Nokea
The instructor is teaching a group of students about Simmonds disease. The instructor determines that additional instruction is necessary when the students identify which hormone as being involved?
- A. Growth hormone
- B. Luteinizing hormone
- C. Adrenocorticotropic hormone
- D. Oxytocin
Correct Answer: D
Rationale: Oxytocin is a hormone of the posterior pituitary gland and would not be involved. Simmonds disease affects all hormones of the anterior pituitary: GH (bones and muscles), adrenocorticotropic hormone (ACTH, adrenals), thyroid-stimulating hormone (TSH, thyroid), follicle-stimulating hormone (FSH, ovaries and testes), luteinizing hormone (LH, ovaries), interstitial cell-stimulating hormone (ICSH (LH), testes), and prolactin (breasts).
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The nurse is caring for a client who has developed diabetes insipidus. The cause is unknown, and the physician has ordered a diagnostic test to determine if the cause is nephrogenic or neurogenic. What test will the nurse prepare the client for?
- A. Urine specific gravity
- B. Fluid deprivation test
- C. Urine osmolality
- D. Serum osmolality
Correct Answer: B
Rationale: A fluid deprivation test can diagnose diabetes insipidus (DI) and differentiate neurogenic DI from nephrogenic DI. The other tests listed are nonspecific tests that help support diagnosis.
A client with acromegaly has been given the option of a surgical approach or a medical approach. The client decides to have a surgical procedure to remove the pituitary gland. What does the nurse understand this surgical procedure is called?
- A. Hypophysectomy
- B. Hysteroscopy
- C. Thyroidectomy
- D. Ablation
Correct Answer: A
Rationale: The treatment of choice is surgical removal of the pituitary gland (transsphenoidal hypophysectomy) through a nasal approach. The surgeon may substitute an endoscopic technique using microsurgical instruments to reduce surgical trauma. A hysteroscopy is a gynecologic procedure. The thyroid gland is not involved for a surgical procedure. Ablation is not a removal of the pituitary gland.
A client is receiving a test to determine adrenal function. What medication does the nurse administer as a screening test?
- A. Cosyntropin
- B. Sodium bicarbonate
- C. Fludrocortisone
- D. Glucagon
Correct Answer: A
Rationale: A dose of synthetic ACTH, cosyntropin, is administered intramuscularly as a screening test for adrenal function. The other medications are not screening medications to determine adrenal function.
The nurse is reviewing a client's history which reveals that the client has had an oversecretion of growth hormone (GH) that occurred before puberty. The nurse interprets this as resulting in which condition?
- A. Gigantism
- B. Dwarfism
- C. Acromegaly
- D. Simmonds disease
Correct Answer: A
Rationale: When oversecretion of GH occurs before puberty, gigantism results. Dwarfism occurs when secretion of GH is insufficient during childhood. Oversecretion of GH during adulthood results in acromegaly. An absence of pituitary hormonal activity causes Simmonds disease.
A client sustained a head injury when falling from a ladder. While in the hospital, the client begins voiding large amounts of clear urine and reports being very thirsty. The client states feeling weak and having experienced an 8 pound weight loss since admission. What condition does the nurse expect the client to be tested for?
- A. Diabetes insipidus (DI)
- B. Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
- C. Pituitary tumor
- D. Hypothyroidism
Correct Answer: A
Rationale: With diabetes insipidus, urine output may be as high as 20 L/24 hours. Urine is dilute, with a specific gravity of 1.002 or less. Limiting fluid intake does not control urine excretion. Thirst is excessive and constant. Activities are limited by the frequent need to drink and void. Weakness, dehydration, and weight loss develop. SIADH will have the opposite clinical manifestations. The client's symptoms are related to the trauma and not to a pituitary tumor. The thyroid gland does not cause these symptoms.