Adrenal and Pituitary
which are physical findings of cushings disease? sata a. "moon-faced" appearance b. decreased amount of body hair c. truncal obesity d. coarse facial features e. thin, easily damaged skin f. extremity muscle wasting
a. "moon-faced" appearance c. truncal obesity e. thin, easily damaged skin f. extremity muscle wasting
which interventions are necessary for a patient with acute adrenal insufficiency (addisonian crisis)? sata a. IV infusion of normal saline b. IV infusion of 3% saline c. hourly glucose monitoring d. insulin administration e. IV potassium therapy f. administer IV hydrocortisone sodium
a. IV infusion of normal saline c. hourly glucose monitoring d. insulin administration f. administer IV hydrocortisone sodium
what should the nurse do when collecting a 24-hour urine specimen? a. check to verify if a preservative is needed b. weigh the client before starting the collection c. discard the last voided specimen of the 24-hour period d. assess the clients intake and output for the previous 24-hour period
a. check to verify if a preservative is needed
following a complete hypophysectomy, the patient requires instruction on hormone replacement for which hormones? sata a. cortisol b. thyroid c. gonadal d. aldosterone e. prolactin (PRL) f. vasopressin
a. cortisol b. thyroid c. gonadal f. vasopressin
the LPN/LVN who is assigned to care for a patient with Cushing disease asks the RN why the patient has bruising and petechiae cross her abdomen. what is the RN's best response? a. "patients with Cushing disease often have bleeding disorders" b. "patients with Cushing disease have very fragile capillaries" c. "please ask the patient if she slipped or fell during the night" d. "thin and delicate skin can result in development of bruising"
b. "patients with Cushing disease have very fragile capillaries"
which drug decreases cortisol production? a. mitotane b. aminoglutethimide c. cyproheptadine d. hydrocortisone
b. aminoglutethimide
after surgical clipping of a cerebral aneurysm, the client develops the syndrome of inappropriate secretion of antidiuretic hormone. for which manifestations of excessive levels of antidiuretic hormone (ADH) should the nurse assess the client? sata a. polyuria b. weight gain c. hypotension d. hyponatremia e. decreased specific gravity
b. weight gain d. hyponatremia
in SIADH, as a result of water retention from the excess ADH, which laboratory values does the nurse expect to find? sata a. increased sodium in urine b. elevated serum sodium level c. increased urine specific gravity d. decreased serum osmolarity e. decreased urine specific gravity f. deceased serum sodium level
a. increased sodium in urine c. increased urine specific gravity d. decreased serum osmolarity f. deceased serum sodium level
which statement about hormone replacement therapy for hypopituitarism is correct? a. once manifestations of hypo function are corrected, treatment is no longer needed b. the most effective route of androgen replacement is the oral route c. testosterone replacement therapy is contraindicated in men with prostate cancer d. clomiphene citrate is used to suppress ovulation in women
c. testosterone replacement therapy is contraindicated in men with prostate cancer
the female patient with cushings syndrome expresses concern about the changes in her general appearance. what is the expected outcome for this patient? a. to verbalize an understanding that treatment will reverse any of the problems b. to ventilate about the frustration of these lifelong physical changes c. to verbalize ways to cope with the changes such as joining a support group or changing style of dress d. to achieve a personal desired level of sexual functioning
a. to verbalize an understanding that treatment will reverse any of the problems
which interdisciplinary intervention is a preventative measure for adrenocortical insufficiency? a. maintaining diuretic therapy b. instructing the patient on salt restriction c. reducing high-dose glucocorticoid therapy quickly d. reducing high-dose glucocorticoid doses gradually
d. reducing high-dose glucocorticoid doses gradually
In addition to IV fluids, a patient with SIADH is on a fluid restriction as low as 500 to 600 mL/24 hours. Which serum and urine results demonstrate effectiveness of this treatment? sata a. Decreased urine specific gravity b. Decreased serum sodium c. Increased urine output d. Increased urine specific gravity e. Increased serum sodium f. Decreased urine output
a. Decreased urine specific gravity c. Increased urine output e. Increased serum sodium
the nurse is caring for a patient with diabetes insipidus (DI). what is the priority goal of collaborative care? a. correct the water metabolism problem b. control blood sugar and blood pH c. measure urine output, specific gravity, and osmolality hourly d. monitor closely for respiratory distress
a. correct the water metabolism problem
when providing care for a patient with Addison disease, the nurse should be alert for which laboratory value change? a. decreased hematocrit b. increased sodium level c. decreased potassium level d. decreased calcium level
a. decreased hematocrit
which medication is used to treat diabetes insipidus (DI)? a. desmopressin acetate b. lithium c. vasopressin d. demeclocycline
a. desmopressin acetate
a client is scheduled for an adrenalectomy. which nursing intervention should the nurse anticipate will be ordered for this client? a. administer IV steroids b. provide a high protein diet c. collect a 24-hour urine specimen d. withhold all medications for 48 hours
a. administer IV steroids
An ACTH stimulation test is the most definitive test for which disorder? a. adrenal insufficiency b. cushings syndrome c. pheochromocytoma d. acromegaly
a. adrenal insufficiency
the patient who is to be discharge with a prescription for prednisone asks the nurse why it is necessary to report any illness to the health care provider. what is the nurses best response? a. because the usual daily dosage may not be adequate during periods of illness or severe stress b. because you need to be protected from the risk for infection c. because the health care provider needs to know when you are ill d. because you will need to have you dosage tapered to safely come off this drug
a. because the usual daily dosage may not be adequate during periods of illness or severe stress
after a hypophysectomy, focused assessment and monitoring by the nurse include which factors? sata a. cognition and mental status b. maintaining bedrest with bedside commode c. possible leakage of cerebrospinal fluid (CSF) d. 24-hour intake of fluids and urine output e. 24-hour diet recall f. headaches or visual disturbances
a. cognition and mental status c. possible leakage of cerebrospinal fluid (CSF) d. 24-hour intake of fluids and urine output f. headaches or visual disturbances
when reviewing the medication record for a patients being treated for a PRL-secreting tumor, the nurse is most likely to note the use of which medication? a. dopamine agonists b. antidiuretic hormone c. corticosteroids d. growth hormone (GH)
a. dopamine agonists
which statements about the etiology of hypopituitarism are correct? sata a. dysfunction can result from radiation treatment to the head or brain b. dysfunction can result from infection or a brain tumor c. infarction following systemic shock can result in hypopituitarism d. severe malnutrition and body fat depletion can depress pituitary gland function e. there is always and underlying cause of hypopituitarism f. pituitary tumors are the most common cause of hypopituitarism
a. dysfunction can result from radiation treatment to the head or brain b. dysfunction can result from infection or a brain tumor c. infarction following systemic shock can result in hypopituitarism d. severe malnutrition and body fat depletion can depress pituitary gland function
fludrocortisone (florinef) is prescribed for a client with adrenal insufficiency. which responses to the medication should the nurse teach the client to report? sata a. edema b. rapid weight gain c. fatigue in the afternoon d. unpredictable changes in mood e. increased frequency of urination
a. edema b. rapid weight gain
a patient is recovering from a transsphenoidal hypophysectomy. what postoperative nursing interventions apply to this patient? sata a. encouraging the patient to perform deep-breathing exercises b. vigorous coughing and deep-breathing exercises c. instructing on the use of a soft-bristled toothbrush for brushing the teeth d. strict monitoring of fluid balance e. hourly neurologic check for the first 24 hours f. instructing the patient to alert the nurse regarding postnasal drip
a. encouraging the patient to perform deep-breathing exercises d. strict monitoring of fluid balance e. hourly neurologic check for the first 24 hours f. instructing the patient to alert the nurse regarding postnasal drip
a nurse is assessing a client with a diagnosis of diabetes insipidus. for which sings indicative of diabetes insipidus should the nurse assess the client? sata a. excessive thirst b. increased blood glucose c. dry mucous membranes d. increased blood pressure e. decreased serum osmolarity f. decreased urine specific gravity
a. excessive thirst c. dry mucous membranes f. decreased urine specific gravity
a hospitalized patient is prescribed desmopressin acetate metered dose spray as a replacement hormone for vasopressin (ADH). which is an indication for another dose? sata a. excessive urination b. specific gravity of 1.003 c. dark, concentrated urine d. edema in the legs e. decreased urination f. shortness of breath
a. excessive urination b. specific gravity of 1.003
a patient with adrenal insufficiency is to be discharged and will take prednisone 10 mg orally each day. which instruction would the nurse be sure to teach the patient? a. excessive weight gain or swelling should be reported to the health care provider b. changing positions rapidly may cause hypotension and dizziness c. a diet with foods low in sodium may be beneficial to prevent side effects d. signs of hypoglycemia may occur while taking this drug
a. excessive weight gain or swelling should be reported to the health care provider
a 30-year-old female patient is prescribed bromocriptine. which information does the nurse teach the patient? sata a. get up slowly from a lying position b. take medication on an empty stomach c. take daily for purposes of raising GH levels to reduce symptoms of acromegaly d. begin therapy with a maintenance level dose e. report watery nasal discharge to the health care provider immediately f. if pregnancy occurs the drug is stopped immediately
a. get up slowly from a lying position e. report watery nasal discharge to the health care provider immediately f. if pregnancy occurs the drug is stopped immediately
a nurse is assessing a female client with Cushing syndrome. which clinical findings can the nurse expect to identify? sata a. hirsutism b. menorrhagia c. buffalo hump d. dependent edema e. migraine headaches
a. hirsutism c. buffalo hump
which patient is at risk for developing secondary adrenal insufficiency? a. patient who suddenly stops taking high-dose steroid therapy b. patient who tapers the dosages of steroid therapy c. patient deficient in ADH d. patient with an adrenal tumor causing excessive secretion of ACTH
a. patient who suddenly stops taking high-dose steroid therapy
a malfunctioning anterior pituitary gland can result in which disorders? sata a. pituitary hypofunction b. pituitary hyperfunction c. diabetes insipidus d. hypothyroidism e. osteoporosis f. syndrome of inappropriate antidiuretic hormone secretion
a. pituitary hypofunction b. pituitary hyperfunction d. hypothyroidism e. osteoporosis
when analyzing laboratory values, the nurse expects to find which value a a direct result of overproduction of GH? a. hyperglycemia b. hyperphosphatemia c. hypocalcemia d. hypercalcemia
a. hyperglycemia
a nurse is caring for a client who had an adrenalectomy. for what clinical response should the nurse monitor while steroid therapy is being regulated? a. hypotension b. hyperglycemia c. sodium retention d. potassium excretion
a. hypotension
which statements about diabetes insipidus (DI) are accurate? sata a. it is caused by ADH insufficiency b. it is characterized by a decrease in urination c. urine output of greater than 4L/24 hours is the first diagnostic indication d. the water loss increases plasma osmolarity e. nephrogenic DI can be caused by lithium (Eskalith) f. increased thirst is a mechanism of the body to attempt maintaining fluid balance
a. it is caused by ADH insufficiency c. urine output of greater than 4L/24 hours is the first diagnostic indication d. the water loss increases plasma osmolarity f. increased thirst is a mechanism of the body to attempt maintaining fluid balance
in caring for a patient with hyperpituitarism, which symptoms does the nurse expect the patient to report? sata a. joint pain b. visual disturbances c. changes in menstruation d. increased libido e. headache f. fatigue
a. joint pain b. visual disturbances c. changes in menstruation e. headache f. fatigue
which clinical indicators can the nurse expect when assessing a client with Cushing syndrome? sata a. lability of mood b. slow wound healing c. a decrease in the growth of hair d. ectomorphism with a moon face e. an increased resistance to bruising
a. lability of mood b. slow wound healing
which drug is an adrenal cytotoxic agent used for inoperable adrenal tumors? a. mitotane b. aminoglutethimide c. cyproheptadine d. fludrocortisone
a. mitotane
The nurse is caring for a patient with syndrome of inappropriate antidiuretic hormone secretion (SIADH). which patient care actions should the nurse delegate to the experience unlicensed assistive personnel? (SATA) a. monitor and record strict intake and output b. provide the patient with ice chips when requested c. remind the patient about his or her fluid restriction d. weight the patient every morning using the same scale e. report a weight gain of 2.2 lb (1kg) to the nurse f. provide mouth care allowing the patient to swallow the rinses
a. monitor and record strict intake and output c. remind the patient about his or her fluid restriction d. weight the patient every morning using the same scale e. report a weight gain of 2.2 lb (1kg) to the nurse
a female patient is admitted with a diagnosis of primary hypofunction of the adrenal glands. which nursing assessment finding supports this diagnosis? a. patchy areas of pigment loss over the face b. decreased muscle strength c. greatly increased urine output d. scalp alopecia
a. patchy areas of pigment loss over the face
The nurse is caring for a patient who has just undergone hypophysectomy for hyperpituitarism. which postoperative finding requires immediate intervention? a. presence of glucose in the nasal drainage b. presence of nasal packing in the nares c. urine output of 40-50 mL/hr d. patient reports of thirst
a. presence of glucose in the nasal drainage
the nurse should instruct a patient who is taking hydrocortisone to report which symptoms to the health care provider for possible dosage adjustment? sata a. rapid weight gain b. changes in blood pressure c. fluid retention d. gastrointestinal irritation e. urinary incontinence f. round face
a. rapid weight gain c. fluid retention f. round face
which information from the clients history does the nurse identify as a risk factor for developing osteoporosis? a. receives long term steroid therapy b. has a history of hypoparathyroidism c. engages in strenuous physical activity d. consumes high doses of the hormone estrogen
a. receives long term steroid therapy
a patient is hospitalized with adrenocortical insufficiency. which nursing activity should the nurse delegate to the unlicensed assistive personnel (UAP)? a. reminding the patient to change positions slowly b. assessing the patient for muscle weakness c. teaching the patent how to collect a 24-hour urine sample d. revising the patients nursing plan of care
a. reminding the patient to change positions slowly
which nursing intervention is the priority for a patient with SIADH? a. restrict fluid intake b. monitor neurologic status at least every 2 hours c. offer ice chips frequently to ease discomfort of dry mouth d. monitor urine testes for decreased sodium levels and low specific gravity
a. restrict fluid intake
a nurse is monitoring for clinical manifestations of infection in a client with a diagnosis of Addison disease. which body mechanism related to infectious processes does the nurse conclude is impaired as a result of this disease? a. stress response b. electrolyte balance c. metabolic processes d. respiratory function
a. stress response
the nurse is preparing the discharge a patient with hyperpituitarism caused by a benign pituitary tumor, who is prescribed the drug bromocriptine. which key points would the nurse teach the patient about this drug? sata a. take this drug with a meal or snack to avoid gastrointestinal (GI) symptoms b. side effects of bromocriptine include severe fatigue and reflux after meals c. seek medical care if you experience chest pain or dizziness while taking this drug d. if the drug causes headaches, you can take over-the-counter acetaminophen e. treatment starts with a high dose, which is gradually lowered f. the purpose of bromocriptine is to shrink your pituitary to normal size
a. take this drug with a meal or snack to avoid gastrointestinal (GI) symptoms c. seek medical care if you experience chest pain or dizziness while taking this drug d. if the drug causes headaches, you can take over-the-counter acetaminophen f. the purpose of bromocriptine is to shrink your pituitary to normal size
which medications are used in SIADH to promote water excretion without causing sodium loss? sata a. tolvaptan b. demeclocycline c. furosemide d. conivaptan e. spironolactone f. hydrochlorothiazide
a. tolvaptan d. conivaptan
which patient care tasks could the nurse delegate to the unlicensed assistive personnel (UAP) in the care of a patient with acute adrenal insufficiency that is immobile? sata a. turn the patient every 1-2 hours b. apply skin lubricants c. assess lung sounds every 2-4 hours d. provide mouth care every 2 hours while awake e. record accurate intake and output f. teach the patient to cough and deep breathe
a. turn the patient every 1-2 hours b. apply skin lubricants d. provide mouth care every 2 hours while awake e. record accurate intake and output
a patient with a hypophysectomy can postoperatively experience transient diabetes insipidus (DI). which manifestation alerts the nurse to this problem? a. urine output much greater than intake b. change in mental status indicating confusion c. laboratory results indicating hyponatremia d. non pitting edema of the lower extremities
a. urine output much greater than intake
which actions prescribed by the health care provider for the patient with Addison disease should the nurse delegate to the experienced unlicensed assistive personnel (UAP)? (SATA) a. weigh the patient every morning b. obtain fingerstick glucose before each meal and at bedtime c. check vital signs every 2 hours d. monitor for cardiac dysrhythmias e. administer oral prednisone 10 mg every morning f. record intake and output
a. weigh the patient every morning b. obtain fingerstick glucose before each meal and at bedtime c. check vital signs every 2 hours f. record intake and output
a female patient has been prescribed hormone replacement therapy. what does the nurse instruct the patient to do regarding this therapy? sata a. report any recurrence of symptoms, such as decreased libido, between injections b. avoid smoking because of the increased risk for cardiovascular complications c. treat leg pain, especially in the calves, with gentle muscle stretching d. take measures to reduce risk for hypertension and thrombosis e. monitor blood pressure at least weekly for potential hypotension f. regular follow-up visits with the health care provider are essential
b. avoid smoking because of the increased risk for cardiovascular complications d. take measures to reduce risk for hypertension and thrombosis f. regular follow-up visits with the health care provider are essential
The nurse is caring for a 25 year old patient admitted to the acute care unit with an extra strong thirst, and dilute, excessive straw-colored urine output (up to 15L/day). What does the nurse suspect? a. Type 2 diabetes b. diabetes insipidus (DI) c. cushings disease d. Addison disease
b. diabetes insipidus (DI)
what is the disorder that results from a deficiency of vasopressin (ADH) from the posterior pituitary gland called? a. SIADH b. diabetes insipidus (DI) c. cushings syndrome d. Addisons disease
b. diabetes insipidus (DI)
while caring for a postoperative patient following a transsphenoidal hypophysectomy, the nurse observes nasal drainage that is clear with yellow color at the edge. this "halo sign" is indicative of which condition? a. worsening neurologic status of the patient b. drainage of CSF from the patients nose c. onset of postoperative infection d. an expected finding following this surgery
b. drainage of CSF from the patients nose
which statement about a patient with hyperaldosteronism after a successful unilateral adrenalectomy is correct? a. the low-sodium diet must be continued postoperatively b. glucocorticoid replacement therapy is temporary c. spironolactone must be take for life d. additional measures are needed to control hypertension
b. glucocorticoid replacement therapy is temporary
a client is diagnosed with Cushing syndrome. which clinical manifestation does the nurse expect to increase in a client with Cushing syndrome? a. urine output b. glucose level c. serum potassium d. immune response
b. glucose level
the nurse admits a patient whose assessment reveals prominent brow ridge, large hands and feet, and large lips and nose. which pituitary hormone does the nurse suspect is elevated? a. thyroid-stimulating hormone b. growth hormone c. adrenocorticotropic hormone d. vasopressin antidiuretic hormone
b. growth hormone
a patina in the emergency department who reports lethargy, muscle weakness, nausea, vomiting, and weight loss over the past weeks is diagnosed with addisonian crisis (acute adrenal insufficiency). which drug(s) does the nurse expect to administer to this patient? a. beta-blocker to control hypertension and dysrhythmias b. hydrocortisone sodium IV along with IM injections of hydrocortisone c. IV fluids of D5 NS with KCl added for dehydration d. spironolactone to promote diuresis
b. hydrocortisone sodium IV along with IM injections of hydrocortisone
a nurse is caring for a client with a diagnosis of Cushing syndrome. what is the most common cause of Cushing syndrome that the nurse should consider before assessing this client for physiological responses? a. pituitary hypoplasia b. hyperplasia of the adrenal cortex c. deprivation of adrenocortical hormones d. insufficient adrenocorticotropic hormone production
b. hyperplasia of the adrenal cortex
the nurse is preparing a care plan for a patient with Cushing disease. which abnormal laboratory values would the nurse expect? (SATA) a. increased serum calcium level b. increased salivary cortisol level c. increased urinary cortisol level d. decreased serum glucose level e. decreased sodium level f. increased serum cortisol level
b. increased salivary cortisol level c. increased urinary cortisol level f. increased serum cortisol level
which laboratory findings does the nurse expect to find with cushings syndrome? sata a. decreased serum sodium b. increased serum glucose c. increased serum sodium d. increased serum potassium e. decreased serum calcium f. increased lymphocyte count
b. increased serum glucose c. increased serum sodium e. decreased serum calcium
which intervention applies to a patient with pheochromocytoma? a. assist to sit in a chair for blood pressure monitoring b. instruct not to smoke, drink coffee, or change positions suddenly c. encourage to maintain and active exercise schedule including activity such as running d. encourage one glass of red wine nightly to promote rest
b. instruct not to smoke, drink coffee, or change positions suddenly
which statement about pheochromocytoma is correct? a. it is most often malignant b. it is a catecholamine-producing tumor c. it is found only in the adrenal medulla d. it is manifested by hypotension
b. it is a catecholamine-producing tumor
a patient in the emergency department is diagnosed with possible pheochromocytoma. what is the priority nursing intervention for this patient? a. monitor the patients intake and output and urine specific gravity b. monitor blood pressure for severe hypertension c. monitor blood pressure for sever hypotension d. administer medication to increase cardiac output
b. monitor blood pressure for severe hypertension
what does the nurse instruct patients with permanent diabetes insipidus (DI) to do? sata a. continue vasopressin therapy until symptoms disappear b. monitor for recurrence of polydipsia and polyuria c. monitor and record weight daily d. check urine specific gravity three times a week e. wear a medical alert bracelet f. urge the patient to drink fluids in an amount equal to urine output
b. monitor for recurrence of polydipsia and polyuria c. monitor and record weight daily e. wear a medical alert bracelet f. urge the patient to drink fluids in an amount equal to urine output
a nurse is caring for a male client with a diagnosis of Cushing syndrome. which clinical manifestations does the nurse expect to find? sata a. polyuria b. obese trunk c. hypotension d. sleep disturbance e. thin arms and legs
b. obese trunk d. sleep disturbance e. thin arms and legs
which intervention is contraindicated for a patient with pheochromocytoma? a. monitoring blood pressure b. palpating the abdomen c. collecting 24-hour urine specimens d. instructing the patient to limit activity
b. palpating the abdomen
decreased production of all of the anterior pituitary hormones results in which condition? a. adenohypohysis b. panhypopituitarism c. primary pituitary dysfunction d. secondary pituitary dysfunction
b. panhypopituitarism
which are causes of secondary adrenal insufficiency? sata a. tuberculosis b. pituitary tumors c. adrenalectomy d. hypophysectomy e. metastatic cancer f. high-dose pituitary radiation
b. pituitary tumors d. hypophysectomy f. high-dose pituitary radiation
which is an important intervention that the nurse should include in the plan of care that is specific for a client with Addison disease? a. encouraging the client to exercise b. protecting the client from exertion c. restricting the clients fluid intake d. monitoring the client for hypokalemia
b. protecting the client from exertion
a client who has acromegaly and insulin-dependent diabetes undergoes a hypophysectomy. the nurse identifies that further teaching about the hypophysectomy is necessary when the client states "I know I will: a. be sterile for the rest of my life" b. require larger doses of insulin that I did preoperatively" c. have to take cortisone or a similar drug for the rest of my life" d. have to take thyroxine or a similar medication for the rest of my life"
b. require larger doses of insulin that I did preoperatively"
the patient with pheochromocytoma has intermittent episodes of hypertension. what manifestations does the nurse expect? a. confusion, abdominal pain, and unsteady gait b. severe headaches, palpitations and diaphoresis c. visual disturbances, decreased pulses, and nausea d. tachycardia, cold intolerance, and decreased urine output
b. severe headaches, palpitations and diaphoresis
the nurse is providing care for a patient who had an hypophysectomy by the minimally invasive endoscopic trans nasal approach. how is care different for this patient as opposed to a patient with a transsphenoidal hypophysectomy? a. the patient is encouraged to cough and deep-breathe to decrease pulmonary complications b. the patient does not have nasal packing of a mustache dressing c. the patient should be taught to floss and rinse his or her mouth frequently d. the patient must be taught that hormone replacement is life long
b. the patient does not have nasal packing of a mustache dressing
the unlicensed assistive personnel (UAP) asks the nurse why it is necessary to check temperature every 4 hours for a patient with acute adrenal insufficiency. what is the nurses best response? a. the temperature on all patients with endocrine disorders should be checked every 4 hours b. the patient is at risk for infection; a temperature elevation of 1 degree above baseline is significant c. it is essential to monitor all patients with endocrine disorders carefully to prevent infection d. because the patient is in the hospital, he is exposed to many infectious organisms
b. the patient is at risk for infection; a temperature elevation of 1 degree above baseline is significant
the nurse is performing an assessment of an adult patient with new-onset acromegaly. what does the nurse expect to find? a. extremely long arms and legs b. thickened lips c. changes in menses with infertility d. rough, extremely dry skin
b. thickened lips
a patient is scheduled for bilateral adrenalectomy. steroids will be given before surgery. what is the reasoning behind the administration of this drug? a. to promote glycogen storage by the liver for body energy reserves b. to compensate for sudden lack of adrenal hormones following surgery c. to increase the body inflammatory response to promote scar formation d. to enhance urinary excretion of salt and water following surgery
b. to compensate for sudden lack of adrenal hormones following surgery
which statement about the pathophysiology of SIADH is correct? a. ADH secretion is inhibited in the presence of low plasma osmolality b. water retention results in dilution hyponatremia and expanded extracellular fluid (ECF) volume c. the glomerulus is unable to increase its filtration rate to reduce the excess plasma volume d. renin and aldosterone are released and help decrease the loss of urinary sodium
b. water retention results in dilution hyponatremia and expanded extracellular fluid (ECF) volume
Which type of IV fluid does the nurse use to treat a patient with SIADH when the serum sodium level is very low? a. D5 1/2 normal saline b. D5W c. 3% normal saline d. Normal saline
c. 3% normal saline
which patients history puts him or her at risk for developing SIADH? a. 27-year-old patient on high-dose steroids b. 47-year-old hospitalized adult patient with acute renal failure c. 58-year-old with small cell lung cancer d. older adult with history of a stroke within the last year
c. 58-year-old with small cell lung cancer
which prescribed order for a patient with diabetes insipidus (DI) would the nurse be sure to question? a. monitor and record accurate intake and output b. check urine specific gravity c. restrict fluids for 6 hours d. weight the patient every morning
c. restrict fluids for 6 hours
the nurse is caring for the following patients with endocrine disorders. which patient must the nurse assess first? a. a 21 year old patient with diabetes insipidus whose urine output overnight was 2000 mL b. a 55 year old patient with syndrome of inappropriate antidiuretic hormone secretion (SIADH) who is demanding that the unlicensed assistive personnel refill his water pitcher c. a 65 year old patient with Addison disease whose morning potassium level is 6.2 mEq/L d. a 48 year old patient with Cushing disease with a weight gain of 1.5 lb (0.7 kg) over the past four days
c. a 65 year old patient with Addison disease whose morning potassium level is 6.2 mEq/L
a nurse is caring for two clients newly diagnosed with diabetes. one client has type 1 diabetes and the other client has type 2 diabetes. the nurse determines that the main difference between newly diagnosed type 1 and type 2 diabetes is that in type 1 diabetes: a. onset of the disease is slow b. excessive weight is a contributing factor c. complications are not present at the time of diagnosis d. treatment involves diet, exercise, and oral medications
c. complications are not present at the time of diagnosis
a malfunctioning posterior pituitary gland can result in which disorders? sata a. hypothyroidism b. altered sexual function c. diabetes insipidus (DI) d. growth retardation e. syndrome of inappropriate antidiuretic hormone (SIADH) f. virilization
c. diabetes insipidus (DI) e. syndrome of inappropriate antidiuretic hormone (SIADH)
the action of antidiuretic hormone (ADH) influences normal kidney function by stimulating which mechanism? a. glomerulus to control the filtration rate b. proximal nephron tubules to reabsorb water c. distal nephron tubules and collecting ducts to reabsorb water d. constriction of globular capillaries to prevent loss of protein in urine
c. distal nephron tubules and collecting ducts to reabsorb water
a nurse is caring for a newly admitted client with a diagnosis of Cushing syndrome. why should the nurse monitor this client for clinical indicators of diabetes mellitus? a. cortical hormones stimulate rapid weight loss b. tissue catabolism results in a negative nitrogen balance c. glucocorticoids accelerate the process of gluconeogenesis d. excessive adrenocorticotropic hormone secretion damages pancreatic tissue
c. glucocorticoids accelerate the process of gluconeogenesis
a patient requires 100 grams of oral glucose for suppression testing and growth hormone (GH) levels are measure serially for 120 minutes. the results of the suppression testing are abnormal. the nurse assess for the signs and symptoms of which endocrine disorder? a. adrenal insufficiency b. diabetes insipidus c. hyperpituitarism d. hypothyroidism
c. hyperpituitarism
a client is admitted with a head injury. the nurse identifies that the clients urinary retention catheter is draining large amounts of clear, colorless urine. what does the nurse identify as the most likely cause? a. increased serum glucose b. deficient renal perfusion c. inadequate ADH secretion d. excess amounts of IV fluid
c. inadequate ADH secretion
the assessment findings of a male patient with an anterior pituitary tumors include reports of changes in secondary sex characteristics, such as episodes of impatience and decreased libido. the nurse explains to the patient that these findings are a result of overproduction of which hormone? a. gonadotropins inhibiting prolactin (PRL) b. thyroid hormone inhibiting prolactin (PRL) c. prolactin (PRL) inhibiting secretion of gonadotropins d. steroids inhibiting production of sex hormones
c. prolactin (PRL) inhibiting secretion of gonadotropins
a client is admitted to a medical unit with a diagnosis of Addison disease. the client is emaciated and reports muscular weakness and fatigue. which disturbed body process does the nurse determine is the root cause of the clients clinical manifestations? a. fluid balance b. electrolyte levels c. protein anabolism d. masculinizing hormones
c. protein anabolism
the patient with hypercortisolism asks the nurse why she is prescribed the drug ranitidine. what is the nurses best response? a. this drug inhibits the gastric proton pump and prevents the formation of hydrochloric acid in your stomach b. gastrointestinal bleeding is a common complication in patients with hypercortisolism c. ranitidine blocks the H2-receptor site to decrease formation of hydrochloric acid and prevent GI bleeding d. this drug buffers stomach acids and protects the gastrointestinal mucosa
c. ranitidine blocks the H2-receptor site to decrease formation of hydrochloric acid and prevent GI bleeding
a health care provider writes orders addressing the needs of a client with Addison disease. which outcome does the nurse conclude is the main focus of treatment for this client? a. decrease in eosinophils b. increase in lymphoid tissue c. restoration of electrolyte balance d. improvement of carbohydrate metabolism
c. restoration of electrolyte balance
a client who has just had an adrenalectomy is told about a death in the family and becomes very upset. what concern about the client require the nurse to notify the health care provider? a. analgesia and mild sedation will be required to ensure rest b. steroid replacement mediation therapy will have to be reduced c. there is a decreased ability to handle stress despite steroid therapy d. feelings of exhaustion and lethargy may result from the emotional stress
c. there is a decreased ability to handle stress despite steroid therapy
the effect of increased ADH in the blood results in which effect on the kidney? a. urine concentration tends to decrease b. glomerular filtration tends to decrease c. tubular reabsorption of water increases d. tubular reabsorption of sodium increases
c. tubular reabsorption of water increases
a 24 year old patient with diabetes insipidus makes all of these statements when the nurse is preparing the patient for discharge from the hospital. which statement indicates to the nurse that the patient needs additional teaching? a. "I will drink fluids equal to the amount of my urine output" b. "I will weight myself every day using the same scale" c. "I will wear my medical alert bracelet at all times" d. "I will gradually wean myself off the vasopressin"
d. "I will gradually wean myself off the vasopressin"
a health care provider orders a low sodium, high potassium diet for a client with Cushing syndrome. which explanation should the nurse provide as to why the client needs to follow this diet? a. "the use of salt probably contributed to the disease" b. "excess weight will be gained if sodium is not limited" c. "the loss of excess sodium and potassium in the urine requires less renal stimulation" d. "excessive aldosterone and cortisone cause retention of sodium and loss of potassium"
d. "excessive aldosterone and cortisone cause retention of sodium and loss of potassium"
the nurse expects to perform which diagnostic test for pheochromocytoma? a. 24- hour urine collection for sodium, potassium, and glucose b. catecholamine-stimulation test c. administration of beta-adrenergic blocking agent and monitor results d. 24-hour urine collection for fractionated metanephrien and catecholamine levels
d. 24-hour urine collection for fractionated metanephrien and catecholamine levels
patients diagnosed with an anterior pituitary tumor can have symptoms of acromegaly. these symptoms are a result of overproduction of which hormone? a. ACTH b. PRL c. gonadotropins d. GH
d. GH
a client is scheduled for a bilateral adrenalectomy. before surgery, steroids are administered to the client. what does the nurse determine is the reason for the steroids? a. foster accumulation of glycogen in the liver b. increase the inflammatory action to promote scar formation c. facilitate the urinary excretion of salt and water following surgery d. compensate for sudden lack of these hormones following surgery
d. compensate for sudden lack of these hormones following surgery
when diagnosed with cushings syndrome, the patient manifestations are most likely related to an excess production of which hormone? a. insulin from the pancreas b. ADH from the posterior pituitary gland c. PRL from the anterior pituitary gland d. cortisol from the adrenal cortex
d. cortisol from the adrenal cortex
assessment findings for a patient with Cushing disease include all of the following. for which finding would the nurse notify the health care provider (HCP) immediately? a. purple striae present on the abdomen and thighs b. weight gain of 1 lb (0.5kg) since the previous day c. dependent edema rated as +1 in the ankles and calves d. crackles bilaterally in the lower lobes of the lungs
d. crackles bilaterally in the lower lobes of the lungs
a nurse is caring for a client with Addison disease. which information should the nurse include in a teaching plan as a means of encouraging this client to modify dietary intake? a. increased amounts of potassium are needed to replace renal losses b. increased protein is needed to heal the adrenal tissue and thus cure the disease c. supplemental vitamins are needed to supply energy and assist in regaining the lost weight d. extra salt is needed to replace the amount being lost due to lack of sufficient aldosterone to conserve sodium
d. extra salt is needed to replace the amount being lost due to lack of sufficient aldosterone to conserve sodium
a nurse is caring for a client who is scheduled for a bilateral adrenalectomy. which medication should the nurse expect to be prescribed for this client on the day of surgery and in the immediate postoperative period? a. methimazole (tapazole) b. pituitary extract (pituitrin) c. regular insulin (novolin R) d. hydrocortisone succinate (solu-cortef)
d. hydrocortisone succinate (solu-cortef)
a client with a tentative diagnosis of Cushing syndrome has an increased cortisol level. for what response should the nurse assess this client? a. hypovolemia b. hyperkalemia c. hypoglycemia d. hypernatremia
d. hypernatremia
what is the most common caused of endogenous hypercortisolism, or Cushings disease? a. pituitary hypoplasia b. insufficient ACTH production c. adrenocortical hormone deficiency d. hyperplasia of the adrenal cortex
d. hyperplasia of the adrenal cortex
which statement about hyperaldosteronism is correct? a. painful "charley horses" are common from hyperkalemia b. it occurs more often in men than in women c. it is a common cause of hypertension in the population d. hypokalemia and hypertension are the main issues
d. hypokalemia and hypertension are the main issues
a nurse is caring for a client who had a hypophysectomy. for which complication specific to this surgery should the nurse assess the client for early clinical manifestations? a. urinary retention b. respiratory distress c. bleeding at the suture line d. increased intracranial pressure
d. increased intracranial pressure
the nurse determines that the administration of hydrocortisone for addisonian crisis is effective when which outcome is addressed? a. increased urine output b. no signs of pitting edema c. weight gain d. lethargy improving; patient alert and oriented
d. lethargy improving; patient alert and oriented
a nurse is caring for a client with the clinical manifestation of hypotension associated with a diagnosis of Addison disease. which hormone is impaired in its production as a result of this disease? a. estrogens b. androgens c. glucocorticoids d. mineralocorticoids
d. mineralocorticoids
a patient with pheochromocytoma underwent surgery to remove his adrenal glands. which nursing intervention should the nurse delegate to an unlicensed assistive personnel (UAP)? a. revising then nursing care plan to include strategies to provide a calming restful environment postoperatively b. instructing the patient to avoid smoking and drinking caffeine-containing beverages c. assessing the patients kin and mucous membranes for signs of adequate hydration d. monitoring lying and standing blood pressure every 4 hours with a cuff placed on the same arm
d. monitoring lying and standing blood pressure every 4 hours with a cuff placed on the same arm
which diuretic is ordered by the health care provider to treat hyperaldosteronism? a. furosemide b. ethacrynic acid c. bumetanide d. spironolactone
d. spironolactone
the nurse is teaching a patient being discharged after bilateral adrenalectomy. what medication information does the nurse emphasize in the teaching plan? a. the dosage of steroid replacement drugs will be consistent throughout the patients lifetime b. the steroid drugs should be taken in the evening as to not interfere with sleep c. the patient should take the drugs on an empty stomach d. the patient should learn how to give himself an intramuscular injection of hydrocortisone
d. the patient should learn how to give himself an intramuscular injection of hydrocortisone
the nurse is supervising a student nurse providing care for a patient with adrenal insufficiency. which action by the student nurse requires the nurse to intervene? a. the student nurse records patient intake and output for lunch b. the student nurse weighs the patient in the morning before breakfast c. the student nurse checks the patients serum electrolyte results d. the student nurse prepares to administer prednisolone instead of prednisone
d. the student nurse prepares to administer prednisolone instead of prednisone
a deficiency of which anterior pituitary hormones is considered life-threatening? sata a. growth hormone (GH) b. melanocyte-stimulating hormone (MSH) c. prolactin (PRL) d. thyroid-stimulating hormone (TSH) e. adrenocorticotropic hormone (ACTH) f. luteinizing hormone (LH)
d. thyroid-stimulating hormone (TSH) e. adrenocorticotropic hormone (ACTH)
after a head injury a client develops a deficiency of antidiuretic hormone (ADH). what should the nurse consider about the response to secretion of ADH before assessing this client? a. serum osmolarity increases b. urine concentration decreases c. glomerular filtration decreases d. tubular reabsorption of water increases
d. tubular reabsorption of water increases
