b. radiation to the abdomen or head c. salt intake d. anorexia e. anticoagulant therapy f. change in activity level

Which nursing intervention is appropriate for a patient diagnosed with adrenal hypofunction? (select all) a. monitor BUN levels b. monitor hematocrit levels c. administer steroid therapy d. place the patient on salt restrictions e. administer a potassium replacement

a. monitor BUN levels b. monitor hematocrit levels c. administer steroid therapy

Which instruction would the nurse include when providing medication education for a patient with adrenal insufficiency who receives a prescription for cortisol replacement? (select all) a. take the medication twice per day b. monitor weight daily c. decrease the dose if feeling ill d. anticipate hypotension, which is a side effect of the medication e. take the medication with food

a. take the medication twice per day b. monitor weight daily e. take the medication with food

Which is a nursing priority for a patient with a diagnosis of Cushing disease who has been hospitalized? a. treating fluid overload b. preventing complications c. monitoring for signs of infection d. providing support regarding body image

a. treating fluid overload

Which information about GI tube care in patients with syndrome of inappropriate antidiuretic hormone (SIADH) does the nurse include in education given to nursing students? a. use saline instead of water to give drugs through the tube b. dilute tube feeding with plain water c. irrigate the tube with lukewarm water d. flush the tube after each use with hypertonic saline

a. use saline instead of water to give drugs through the tube

Which manifestation does the nurse expect to find in a female patient with gonadotropin deficiency? (select all) a. anorexia b. amenorrhea c. breast atrophy d. pale, sallow complexion e. decreased axillary hair

b. amenorrhea c. breast atrophy e. decreased axillary hair

The nurse expects to find which intervention in a plan of care for a patient with diabetes insipidus (DI)? (Select all) a. check urine for ketones b. assess mucous membranes c. implement seizure precautions d. monitor blood glucose every hour e. perform strict urinary intake and output assessment

b. assess mucous membranes e. perform strict urinary intake and output assessment

Which is an important nursing assessment when caring for a patient who is receiving fludrocortison to treat adrenal hypofunction? a. bowel function b. blood pressure c. pupillary reaction d. deep tendon reflexes

b. blood pressure major side effect of fludrocortison - hypertension

The nurse monitors for which condition in a patient with adrenal gland hypofunction? a. HTN b. hyperkalemia c. hyperglycemia d. hypernarema

b. hyperkalemia

Which intervention is a priority for a patient who presents with symptoms of acute adrenal insufficiency and vital signs that include a pulse of 118 beats/min; respiratory rate of 18 breaths/min; blood pressure 84/44 mm Hg; pulse oximetry of 98%; and a temperature of 98.8°F (37.1°C) oral? a. restricting sodium b. starting a rapid infusion of normal saline c. administering furosemide d. replacing potassium loss

b. starting a rapid infusion of normal saline

Which nursing intervention is a priority for a male patient diagnosed with gonadotropin deficiency who is experiencing body image disturbance? a. refer the patient to a psychologist b. teaching the patient about testosterone therapy c. provide the patient information about penile implants d. encourage the patient to engage in daily exercise with weight training

b. teaching the patient about testosterone therapy

After providing education for a patient with acromegaly who is beginning bromocriptine therapy, the nurse identifies that which statement by the patient indicates the need for further teaching? a. the medication has a side effect of headaches b. the medication should help my lips return to normal size c. i should take the medicine with food d. i will need to change positions slowly

b. the medication should help my lips return to normal size

When a patient with syndrome of inappropriate antidiuretic hormone (SIADH) reports a 3.3 lb (1.5 kg) increase in weight in 1 day, the nurse calculates which amount of fluid retention in the patient? a. 500 mL b. 1000 mL c. 1500 mL d. 2000 mL

c. 1500 mL 1/2 kg = 500 mL 500mL x. 1.5kg = 1500 mL

Which imaging assessment can identify abnormalities of of the sella turcica in a patient with pituitary problems, including enlargement, erosion, and calcification? a. skull x-ray b. angiogram c. CT d. venous ultrasound (US)

c. CT

After educating a patient with hypercortisolism about preventing injury, the nurse identifies that which patient statement indicates effective understanding? a. I can have coffee every day b. I can safely use aspirin for pain c. I should eat a diet rich in calcium d. I should not take antacids

c. I should eat a diet rich in calcium

A patient diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH) has received education about the diagnoses. Which statement by the patient indicates an understanding of the teaching provided? a. I should restrict sodium intake in my diet. b. I will need to increase the amount of fluid I drink c. I will need to urinate more while I am taking conivaptan d. I will need to change positions slowly to avoid getting light-headed

c. I will need to urinate more while I am taking conivaptan

The nurse expects that which medication will be prescribed for a patient whose assessment finding include increased thirst, poor skin turgor, tachycardia, and urine output in 24 hours that is 4.5 L greater than the volume of fluid ingested? a. octreotide b. pegvisomant c. desmopressin d. bromocriptine

c. desmopressin

Hyperfunction of which anterior pituitary hormone can cause sleep apnea? a. prolactin (PRL) b. thyrotopin (thyroid-stimulating hormone [TSH]) c. growth hormone (GH) d. adrenocorticotropic hormone (ACTH)

c. growth hormone (GH)

The nurse suspects an addisonian crisis when a patient presents to the emergency department with hypertension, fatigue, and a 3-day history of weight loss and vomiting. Which is a priority nursing question? a. have you had any cravings for salt b. have you been told that you have low calcium? c. have you recently been on steroids or pain meds d. have you ever been diagnosed with excess cortisol production

c. have you recently been on steroids or pain meds

Which finding would the nurse expect to see in a patient with hyperaldosteronism? a. hypotension b. hyperkalemia c. hypernatremia d. metabolic acidosis

c. hypernatremia

Which type of cortisol response would the nurse expect when a patient with secondary adrenal insufficiency undergoes an adrenocorticotropic hormone (ATCH) stimulation test? a. absent b. normal c. increased d. decreased

c. increased ACTH stimulation test involves administering ATCH IV to patient, and plasma cortisol levels are obtained at 30-min and 1-hr intervals

After providing a patient with discharge education about drug therapy and treatment for diabetes insipidus (DI), the nurse identifies that which statement by the patient indicates effective teaching? a. I will need to decrease the amount of fluid I drink b. I should increase my sodium intake to avoid seizures c. It is important to take my conivaptan at the same time every day d. I will need to weigh myself every day

d. I will need to weigh myself every day

The nurse is assigned four patients and determines that which patient should be assessed first? a. a patient diagnosed with hypercortisolism who just returned from a CT scan b. a patient diagnosed with Cushing disease who is scheduled to take prescribed metyrapone c. a patient diagnosed with hyperaldosteronism with a blood pressure of 154/90 mm Hg and muscle weakness d. a patient diagnosed with adrenal insufficiency with a potassium level of 6.0 mEq/L and a sodium level of 127 mEq/L

d. a patient diagnosed with adrenal insufficiency with a potassium level of 6.0 mEq/L and a sodium level of 127 mEq/L

After reviewing inpatient assignments, the nurse determines that which patient should be assessed first? a. a patient with hyperaldosteronism who is eating pizza b. a patient with adrenal insufficiency who reports muscle weakness and fatigue c. a patient with suspected Cushing disease who completed dexamethasone suppression testing d. a patient with Cushing disease who just returned to the unit after a bilateral adrenalecomy

d. a patient with Cushing disease who just returned to the unit after a bilateral adrenalecomy

After reviewing the patient assignment, the nurse determines that which patient should be assessed first? a. a patient with diabetes insipidus who is experiencing polyuria b. a patient with DI with a pulse of 102 beats/min and BP of 100/62 mm Hg c. a patient with syndrome of inappropriate antidiuretic hormone whose serum sodium is 132 mEq/L d. a patient with syndrome of inappropriate antidiuretic hormone with an intake of 1000 mL and an output of 700 mL

d. a patient with syndrome of inappropriate antidiuretic hormone with an intake of 1000 mL and an output of 700 mL

Which prescribed intervention does the nurse perform first when caring for a patient with syndrome of inappropriate antidiuretic hormone (SIADH) whose serum sodium level is 105 mEq/L? a. draw blood specimens to assess hemoglobin and hematocrit levels b. insert an indwelling urinary catheter and monitor urine output c. weight the patient on admission and daily thereafter d. administer an infusion of 150 mL of 3% sodium chloride (NaCl) over 3 hours

d. administer an infusion of 150 mL of 3% sodium chloride (NaCl) over 3 hours

The nurse suspects which condition in a patient whose laboratory results include a urinary specific gravity of 1.001, osmolarity of 60 mOsm/kg, and a decrease in antidiuretic hormone (ADH) levels? a. myxedema b. thyrotoxicosis c. graves disease d. diabetes insipidus (DI)

d. diabetes insipidus (DI) DI: - specific gravity less than 1.005 - osmolarity reduced from 50 - 200 mOsm/kg

Which is a cause of growth hormone (GH) deficiency? a. increased serum cholesterol levels b. increased production of somatomedins c. overgrowth of tissues of the pituitary gland d. failure of tissues to respond to somatomedins

d. failure of tissues to respond to somatomedins GH stimulates liver to produce somatomedins, which enhances growth activities in cells and tissues.

The nurse expects which intervention on a postoperative plan of care for a patient who has undergone a hypophysectomy? a. have the patient lie flat after surgery b. monitor neurologic status every 4 hours c. discard and replace the nasal drip pad at regular intervals d. have the patient avoid brushing teeth for 2 weeks after surgery

d. have the patient avoid brushing teeth for 2 weeks after surgery

Which factor is the most common cause of Sheehan syndrome? a. shock b. osteoporosis c. severe malnutrition d. postpartum hemorrhage

d. postpartum hemorrhage most common cause of sheehan syndrome. results in pituitary infarction and ischemia, leads to decreased hormone secretion