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CHAPTER 49: ENDOCRINE PROBLEMS LEWIS: MEDICAL-SURGICAL NURSING, 10TH EDITION QUESTIONS AND ANSWERS WITH SOLUTIONS 2024 $13.99   Add to cart
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CHAPTER 49: ENDOCRINE PROBLEMS LEWIS: MEDICAL-SURGICAL NURSING, 10TH EDITION QUESTIONS AND ANSWERS WITH SOLUTIONS 2024
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CHAPTER 49: ENDOCRINE PROBLEMS LEWIS: MEDICAL-SURGICAL NURSING, 10TH EDITION QUESTIONS AND ANSWERS WITH SOLUTIONS 2024

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CHAPTER 49: ENDOCRINE PROBLEMS
LEWIS: MEDICAL-SURGICAL NURSING,
10TH EDITION QUESTIONS AND
ANSWERS WITH SOLUTIONS 2024
1. A 40-yr-old patient with suspected acromegaly is seen at the clinic. To assist in making the diagnosis,
which question should the nurse ask?



a. "Have you had a recent head injury?"

b. "Do you have to wear larger shoes now?"

c. "Is there a family history of acromegaly?"

d. "Are you experiencing tremors or anxiety?" - ANSWER ANS: B

Acromegaly causes an enlargement of the hands and feet. Head injury and family history are not risk
factors for acromegaly. Tremors and anxiety are not clinical manifestations of acromegaly.



DIF: Cognitive Level: Apply (application)

TOP: Nursing Process: Assessment

REF: 1157

MSC: NCLEX: Physiological Integrity



2. A patient is scheduled for transsphenoidal hypophysectomy to treat a pituitary adenoma. During
preoperative teaching, the nurse instructs the patient about the need to:



a. cough and deep breathe every 2 hours postoperatively.

b. remain on bed rest for the first 48 hours after the surgery.

c. avoid brushing teeth for at least 10 days after the surgery.

d. be positioned flat with sandbags at the head postoperatively. - ANSWER ANS: C

To avoid disruption of the suture line, the patient should avoid brushing the teeth for 10 days after
surgery. It is not necessary to remain on bed rest after this surgery. Coughing is discouraged because it
may cause leakage of cerebrospinal fluid (CSF) from the suture line. The head of the bed should be
elevated 30 degrees to reduce pressure on the sella turcica and decrease the risk for headaches.

,DIF: Cognitive Level: Apply (application)

TOP: Nursing Process: Implementation

REF: 1159



3. The nurse is planning postoperative care for a patient who is being admitted to the surgical unit from
the recovery room after transsphenoidal resection of a pituitary tumor. Which nursing action should be
included?



a. Palpate extremities for edema.

b. Measure urine volume every hour.

c. Check hematocrit every 2 hours for 8 hours.

d. Monitor continuous pulse oximetry for 24 hours. - ANSWER ANS: B

After pituitary surgery, the patient is at risk for diabetes insipidus caused by cerebral edema. Monitoring
of urine output and urine specific gravity is essential. Hemorrhage is not a common problem. There is no
need to check the hematocrit hourly. The patient is at risk for dehydration, not volume overload. The
patient is not at high risk for problems with oxygenation, and continuous pulse oximetry is not needed.



DIF: Cognitive Level: Apply (application)

TOP: Nursing Process: Planning

REF: 1159

MSC: NCLEX: Physiological Integrity



4. The nurse is assessing a male patient diagnosed with a pituitary tumor causing panhypopituitarism.
Assessment findings consistent with panhypopituitarism include:

a. high blood pressure.

b. decreased facial hair.

c. elevated blood glucose.

d. tachycardia and palpitations. - ANSWER ANS: B

Changes in male secondary sex characteristics such as decreased facial hair, testicular atrophy,
diminished spermatogenesis, loss of libido, impotence, and decreased muscle mass are associated with
decreases in follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Fasting hypoglycemia and
hypotension occur in panhypopituitarism as a result of decreases in adrenocorticotropic hormone

, (ACTH) and cortisol. Bradycardia is likely due to the decrease in thyroid-stimulating hormone (TSH) and
thyroid hormones associated with panhypopituitarism.



5. Which information will the nurse include when teaching a 50-yr-old male patient about somatropin
(Genotropin)?

a.The medication will be needed for 3 to 6 months.

b. Inject the medication subcutaneously every day.

c. Blood glucose levels may decrease when taking the medication.

d. Stop taking the medication if swelling of the hands or feet occurs. - ANSWER ANS: B

Somatropin is injected subcutaneously on a daily basis, preferably in the evening. The patient will need
to continue on somatropin for life. If swelling or other common adverse effects occur, the health care
provider should be notified. Growth hormone will increase blood glucose levels.



6. The nurse determines that demeclocycline is effective for a patient with syndrome of inappropriate
antidiuretic hormone (SIADH) based on finding that the patient's

a. weight has increased.

b. urinary output is increased.

c. peripheral edema is increased.

d. urine specific gravity is increased. - ANSWER ANS: B

Demeclocycline blocks the action of antidiuretic hormone (ADH) on the renal tubules and increases urine
output. An increase in weight or an increase in urine specific gravity indicates that the SIADH is not
corrected. Peripheral edema does not occur with SIADH. A sudden weight gain without edema is a
common clinical manifestation of this disorder.



7. The nurse determines that additional instruction is needed for a patient with chronic syndrome of
inappropriate antidiuretic hormone (SIADH) when the patient makes which statement?

a. "I need to shop for foods low in sodium and avoid adding salt to food."

b. "I should weigh myself daily and report any sudden weight loss or gain."

c. "I need to limit my fluid intake to no more than 1 quart of liquids a day."

d. "I should eat foods high in potassium because diuretics cause potassium loss." - ANSWER ANS: A

Patients with SIADH are at risk for hyponatremia, and a sodium supplement may be prescribed. The
other patient statements are correct and indicate successful teaching has occurred.

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