SESSIONS 12-14 NUR 149

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SESSION 13: DISORDERS OF PITUITARY AND THYROID GLANDS

What test should be ordered if hypothyroidism is suspected? * 1 point

A. Liver function tests

B. Hemoglobin A1c

C. T4 and thyroid-stimulating hormone

D. 24-hour urine free cortisol measurement

An incoherent female client with a history of hypothyroidism is brought to * 1 point

the emergency department by the rescue squad. Physical and laboratory

findings reveal hypothermia, hypoventilation, respiratory acidosis,
bradycardia, hypotension, and non-pitting edema of the face and pretibial
area. Knowing that these findings suggest severe hypothyroidism, Nurse
Libby prepares to take emergency action to prevent the potential
complication of:

A. Thyroid storm

B. Cretinism

C. Myxedema coma

D. Hashimoto’s thyroiditis
Which outcome indicates that treatment of a male client with diabetes * 1 point

insipidus has been effective?

A. Fluid intake is less than 2,500 ml/day.

B. Urine output measures more than 200 ml/hour.

C. Blood pressure is 90/50 mm Hg.

D. The heart rate is 126 beats/minute.

Initial treatment for a CSF leak after transsphenoidal hypophysectomy * 1 point

would most likely involve:

A. Repacking the nose.

B. Returning the client to surgery.

C. Enforcing bed rest with the head of the bed elevated.

D. Administering high-dose corticosteroid therapy.

When caring for a male client with diabetes insipidus, nurse Juliet expects * 1 point

to administer:

A. Vasopressin (Pitressin Synthetic).

B. Furosemide (Lasix).

C. Regular insulin.

D. 10% dextrose.
Nurse Louie is developing a teaching plan for a male client diagnosed with * 1 point

diabetes insipidus. The nurse should include information about which

hormone lacking in clients with diabetes insipidus?

A. Antidiuretic hormone (ADH).

B. Thyroid-stimulating hormone (TSH).

C. Follicle-stimulating hormone (FSH).

D. Luteinizing hormone (LH).

Surgical management for large, invasive pituitary tumors is a * 1 point

transsphenoidal hypophysectomy. The nurse would explain that the surgery

will be performed through an incision in the:

A. Nose

B. Back of the mouth

C. Sinus channel below the right eye

D. Upper gingival mucosa in the space between the upper gums and lip
A female client whose physical findings suggest a hyperpituitary condition * 1 point
undergoes an extensive diagnostic workup. Test results reveal a pituitary
tumor, which necessitates a transsphenoidal hypophysectomy. The evening
before the surgery, nurse Jacob reviews preoperative and postoperative
instructions given to the client earlier. Which postoperative
instruction should the nurse emphasize?

A. “You must lie flat for 24 hours after surgery.”

B. “You must avoid coughing, sneezing, and blowing your nose.”

C. “You must restrict your fluid intake.”

D. “You must report ringing in your ears immediately.”

A male client has recently undergone surgical removal of a pituitary tumor. * 1 point
Dr. Wong prescribes corticotropin (Acthar), 20 units I.M. q.i.d. as a
replacement therapy. What is the mechanism of action of corticotropin?

A. It decreases cyclic adenosine monophosphate (cAMP) production and affects the

metabolic rate of target organs.

B. It interacts with plasma membrane receptors to inhibit enzymatic actions.

C. It interacts with plasma membrane receptors to produce enzymatic actions that

affect protein, fat, and carbohydrate metabolism.

D. It regulates the threshold for water resorption in the kidneys

Which of the following conditions is caused by excessive secretion of * 1 point

vasopressin?

A. Thyrotoxic crisis

B. Diabetes insipidus

C. Primary adrenocortical insufficiency

D. Syndrome of inappropriate antidiuretic hormone (SIADH)

A male client is admitted for treatment of the syndrome of inappropriate * 1 point

antidiuretic hormone (SIADH). Which nursing intervention is appropriate?

A. Infusing I.V. fluids rapidly as ordered.

B. Encouraging increased oral intake.

C. Restricting fluids.

D. Administering glucose-containing I.V. fluids as ordered.

The appropriate nursing diagnosis for a patient with SIADH is: * 1 point

A. Fluid volume deficit related to excessive fluid loss

B. Fluid volume excess related to fluid retention

C. Risk for injury related to decreased blood pressure

D. Impaired skin integrity related to dehydration

 A somatotropin-secreting tumor of which of the following glands would * 1 point
lead to the development of acromegaly, Cushing’s syndrome, and
hypopituitarism?

A. Adrenal gland

B. Hypothalamus

C. Pituitary gland

D. Thyroid gland

A client represents with flushed skin, bulging eyes, and perspiration, and * 1 point
states that he has been irritable and having palpitations. This client is
presenting with symptoms of which disorder?

A. Pancreatitis

B. Hypothyroidism

C. Hyperthyroidism

D. Diabetes insipidus

Vasopressin is administered to the client with diabetes insipidus (DI) * 1 point

because it:

A. Decreases blood sugar.

B. Increases tubular reabsorption of water.

C. Increases release of insulin from the pancreas.

D. Decreases glucose production within the liver

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