Deck 44: Management of Clients with Adrenal and Pituitary Disorders

Question 1

In making the care plan for a client with Cushing's disease, the nurse would choose which diagnosis as a priority?

A) Activity Intolerance
B) Pain, Chronic
C) Risk for Fluid Volume Deficit
D) Risk for Injury

Answer 1

Risk for Injury

Question 2

Before surgery, a client diagnosed with pheochromocytoma would be instructed to avoid

A) a diet high in vitamins and minerals.
B) coffee, tea, and cola.
C) long rest periods.
D) sedative medications.

Answer 2

coffee, tea, and cola.

Question 3

The nurse would assess that the individual most at risk for adrenal insufficiency is the

A) asthmatic client taking hydrocortisone once a week who has emergency surgery.
B) athlete who stops daily doses of steroids after taking them for 2 years.
C) COPD client using an aerosol bronchodilator daily who becomes pregnant.
D) hypertensive client taking a diuretic who contracts a febrile illness.

Answer 3

athlete who stops daily doses of steroids after taking them for 2 years.

Question 4

For a client who has undergone transsphenoidal hypophysectomy, the aspect of usual postoperative care that the nurse would modify is

A) administration of oxygen.
B) leg exercises.
C) nutrition.
D) oral care.

Question 5

A client has Addison's disease. The nurse should teach the client to carry an injection kit at all times with the medication

A) adrenaline.
B) Benadryl.
C) epinephrine.
D) hydrocortisone.

Question 6

In reviewing laboratory data for a client with Cushing's syndrome, the nurse might expect to see the laboratory abnormalities of (Select all that apply)

A) hypercalcemia.
B) hyperglycemia.
C) hyperproteinemia.
D) hypoglycemia.
E) hypokalemia.
F) hyponatremia.

Question 7

Critical actions the nurse takes specifically when caring for the client with Cushing's syndrome who had an adrenalectomy include (Select all that apply)

A) ambulate the client as soon as the client is able.
B) begin discharge planning on admission for the operation.
C) use strict aseptic technique when changing dressings.
D) strongly encourage client to cough and deep breathe.

Question 8

During assessment of a 45-year-old man with the medical diagnosis of Cushing's syndrome, the nurse would note the most consistent finding of

A) male pattern baldness.
B) peripheral edema.
C) hypertension.
D) jaundice.

Question 9

A client has Cushing's syndrome secondary to needing large doses of glucocorticoids to control asthma. Today the client calls the clinic complaining of "not feeling very well," but has no other complaints. The nurse should advise this client to

A) come in for an examination and lab work.
B) cut the steroid dose in half for the next week.
C) make an appointment for next week.
D) rest and drink plenty of fluids.

Question 10

The nurse recognizes that the manifestations of Addison's disease are primarily related to the pathophysiology of

A) adrenal insufficiency.
B) increased intracranial pressure.
C) renal disease.
D) thyroid hyperfunction.

Question 11

Health promotion activities a school nurse could teach the student athletes that will help them avoid endocrine problems in the future include

A) avoiding alcohol.
B) getting plenty of rest.
C) not smoking.
D) not using steroids.

Question 12

The nurse formulating a discharge plan for a client with Addison's disease should place the highest emphasis on

A) compliance with replacement therapy.
B) prevention of the complication of hypertension.
C) teaching the client how to cope with a chronic disease.
D) weight control and the importance of good nutrition.

Question 13

The nurse assessing a client with hypopituitarism would note the finding most consistent with this disorder as

A) a pendulous abdomen.
B) frequent nasal drainage.
C) mottled skin.
D) short stature.

Question 14

In a client with addisonian crisis, assessment would indicate that the drug Kayexalate is not effective when the nurses assesses the clinical manifestation of

A) decreasing blood pressure.
B) low back pain.
C) pedal edema.
D) rapid or erratic pulse.

Question 15

When formulating the teaching plan for a client with hyperpituitarism being prepared for transsphenoidal hypophysectomy, the nurse would give priority to

A) alerting the client to the need for constant monitoring after surgery.
B) instructing the client to avoid activities such as coughing and sneezing.
C) reviewing the clinical manifestations of infection.
D) teaching coughing and deep-breathing techniques.

Question 16

A client with hyperpituitarism tells the nurse that he thinks he looks different now than he did 5 years ago. The nurse's most appropriate response to this remark considers that the client is

A) experiencing a sensory disturbance and needs reorientation.
B) having visual disturbances and may need a ophthalmologist consult.
C) making bizarre comments because of increased intracranial pressure and needs a neurosurgical consult.
D) referring to physical changes from acromegaly and needs emotional support.

Question 17

For a client with a pheochromocytoma, the most critical assessment by the nurse is

A) abdominal girth.
B) blood pressure.
C) daily weight.
D) pulse quality.

Question 18

Twelve hours after surgery for pheochromocytoma, the nurse should assess a postoperative client for manifestations of abdominal hematoma, including

A) absent bowel sounds.
B) blurred vision.
C) elevated blood pressure.
D) increased urine output.

Question 19

The nurse explains the pathophysiology of diabetes insipidus as arising from a deficiency in

A) antidiuretic hormone (ADH).
B) follicle-stimulating hormone (FSH).
C) growth hormone (GH).
D) oxytocin.

Question 20

The nurse monitoring hourly urine output in a client following transsphenoidal hypophysectomy would immediately report

A) 100 ml of urine in 1 hour.
B) 150 ml of urine in 1 hour.
C) 175 ml of urine in 1 hour.
D) 225 ml of urine in 1 hour.