Which response is best when a patient refuses a stool softener after pituitary surgery?

"You need the stool softener because it will be hard to defecate while you remain in bed."

"Any manipulation of the pituitary gland can cause difficulty in defecation, so stool softeners are important after your surgery."

"It is important you do not strain during bowel movements because this could result in increased pressure on your surgical site."

"You can choose not to take the stool softener if you feel you do not need it."

Answer and Explanation

The Correct Answer is C

A. "You need the stool softener because it will be hard to defecate while you remain in bed.": This is not the most appropriate response. While immobility can make bowel movements more difficult, the primary concern following pituitary surgery is the avoidance of straining due to the potential for increased intracranial pressure (ICP). The emphasis should be on avoiding pressure on the surgical site rather than general difficulties from immobility.
B. "Any manipulation of the pituitary gland can cause difficulty in defecation, so stool softeners are important after your surgery.": This is misleading. While pituitary surgery may influence certain bodily functions, the most critical concern is preventing straining to avoid raising ICP. The focus should be on explaining the rationale for avoiding pressure on the surgical site.
C. "It is important you do not strain during bowel movements because this could result in increased pressure on your surgical site.": This is the correct response. Straining during bowel movements can increase ICP, which could potentially compromise healing or lead to complications after pituitary surgery. This explanation directly addresses the patient's safety and emphasizes the need for stool softeners to prevent straining.
D. "You can choose not to take the stool softener if you feel you do not need it.": This response is inappropriate because it does not emphasize the importance of preventing straining, which is a critical consideration after pituitary surgery. The nurse should provide education on the necessity of the stool softener to avoid complications rather than leaving the decision solely to the patient.

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Correct Answer is ["A","C","D","E"]

Explanation

A. Purple striations: This is correct. One of the characteristic manifestations of Cushing's syndrome is the development of purple or reddish stretch marks (striae) on the skin, which are caused by the weakening of the skin due to excessive cortisol.
B. Tremors: This is not typically a manifestation of Cushing's syndrome. Tremors are more commonly seen in conditions such as hyperthyroidism or neurological disorders, not in Cushing's syndrome.
C. Hypertension: This is correct. Elevated cortisol levels in Cushing's syndrome can lead to fluid retention, sodium retention, and increased blood pressure, resulting in hypertension.
D. Buffalo hump: This is correct. A buffalo hump, or a fatty accumulation on the upper back and neck, is a common feature of Cushing's syndrome. It is caused by the redistribution of fat due to elevated cortisol levels.
E. Moon face: This is correct. "Moon face" refers to the round, puffy face that is a hallmark sign of Cushing's syndrome. The face becomes swollen due to fat accumulation, a result of high cortisol levels.

A. Document the amount of drainage. B. Notify the client's provider. C. Obtain a culture of the drainage. D. Check the drainage for glucose.

Correct Answer is D

Explanation

A. While documenting the amount of drainage is important, it is not the most urgent action when clear drainage is observed after a transsphenoidal hypophysectomy.
B. Notifying the provider is important but should not be the first step. The nurse should first assess the nature of the drainage, as it could indicate a serious complication, such as cerebrospinal fluid (CSF) leakage.
C. A culture may be necessary if infection is suspected, but the priority action is to assess whether the drainage is CSF.
D. Checking the drainage for glucose is the most appropriate initial action. Clear drainage from the nasal packing could indicate a CSF leak, which is a complication that can occur after transsphenoidal surgery. CSF contains glucose, so testing for glucose in the drainage will help determine if it is CSF. If glucose is detected, the nurse should immediately notify the provider, as CSF leakage requires prompt intervention.

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Which response is best when a patient refuses a stool softener after pituitary surgery?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has Cushing's syndrome. The nurse should recognize that which of the following are manifestations of Cushing's syndrome? (Select all that apply.)

Correct Answer is ["A","C","D","E"]

Explanation

A nurse is caring for a client who is 1 day postoperative following a transsphenoidal hypophysectomy. While assessing the client, the nurse notes a large area of clear drainage seeping from the nasal packing. Which of the following should be the nurse's initial action?

Correct Answer is D

Explanation

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