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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.
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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.
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.
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 cares for a client who is recovering from a hypophysectomy. Which action should the nurse take?
- A. I must wash the incision with peroxide and redress it daily
- B. I shall cough and deep breathe every 2 hours while I am awake
- C. Avoid activities that increase intracranial pressure
- D. Apply petroleum jelly to lips to avoid dryness
Correct Answer: C
Rationale: After this surgery, the client must take care to avoid activities that can increase intracranial pressure. The client should avoid bending from the waist, bearing down, coughing, or lying flat. With this approach, there is no incision to clean and dress. Protection from sun exposure is not necessary after this procedure.
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.