Med Surg 2 - Endocrine System
The physician has ordered an outpatient dexamethasone suppression test to diagnose the cause of Cushing syndrome in a patient who works at night from 11:00 pm to 7:00 am and normally sleeps from 8:00 am to 4:00 pm. The patient has been given the dexamethasone; to ensure the most reliable test results, the nurse arranges for the plasma cortisol level to be drawn at which of the following times? a) 5:00 pm b) 8:00 pm c) 8:00 am d) 12:00 pm
A. An overnight dexamethasone suppression test is used to diagnosis pituitary and adrenal causes of Cushing syndrome. It can be performed on an outpatient basis. Dexamethasone is administered orally late in the evening or at bedtime, and a plasma cortisol level is obtained at 8 am the next morning. However, in a patient who sleeps during the day, the medication would be given before bed and the plasma level would be drawn soon after awakening in the late afternoon.
A nurse is reviewing the laboratory findings of a client who has cushing's disease. Which of the following findings are expected for this client? (Select all that apply). A. Sodium 150 mEq/L B. Potassium 3.3 mEq/L C. Calcium 8.0 mg/dL D. Lymphocyte count 35% E. Fasting glucose 145 mg/dL
A. CORRECT: Hypernatremia is an expected finding for clients who have Cushing's disease. B. CORRECT: Hypokalemia is an expected finding for clients who have Cushing's disease. C. CORRECT: Hypocalcemia is an expected finding for clients who have Cushing's disease D. INCORRECT: A decreased lymphocyte count is an expected finding for clients who have Cushing's disease. E. CORRECT: Clients who have Cushing's disease have an elevated fasting glucose because glucose metabolism is affected.
A nurse is reviewing serum laboratory results for a client who has Addison's disease. Which of the following findings are typical for a client who has this condition? (select all that apply.) A. Sodium 130 mEq/L B. Potassium 6.1 mEq/L C. Calcium 11.6 mg/dL D. Magnesium 2.5/dL E. Glucose 65 mg/dL
A. CORRECT: In the presence of Addison's disease, insufficient glucose can cause sodium and water excretion. Therefore, this is an expected finding. B CORRECT: Hyperkalemia is an expected finding for a client who has Addison's disease. C. CORRECT: Hypercalcemia is an expected finding for a client who has Addison's disease. D. INCORRECT: Although this finding is above the expected reference range, it is not an expected finding for a client who has Addison's disease. E. CORRECT: This finding is below the expected reference range. Hypoglycemia is an expected finding for a client who has Addison's disease.
A nurse in a provider's office is assisting with the plan of care for a client of care for a client who has a new diagnosis of Grave' disease and a new prescription for methimazole (Tapazole). Which of the following should the nurse include in the plan of care? (Select all that apply). A. Monitor CBC B. Monitor triiodothyronine (T3) C. Inform the client that the medication at the same time every day. D. Advise the client to take the medication at the same time every day. E. Inform the client that an adverse effect of this medication is iodine toxicity.
A. CORRECT: Methimazole can cause a number of hematologic effects, including leukopenia and thrombocytopenia. The nurse should monitor the client's CBC. B. CORRECT: MEthimazole reduces thyroid hormone production. The nurse should monitor the client's T3 C. INCORRECT: Methimazole can be prescribed for the client who has Graves' disease for 1 to 2 years. D. CORRECT: Methimazole should be taken at the same time every day to maintain blood levels. E. INCORRECT: Iodine toxicity is an adverse effect of Lugol's solution.
A nurse is reviewing the laboratory findings of a client who has suspected hyperthyroidism. An elevation of which of the following supports this diagnosis? A. Triiodothyronine (T3) B. Vanillylmandelic (VMA) C. Adrenocorticoticotropic hormone (ACTH) D. Catecholamines
A. CORRECT: T3 increases in a hyperthyroid state. B. INCORRECT: VMA is used to detect pheochromocytoma and reflects the amount of catecholamine byproducts. C.INCORRECT: ACTH is used to detect Cushing's disease. D. INCORRECT: Catecholamines are measured following clonidine (Catapres) administration to diagnose pheocromocytoma.
A nurse is preparing to receive a client from the PACU who is postoperative following a thyroidectomy. The nurse should ensure that which of the following equipment is available? (Select all that apply.) A. Suction equipment B. Humidified air C. Flashlight D. Tracheostomy tray E. Oxygen delivery equipment
A. CORRECT: The client can require oral or tracheal suctioning. The nurse should ensure that this equipment is available. B. CORRECT: Humidified air thins secretions and promotes respiratory exchange. This equipment should be available. C. INCORRECT: A flashlight is used to measure the reaction of the pupils to light for a client who has an intracranial disorder. D. CORRECT: The client can experience respiratory obstruction. E. CORRECT: The client can require supplemental oxygen due to respiratory complication. This equipment should be availiable
A client is suspected of having a disorder of the adrenal medulla. The provider has ordered a vanillylmandelic acid (VMA) test. Which of the following are appropriated reinforcements by the nurse? A. "You will need to collect your urine for 24 hours." B. "Be sure to drink 8 ounces of water before your first void." C. "Minimize your activity during the test." D. "Avoid bananas and chocolate 2 days before the test." E. "Don't take your antihypertensive medication during the test."
A. CORRECT: VMA testing includes 24 hr urine collection. B. INCORRECT: Clients can consume fluids at their own discretion. C. INCORRECT: VMA testing does not restrict the client's activity. D. CORRECT: Bananas, caffeine, vanilla, and chocolate should be avoided 2 to 3 days prior to testing. E. CORRECT: Antihypertensives should be discontinued during testing.
A nurse in a provider's office is reviewing the laboratory findings of a client who is being evaluated for primary hypothyroidism. Which of the following laboratory findings is indicative of this condition? A. Serum t4 10 mcg/dL B. Serum t3 200 ng/dL C. Hematocrit 34% D. Serum cholesterol 180 mg/dL
A. INCORRECT: A serum t4 of 10 mcg/dL is within the expected reference range. A decreased serum t4 is an expected finding for a client who has hypothyroidism B. INCORRECT: Serum T3 of 200 ng/mL is within the expected reference range. A decreased serum t3 is an expected finding for a client who has hyopthyroidism C. CORRECT: Hematocrit of 34% indicates anemia, which is an expected result for a client who has hyopthyroidism. D. INCORRECT: Serum cholesterol of 180 mg/dL is within the expected reference range. An elevated serum cholesterol is an expected finding for a client who has hypothyroidism.
A client asks a nurse why the provider bases his medication regimen on his HbA1c instead of his log of morning fasting blood glucose results. Which of the following is an appropriate response by the nurse? A."HbA1c measures how well insulin is regulation you blood glucose between meals." B."HbA1c indicates how well your blood glucose has been regulated over the past three months." C."A test of HbA1c is the first test to determine if an individual has diabetes D."A test of HbA1c determines if the dosage of insulin needs to be adjusted."
A. INCORRECT: Capillary glucose monitoring evaluates how well insulin is regulating blood glucose between meals. B. CORRECT: HbA1c measures blood glucose control over the past 2 to 3 months. C. INCORRECT: A fasting blood glucose is the first test performed to diagnose diabetes mellitus. D. INCORRECT: Capillary glucose monitoring evaluates how well insulin regulates blood glucose.
A nurse is in a long-term care facility is assisting with the plan of care for a client who has hypothyroidism. Which of the following should the nurse recommend for the client's plan of care? (Select all that apply.) A. Apply heating pad to lower legs to provide warmth. B. Provide rest periods throughout the day. C. Provide a high calorie diet. D. Elevate the client's legs when in chair. E. Apply emollient lotion to the client's skin after bathing.
A. INCORRECT: Clinical manifestations of hypothyroidism include vasodilation, decreased sensation, and decreased alertness. The nurse should avoid the use of electric heating devices because it places the client at risk for burns. B. CORRECT: A clinical manifestation of hypothyroidism is fatigue. The nurse should plan to provide rest periods throughout the day. C. INCORRECT: Weight gain is a clinical manifestation of hypothyroidism. The nurse should provide the client with a low-calorie diet. D. CORRECT: A clinical manifestation of hypothyroidism is edema. The nurse should elevate the client's legs when he is sitting in a chair to promote venous return E. CORRECT: Dry skin is a clinical manifestation of hypothyroidism. The nurse should apply an alcohol-free lotion emollient lotion to the client's skin after bathing.
A nurse is reinforcing teaching with a client who is scheduled for a phentolamine blocking test. This test supports a diagnosis of which of the following disorders? A. Addison's disease B. diabetes mellitus C. Cushing's disease D. Pheochromocytoma
A. INCORRECT: Evaluation of plasma cortisol is used to identify addison's disease. B. INCORRECT: A fasting blood glucose is used to identify diabetes mellitus. C. INCORRECT: an dexamethoasone suprresion test is used to identify Cushing's syndrome. CORRECT: Phentolamine, an alpha blocker, is administered and decreases blood pressure when pheochromocytoma is present.
A nurse in a provider's office is reviewing the health record of a client who is being evaluated for Graves' disease. Which of the following is an expected laboratory finding for this client? A. Decreased thyrotropin antibodies B. Decreased thyroid stimulating hormone C. Decreased free thyroxine index D. Decreased triiodothyronine
A. INCORRECT: In the presence of Graves' disease, elevated thyrotropin receptor antibodies is an expected finding. B. CORRECT: In the presence of Graves' disease, low thyroid stimulating hormone (TSH), is an expected finding. The pituitary gland decreases the production of TSH when thyroid hormone levels are elevated. C. INCORRECT: In the presence of Graves' disease, elevated free thyroxine index is an expected finding. D. INCORRECT: In the presence of GRAVE's disease, elevated triodothyronine is an expected finding.
A nurse is reinforcing teaching with a client who has been prescribed levothyroxine (Synthroid) to treat hypothyroidism. Which of the following should the nurse include in the teaching? (Select all that apply). A. Weight gain is expected while taking this medication B. Medication should not be discontinued without the advice of the provider. C. Follow-up serum TSH levels should be obtained. D. Take the medication on an empty stomach. E. Use fiber laxatives for constipation
A. INCORRECT: Levothyroxine speeds up metabolism. Therefore, weight loss is an expected effect. B. CORRECT: The provider carefully titrates the dosage of this medication. It should be increased slowly until the client reaches an euthyroid state. The client should not discontinue the medication unless directed to do so by the provider. C. CORRECT: Serum TSH levels are used to measure the effectiveness of the medication. D. CORRECT: Serum TSH levels are used to measure the effectiveness of the medication E. INCORRECT: Fiber laxatives reduce absorption of the medication and should be avoided.
A nurse is reviewing the clinical manifestations of hyperthyroidism with a client. Which of the following findings should the nurse include? (Select all that apply) A. Dry skin B. Heat intolerance C. Constipation D. Palpitations E Weight loss F. Bradycardia
A. INCORRECT: Moist skin is an expected finding for the client who has hyperthyroidism. B. CORRECT: HYperthyroidism increases the client's metabolism. Heat intolerance is an expected finding. C. INCORRECT: Diarrhea is an expected finding for the client who has hyperthyroidism. D. CORRECTl Hyperthroidism increases the client's metabolism. Weight loss is an expected finding for the client who has hyperthyroidism. E. CORRECT: Hyperthyroidism increases the client's metabolism. Weight loss is an expected finding for the client who has hyperthyroidism. F. INCORRECT: Hyperthyroidism increases the client's metabolism. Tachycardia is an expected finding for the client who has hyperthyroidism.
A nurse is planning to teach a client who is being evaluated for Addison's disease about the adrenocorticotropic hormone (ACTH) stimulation test. The nurse should base her instructions to the client on which of the following? A. The ACTH stimulation test measures the response by the kidneys to ACTH. B. In the presence of primary adrenal insufficiency, plasma cortisol levels rise in response to administration of ACTH. C. ACTH is a hormone produced by the pituaitary gland. D. The client is instructed to take a dose of ACTH by mouth the evening before the test.
A. INCORRECT: The ACTH stimulation test measures the response by the adrenal glands to ACTH. B. INCORRECT: In the presence of primary adrenal insufficiency, plasma cortisol levels do not rise in response to administration of ACTH. C. CORRECT: Secretion of corticotropin-releasing hormone from the hypothalamus prompts the pituitary gland to secrete ACTH. D. INCORRECT: ACTH is administered IV during the testing process, and plasma cortisol levels are measured 30 min and 1 hr after the injection
A nurse is reinforcing discharge instructions to a client who had a transsphenoidal hypophysectoemy. Which of the following instructions should the nurse include? (Select all that apply). A. Brush teeth after every meal or snack. B. Avoid bending at the knees. C. Eat a high-fiber diet. D. Notify the provider of any sweet-tasting drainage. E. Notify the provider if he has diminished sense of smell.
A. INCORRECT: The client should avoid brushing his teeth for 2 weeks to allow time for the incision to heal. B. INCORRECT: The client should avoid bending at the waist. If bending is necessary, he should bend at the knees. C. CORRECT: To avoid constipation, which contributes to increased intracranial pressure, the client should eat a high-fiber diet. Docusate sodium (Colace) can be used to prevent constipation. D. CORRECT: Sweet tasting fluid is an indication of a cerebral spinal fluid leak. The client should notify the provider. E. INCORRECT: Diminshed sense of smell is an expected finding after the surgery.
A nurse is caring for a client who is 36 hr postoperative following a tanssphenoidal hypophysectomy. The nurse should test the client's nasal drainage for the presence of which of the following? A. RBCs B. Ketones C. Glucose D. Streptococcus
A. INCORRECT: The nurse should not test for the presence of RBC as an indication of cerebral spinal fluid leak. B. INCORRECT: The nurse should not test for the presence of Ketones as an indication of cerebral spinal fluid leak. C. CORRECT: Cerebral spinal fluid contains glucose. Therefore, the nurse should test nasal drainage for glucose to determine whether the nasal drainage contains glucose D. INCORRECT: The nurse should not test for the presence of streptococcus as an indication of cerebral spinal fluid leak
A nurse is collecting data on a client who is 12 hr postoperative following a thyroidectomy. Which of the following findings are indicated of thyroid crisis? (Select all that apply.) A. Bradycardia B. Hypothermia C. Tremors D. Abdominal pain E. Mental confusion
A. INCORRECT: When thyroid crisis occurs, the client experiences an extreme rise in metabolic rate, which results in tachycardia. B. INCORRECT: When thyroid crisis occurs, the client experiences an extreme rise in metabolic rate, which results in a high fever. C. CORRECT: Excessive levels of thyroid hormone can cause the client to experience tremors. D. CORRECT: When thyroid crisis occurs, the client can experience gastrointestinal conditions, such as vomiting. diarrhea, and abdominal pain. E. CORRECT: Excessive thyroid hormone levels can cause the client to experience mental confusion
A nurse is providing instructions to a client who has Graves' disease and has a new prescription for propranolol (Inderal). Which of the following information should the nurse include? A. An adverse effect of this medication is jaundice. B. Take your pulse before each dose. C. The purpose of this medication is to decrease production of thyroid hormone. D. You should stop taking this medication if you have a sore throat.
A. INCORRECT: Yellowing of the skin is an adverse effect of methimazole. B. CORRECT: Propranolol can cause bradycardia. The client should take his pulse before each dose. If there is a significant change, he should withhold the dose and consult his provider. C. INCORRECT: The purpose of this medication is to suppress tachycardia, diaphoresis, and other effects of Graves' disease. D. INCORRECT: sore throat is not an adverse effect of this medication. THe client should not discontinue taking this medication because this action can result in tachycardia and dysrhythias.
Long-term use of antithyroid medication is not generally recommended for elderly patients because of which of the following events? a) Agranulocytosis and hepatic injury b) Renal disease and mental confusion c) GI complications and weight loss d) Cardiac arrhythmias and fatigue
A. Long-term use of certain antithyroid medications, such as propylthiouracil (PTU), is not recommended for treatment of toxic nodular goiter in older patients due to the risk of side effects. Although rare, there is evidence that PTU can result in agranulocytosis and hepatic injury. However, use of antithyroid medications versus radioactive iodine or surgery may be the patient's preferred choice or the option for some older patients and other ill persons with "limited longevity" who can be monitored at least every 3 months.
When teaching a patient diagnosed with hypothyroidism regarding medical intervention, which of the following is important to communicate? a) Thyroid hormone (TH) may increase the effect of digitalis preparation. b) Increased resorption occurs with thyroid hormone (TH). c) Thyroid hormone (TH) may decrease blood glucose levels. d) The normal dosages of sedative agents are prescribed.
A. Thyroid hormones may increase the pharmacologic effect of digitalis glycosides, anticoagulant agents, and indomethacin, necessitating careful observation and assessment by the nurse for side effects.
A nurse is caring for a patient suspected of having a pituitary tumor causing panhypopituitarism. During assessment of the patient, which of the following clinical manifestations would the nurse expect to find? a) Atrophy of the gonads b) Carpopedal spasm c) Hypertension d) Tachycardia
A. Undersecretion (hyposecretion) commonly involves all of the anterior pituitary hormones and is termed panhypopituitarism. In this condition, the thyroid gland, the adrenal cortex, and the gonads atrophy (shrink) because of loss of the tropic-stimulating hormones.
Following a thyroidectomy, a patient develops a carpopedal spasm while the nurse is taking a BP reading on the left arm. Which of the following actions by the nurse is appropriate? a) Administer the IV calcium gluconate ordered. b) Administer the oral calcium supplement ordered. c) Administer the sedative ordered. d) Start administration of oxygen at 2 L/min per cannula.
A. When hypocalcemia and tetany occur after a thyroidectomy, the immediate treatment is administration of IV calcium gluconate. If this does not decrease neuromuscular irritability and seizure activity immediately, sedative agents such as pentobarbital may be administered.
While recording the health history of a patient who is scheduled for a thyroid test, the nurse is informed by the patient about an allergy to shellfish. What is the nurse's most appropriate response? a) Document the allergy and inform the physician. b) Inquire about frequent urination. c) Consult the institution's procedure manual. d) Palpate the thyroid gland.
A. When thyroid tests are scheduled, it is necessary to determine whether the patient is allergic to iodine (shellfish) and whether the patient has taken medications or agents that contain iodine, as these may alter the test results. This information should be documented in the patient's medical record and in the laboratory requisition.
During an assessment of a patient's functional health pattern, which question by the nurse directly addresses the patient's thyroid function? a) "Do you experience fatigue even if you have slept a long time?" b) "Can you describe the amount of stress in your life?" c) "Have you experienced any headaches or sinus problems?" d) "Do you have to get up at night to empty your bladder?"
A. With the diagnosis of hypothyroidism, extreme fatigue makes it difficult for the person to complete a full day's work or participate in usual activities.
Which of the following is indicative of a carpopedal spasm in a patient with hypoparathyroidism? a) Cardiac dysrhythmia b) Hand flexing inward c) Moon face and buffalo hump d) Bulging forehead
B. Carpopedal spasm is evidenced by flexion of the elbows and wrists and extension of the carpophalangeal joints and dorsiflexion of the feet.
Which of the following is a clinical manifestation of diabetes insipidus? a) Weight gain b) Excessive thirst c) Low urine output d) Excessive activities
B. Diabetes insipidus (DI), the most common disorder of the posterior lobe of the pituitary gland, is characterized by a deficiency of antidiuretic hormone (ADH) (vasopressin). Excessive thirst (polydipsia) and large volumes of dilute urine characterize the disorder. Urine output may be as high as 20 L in 24 hours. Thirst is excessive and constant. Activities are limited by the frequent need to drink and void. Weight loss develops.
Which of the following may occur in the postoperative period of an adrenalectomy because of sudden withdraw of excessive amounts of catecholamines? a) Hyporeflexia b) Hypoglycemia c) Hyperglycemia d) Hypertension
B. Hypotension and hypoglycemia may occur in the postoperative period because of the sudden withdrawal of excessive amounts of catecholamines.
Which medication is the treatment of choice for patients with hyperthyroidism who become pregnant? a) Methimazole (MMI) b) Propylthiouracil (PTU) c) Potassium iodide d) Supersaturated potassium iodide (SSKI)
B. PTU is recommended during the first trimester of pregnancy rather than MMI due to the teratogenic effects of MMI. Due to the risk of hepatotoxicity, PTU should be discontinued after the first trimester and the patient should be switched to MMI for the remainder of the pregnancy and when nursing.
The nurse is completing discharge teaching with a patient with hyperthyroidism who has been treated with radioactive iodine (RAI) at an outpatient clinic. The nurse instructs the patient to do which of the following? a) Discontinue all antithyroid medications. b) Monitor for symptoms of hypothyroidism. c) Continue radioactive precautions with all body secretions. d) Watch for symptoms of hyperthyroidism to disappear within 1 week.
B. Symptoms of hyperthyroidism may later be followed by those of hypothyroidism and myxedema. Hypothyroidism also commonly occurs in patients with previous hyperthyroidism who have been treated with radioiodine or antithyroid medications or thyroidectomy (surgical removal of all or part of the thyroid gland).
A patient with a traumatic brain injury is producing an abnormally large volume of dilute urine. Which alteration to a hormone secreted by the posterior pituitary would the nurse expect to find? a) An increase in antidiuretic hormone b) A deficient production of vasopressin c) A deficient amount of somatostatin d) An increase in oxytocin
B. The most common disorder related to posterior lobe dysfunction is diabetes insipidus, a condition in which abnormally large volumes of dilute urine are excreted as a result of deficient production of vasopressin. Diabetes insipidus may occur following surgical treatment of a brain tumor, secondary to nonsurgical brain tumors, and traumatic brain injury.
Which of the following disorders is characterized by a group of symptoms produced by an excess of free circulating cortisol from the adrenal cortex? a) Hashimoto's disease b) Cushing syndrome c) Addison's disease d) Graves' disease
B. The patient with Cushing syndrome demonstrates truncal obesity, moon face, acne, abdominal striae, and hypertension. Regardless of the cause, the normal feedback mechanisms that control the function of the adrenal cortex become ineffective, and the usual diurnal pattern of cortisol is lost. The signs and symptoms of Cushing syndrome are primarily a result of the oversecretion of glucocorticoids and androgens, although mineralocorticoid secretion also may be affected.
A patient who is being tested for syndrome of inappropriate antidiuretic hormone (SIADH) secretion asks the nurse to explain the diagnosis. The nurse explains that there is an excessive secretion of antidiuretic hormone (ADH) from which of the following glands? a) Thyroid b) Anterior pituitary c) Posterior pituitary d) Adrenal
C. Antidiuretic hormone is secreted by the posterior pituitary gland.
Which of the following symptoms of thyroid disease is seen in older adults? a) Weight gain b) Hyperactivity c) Atrial fibrillation d) Restlessness
C. Symptoms of thyroid disease seen in older adults include sinus tachycardia or dysrhythmias, increased pulse pressure, and palpitations. Atrial fibrillation occurs in 15% of older adult patients with new onset hyperthyroidism. These changes may be related to increased sensitivity to catecholamines or to changes in neurotransmitter turnover. Older adults may not experience restlessness or hyperactivity.
A patient with hyperthyroidism is concerned about changes in appearance. How can the nurse convey an understanding of the patient's concern and promote effective coping strategies? a) Refer the patient to professional counseling. b) Suggest that the patient wear cosmetics to cover any changes in appearance. c) Reassure the patient that emotional reactions are a result of the disorder and symptoms can be controlled with effective treatment. d) Encourage the patient to participate in outside activities to boost coping strategies.
C. The patient with hyperthyroidism needs reassurance that the emotional reactions being experienced are a result of the disorder and that with effective treatment those symptoms will be controlled. It is important to use a calm, unhurried approach with the patient. Stressful experiences should be minimized and a quiet uncluttered environment should be maintained. The nurse encourages relaxing activities that will not overstimulate the patient. It is important to balance periods of activity with rest.
The typical triad of manifestations seen in a patient diagnosed with pheochromocytoma includes all of the following except which of the following? a) Diaphoresis b) Palpitations c) Hypotension d) Headache
C. The typical triad of symptoms seen in patients diagnosed with pheochromocytoma is headache, diaphoresis, and palpitations.
A nurse is reviewing the health record of a client who has syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following laboratory findings should the nurse anticipate? (Select all that apply.) A. Low serum sodium B. High serum potassium C. Decreased urine osmolality D. High urine sodium E. Increased urine-specific gravity
CORRECT: SIADH results in water retention, causing a low serum sodium level. INCORRECT: SIADH does not affect serum potassium levels. INCORRECT: SIADH results in a decrease in urine osmolality. CORRECT: SIADH results in water retention, causing a high urine sodium level. CORRECT: SIADH results in water retention, causing an increase in urine specific gravity
Which of the following diagnostic tests are done to determine a suspected pituitary tumor? a) Radiographs of the abdomen b) Measuring blood hormone levels c) A radioimmunoassay d) A computed tomography (CT) scan
D. A CT or magnetic resonance imaging (MRI) scan is used to diagnose the presence and extent of pituitary tumors.
A hypophysectomy is the treatment of choice for which endocrine disorder? a) Hyperthyroidism b) Pheochromocytoma c) Acromegaly d) Cushing syndrome
D. A hypophysectomy is the treatment of choice for the patient diagnosed with Cushing syndrome resulting from excessive production of adrenocorticotropic hormone (ACTH) by a tumor of the pituitary gland.
Which of the following disorders results from excessive secretion of somatotropin (growth hormone)? a) Adrenogenital syndrome b) Cretinism c) Dwarfism d) Acromegaly
D. Acromegaly, an excess of growth hormone (GH) in adults, results in enlargement of peripheral body parts without an increase in height. The patient with acromegaly demonstrates progressive enlargement of peripheral body parts, most commonly the face, head, hands, and feet.
Cardiac effects of hyperthyroidism include which of the following? a) Bradycardia b) Decreased systolic BP c) Decreased pulse pressure d) Palpitations
D. Cardiac effects may include sinus tachycardia, increased pulse pressure, and palpitations. Systolic BP is elevated. The other answers do not apply.
A nurse is completing an assessment of a patient with suspected acromegaly. To assist in making the diagnosis, which of the following questions should the nurse ask? a) "Do you experience skin breakouts?" b) "Is there any family history of acromegaly?" c) "Have you had a recent head injury?" d) "Have you increased your shoe size recently?"
D. Excessive skeletal growth occurs only in the feet, the hands, the superciliary ridge, the molar eminences, the nose, and the chin, giving rise to the clinical picture called acromegaly.
A patient with Cushing syndrome is admitted to the hospital. During the initial assessment, the patient tells the nurse, "The worst thing about this disease is how awful I look. I want to cry every time I look in the mirror." Which of the flowing statements is the best response by the nurse? a) "I do not think you look bad and I am sure your family loves you very much." b) "I can show you how to change your style of dress so that the changes are not so noticeable." c) "I can refer you to a support group. It may help you feel better to talk to someone." d) "If treated successfully, the major physical changes will disappear in time."
D. If treated successfully, the major physical changes associated with Cushing's syndrome disappear in time. The patient may benefit from discussion of the effect the changes have had on his or her self-concept and relationships with others. Weight gain and edema may be modified by a low-carbohydrate, low-sodium diet, and a high protein intake may reduce some of the other bothersome symptoms.
