NCLEX Style
The nurse is teaching a client with hypopituitarism who is prescribed lifelong hormone replacement therapy. Which statement indicates a need for further teaching?
A. "I will take my levothyroxine every morning."
B. "I should never abruptly stop taking corticosteroids."
C. "I will notify my provider if I experience increased urination and thirst."
D. "Once my levels stabilize, I can stop taking the medications."
D. "Once my levels stabilize, I can stop taking the medications."
The nurse is assessing a 7-year-old girl suspected of precocious puberty. Which finding supports this diagnosis?
A. Presence of breast development
B. Increased thirst and urination
C. Absence of menarche
D. Height below the 5th percentile
A. Presence of breast development
The nurse is teaching the parent how often leuprolide (Lupron Depot) injections are administered. Which instruction is correct?
A. Daily
B. Weekly
C. Monthly or every 3 months
D. Only if symptoms worsen
C. Monthly or every 3 months
A child with precocious puberty expresses embarrassment and refuses to attend school. What is the nurse’s PRIORITY intervention?
A. Encourage the child to wear looser clothing
B. Assess for bullying or peer difficulties
C. Provide a pamphlet on puberty
D. Tell the parents that this is normal behavior
B. Assess for bullying or peer difficulties
The nurse teaches a family about nutrition for a child with precocious puberty. Which recommendation supports healthy growth?
A. “Provide a balanced diet and maintain a healthy weight.”
B. “Increase protein and supplements to speed growth.”
C. “Reduce all fats to prevent hormone changes.”
D. “Avoid fruits high in natural sugars.”
A. “Provide a balanced diet and maintain a healthy weight.”
The nurse is educating a parent who worries their daughter will be treated differently at school. What health-promoting action should the nurse recommend?
A. Speak with school staff about supporting age-appropriate expectations
B. Tell the school to treat the child like an older student
C. Avoid informing teachers about the child’s diagnosis
D. Keep the child home from school until puberty stops
A. Speak with school staff about supporting age-appropriate expectations
A nurse is assessing a female client with hypopituitarism. Which clinical manifestation should the nurse expect?
A. Hirsutism
B. Amenorrhea
C. Exophthalmos
D. Hypertension
B. Amenorrhea
A child with precocious puberty is prescribed leuprolide (Lupron). Which teaching should the nurse include?
A. “This medication will permanently stop puberty.”
B. “The medication is given daily by mouth.”
C. “The goal is to slow puberty to allow for normal growth.”
D. “Expect puberty to continue normally throughout treatment.”
C. “The goal is to slow puberty to allow for normal growth.”
The nurse is assessing psychosocial concerns in a child with precocious puberty. Which concern is most important for the nurse to address?
A. Increased appetite
B. Difficulty fitting in with peers
C. Increased energy levels
D. Improved academic performance
B. Difficulty fitting in with peers
The nurse is educating the family about home care for a child with precocious puberty. Which instruction is priority?
A. “Increase your child’s physical activity.”
B. “Monitor your child’s height and growth regularly.”
C. “Encourage them to spend time with older children.”
D. “Restrict participation in sports.”
B. “Monitor your child’s height and growth regularly.”
The nurse is reviewing the laboratory results of a client diagnosed with hypopituitarism. Which finding should the nurse expect?
A. Elevated growth hormone
B. Elevated TSH
C. Decreased ACTH
D. Increased prolactin
C. Decreased ACTH
A client is diagnosed with hyperpituitarism caused by a pituitary adenoma. Which clinical finding should the nurse expect?
A. Weight loss
B. Decreased urine output
C. Enlarged hands and feet
D. Low blood glucose levels
C. Enlarged hands and feet
The nurse is caring for a client receiving bromocriptine for hyperpituitarism. The nurse should include which instruction?
A. Take the medication at bedtime to prevent nausea
B. Stop the medication if you become pregnant
C. Sit or stand up slowly to avoid dizziness
D. Avoid taking the medication with food
C. Sit or stand up slowly to avoid dizziness
A client with hypopituitarism exhibits sudden severe headache, visual changes, and loss of consciousness. What is the nurse’s priority action?
A. Administer scheduled growth hormone
B. Check the client’s blood glucose
C. Notify the healthcare provider immediately
D. Provide warm blankets
C. Notify the healthcare provider immediately
Which statement by a parent requires further teaching about managing a child with precocious puberty?
A. “I will promote age-appropriate activities.”
B. “I should treat my child according to their developmental age.”
C. “My child may need emotional support due to early physical changes.”
D. “I should expect my child to act older because they look older.”
D. “I should expect my child to act older because they look older.”
Which child is at greatest risk for developing precocious puberty?
A. A 9-year-old girl with type 1 diabetes
B. A 3-year-old boy with exposure to testosterone creams
C. A 7-year-old boy with asthma
D. A 5-year-old girl with lactose intolerance
B. A 3-year-old boy with exposure to testosterone creams
A client with hyperpituitarism due to excessive ACTH secretion is being assessed by the nurse. Which finding supports this diagnosis?
A. Hyperpigmentation
B. Hypotension
C. Moon face
D. Hypoglycemia
Moon face
A client with hypopituitarism is prescribed levothyroxine. Which instruction should the nurse include in the teaching?
A. “Take the medication at night for best absorption.”
B. “Take this on an empty stomach every morning.”
C. “You can take this with antacids.”
D. “You may skip a dose if your energy level is normal.”
B. “Take this on an empty stomach every morning.”
The nurse is caring for a client with hyperpituitarism who is at risk for increased intracranial pressure (ICP). Which nursing intervention is MOST appropriate?
A. Encourage coughing and deep breathing
B. Maintain head of the bed at 30 degrees
C. Instruct the client to avoid fluids
D. Lower the head of the bed flat
B. Maintain head of the bed at 30 degrees
The nurse is caring for a client with hypopituitarism who is scheduled for surgery. What preoperative teaching is MOST important?
A. “You will need to discontinue corticosteroids 24 hours before surgery.”
B. “You may require a higher dose of corticosteroids during surgery.”
C. “Do not take levothyroxine on the morning of surgery.”
D. “Growth hormone must be given twice the day before surgery.”
B. “You may require a higher dose of corticosteroids during surgery.”
The nurse teaches a client about symptoms of adrenal insufficiency due to low ACTH. Which symptom should the nurse instruct the client to report immediately?
A. Weight gain
B. Shakiness after meals
C. Dizziness and severe fatigue
D. Mild ankle swelling
C. Dizziness and severe fatigue
Which symptom in a 7-year-old boy is MOST characteristic of precocious puberty?
A. Increased thirst
B. Deepening voice
C. Early facial hair growth
D. Increased appetite only
C. Early facial hair growth
The nurse is teaching a client receiving growth hormone replacement injections. Which statement indicates the client needs further teaching?
A. “I will rotate my injection sites.”
B. “I might notice improved energy and muscle strength.”
C. “I can stop taking this medication when I feel better.”
D. “I will report swelling in my hands or joints.”
C. “I can stop taking this medication when I feel better.”
A parent calls the clinic stating that they may not be able to bring their child for her scheduled leuprolide injection this month. What is the nurse’s PRIORITY response?
A. “Try to come next month instead.”
B. “The medication cannot be delayed; let’s find a solution today.”
C. “We can switch to an oral form of the medication.”
D. “This should not affect her treatment.”
B. “The medication cannot be delayed; let’s find a solution today.”
A parent asks how to support their daughter emotionally during precocious puberty. Which response is best?
A. “Try not to talk about puberty so she won’t worry.”
B. “Remind her that her feelings and questions are normal and welcome.”
C. “Tell her these changes mean she must act more mature.”
D. “Discuss puberty only with the healthcare provider present.”
B. “Remind her that her feelings and questions are normal and welcome.”