Nokea
A nurse assesses clients for potential endocrine dysfunction. Which client is at greatest risk for a deficiency of testosterone and growth hormone.
- A. A 36-year-old female who has used oral contraceptives for 5 years
- B. A 42-year-old male who experienced head trauma 3 years ago
- C. A 35-year-old female with hormone delivery to mellitus and iodine
- D. A 64-year-old male with adult-onset diabetes mellitus
Correct Answer: B
Rationale: Gonadotropin and growth hormone are anterior pituitary hormones. Head trauma is a common cause of anterior pituitary hypofunction. The other factors do not increase the risk of this condition.
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A nurse plans care for a client with a growth hormone deficiency. Which action should the nurse include in this client's plan of care?
- A. A 36-year-old female who has used oral contraceptives for 5 years
- B. A 42-year-old male who experienced head trauma 3 years ago
- C. A 35-year-old female with hormone delivery to mellitus and iodine
- D. A 64-year-old male with adult-onset diabetes mellitus
Correct Answer: B
Rationale: Gonadotropin and growth hormone are anterior pituitary hormones. Head trauma is a common cause of anterior pituitary hypofunction. The other factors do not increase the risk of this condition. For care planning, identifying the client with a history of head trauma as high risk guides appropriate interventions.
A client with hyperaldosteronism is being treated with spironolactone (Aldactone) before surgery. Which precautions does the nurse teach this client?
- A. Read the label before using salt substitutes
- B. Do not add salt to your food when you eat
- C. Avoid exposure to sunlight
- D. Take Tylenol instead of aspirin for pain
Correct Answer: A
Rationale: Spironolactone is a potassium-sparing diuretic used to control potassium levels in hyperaldosteronism. Excessive potassium intake, such as from potassium chloride-based salt substitutes, can lead to hyperkalemia, a serious complication. Clients should read labels to avoid such substitutes.
A nurse is caring for a client who was prescribed high-dose corticosteroid therapy for 1 month to treat a severe inflammatory condition. The client's symptoms have now resolved and the client asks, 'When can I stop taking these medications?' How should the nurse respond?
- A. It is possible for the inflammation to recur if you stop the medication
- B. Once you start corticosteroids, you have to be weaned off them
- C. You have to decrease the dose slowly so your hormones will work again
- D. The drug suppresses your immune system, which must be built back up
Correct Answer: B
Rationale: One of the most common causes of adrenal insufficiency, a life-threatening problem, is the sudden cessation of long-term, high-dose corticosteroid therapy. This therapy suppresses the hypothalamic-pituitary-adrenal axis and must be withdrawn gradually to allow for pituitary production of adrenocorticotropic hormone and adrenal production of cortisol.
A nurse assesses a client who is recovering from a transsphenoidal hypophysectomy. The nurse notes nuchal rigidity. Which action should the nurse take first?
- A. I will no longer need to limit my fluid intake after surgery
- B. Document the finding and monitor the client
- C. Take vital signs, including temperature
- D. I will wear slip-on shoes after surgery to limit bending over
Correct Answer: C
Rationale: Nuchal rigidity may indicate a complication such as meningitis or cerebrospinal fluid leak following transsphenoidal hypophysectomy. Taking vital signs, including temperature, is the priority to assess for signs of infection or other systemic issues that require immediate intervention.
A nurse plans care for a client with Cushing's disease. Which action should the nurse include in this client's plan of care to prevent injury?
- A. Pad the siderails of the client's bed
- B. Assist the client to change positions slowly
- C. Use a lift sheet to change the client's position
- D. Place the client in a position with the head of the bed elevated
Correct Answer: C
Rationale: Cushing's syndrome or disease greatly increases the serum levels of cortisol, which contributes to excessive bone demineralization and increases the risks for pathologic bone fracture. Using a lift sheet to change the client's position minimizes the risk of fractures, providing the most effective protection compared to other options.