A nurse cares for a client with adrenal hyperfunction. The client screams at her husband, bursts into tears, and throws a pitcher against the wall. She then tells the nurse, 'I feel like I am going crazy.' How should the nurse respond?
- A. I will ask your doctor to order a psychiatric consult for you
- B. Your behavior is a result of your condition and will improve with treatment
- C. I will close the door to your room and restrict visitors
Correct Answer: B
Rationale: Hypercortisolism can cause the client to exhibit neurotic to psychotic behavior due to elevated cortisol levels. The client needs to understand that this behavior is a result线�1:27 PM 7/1/2025 result of their condition and will improve with treatment. A psychiatric consult, support groups, or restricted visitors are not necessary at this time.
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A nurse cares for a client with a growth hormone deficiency. Which action should the nurse include in this client's plan of care?
- A. Avoid intramuscular medication
- B. Place the client in protective isolation
- C. Use a lift sheet to re-position the client
- D. Monitor growth hormone levels regularly
Correct Answer: C
Rationale: Clients with growth hormone deficiency may have weakened bones due to reduced bone density. Using a lift sheet to reposition the client minimizes the risk of fractures or injury during movement, which is a priority in care planning.
How should the nurse interpret these results?
- A. Pituitary Hyperfunction
- B. Pituitary hypofunction
- C. Pituitary-induced diabetes mellitus
- D. Normal pituitary response to insulin
Correct Answer: D
Rationale: Some tests for pituitary function involve administering agents that are known to stimulate the secretion of specific pituitary hormones and then measuring the response. Such tests are termed stimulation tests. The stimulation test for GH or ACTH assessment involves injecting the client with regular insulin (0.05 to 1 unit/kg of body weight) and checking circulating levels of GH and ACTH. A normal response indicates adequate pituitary function.
After teaching a client with acromegaly who is scheduled for a hypophysectomy, the nurse assesses the client's understanding. Which statement made by the client indicates a need for additional teaching?
- A. I will no longer need to limit my fluid intake after surgery
- B. I am glad no visible incision will result from this surgery
- C. I will wear slip-on shoes after surgery to limit bending over
- D. I must avoid coughing to prevent complications
Correct Answer: C
Rationale: Although removal of the tissue that is oversecreting hormones can relieve many symptoms of hyperpituitarism, skeletal changes and organ enlargement are not reversible. It is appropriate for the client to drink as needed postoperatively and to avoid bending over to prevent increased intracranial pressure. However, stating that they will wear slip-on shoes to limit bending over is correct, but the phrasing in option C suggests a misunderstanding if it implies no other precautions are needed.
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 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.
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