ATI LPN
Timby's Introductory Medical-Surgical Nursing Thirteenth, North American Edition
Chapter 50 : Caring for Clients With Disorders of the Endocrine System Questions
Question 1 of 5
A client with acromegaly is admitted to the hospital with complaints of partial blindness that began suddenly. What does the nurse suspect is occurring with this client?
Correct Answer: D
Rationale: Partial blindness may result from pressure on the optic nerve. Glaucoma does not occur suddenly, and the client did not report injury to suspect corneal abrasions or retinal detachment.
Question 2 of 5
A client is suspected of having acromegaly. What definitive diagnostic testing is the most reliable method of confirming acromegaly?
Correct Answer: B
Rationale: A glucose tolerance test in combination with a GH measurement is the most reliable method of confirming acromegaly. Ingestion of a bolus of glucose should lower GH levels, but GH levels remain elevated in persons with acromegaly. Increased blood levels of IGF-1 can also indicate acromegaly in nonpregnant women, they typically have IGF-1 levels two to three times higher than normal in pregnant women. A serum glucose level is not an indicator of acromegaly. Growth hormone levels and bone radiographs may support the diagnosis but are not reliable indicators.
Question 3 of 5
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?
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.
Question 4 of 5
The nurse is instructing a client about the use of pegvisomant for the treatment of acromegaly. How will the nurse instruct to take this medication?
Correct Answer: A
Rationale: Pegvisomant, a GH receptor antagonist, is the newest and most effective drug for treating acromegaly. Injected subcutaneously once a day, it normalizes the IGF-I level in 93% to 97% of cases by blocking the GH stimulation of IGF-I produced by the liver.
Question 5 of 5
The nurse is providing education to a client who will be having a hypophysectomy. What should the nurse be sure to include to prevent complications?
Correct Answer: B
Rationale: The nurse should instruct the client to avoid sneezing and coughing postoperatively. If the client has nasal packing, the nurse monitors drainage from the nose and postnasal drainage for the presence of cerebrospinal fluid. The nurse should remind the client to avoid drinking from a straw, sneezing, coughing, blowing the nose, and bending over to prevent dislodging the graft that seals the operative area between the cranium and nose.