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 B

Explanation

A. Cheyne-Stokes breathing is characterized by periods of deep breathing followed by apnea and is often associated with conditions like heart failure or brain injury, not diabetic ketoacidosis (DKA).
B. Acetone odor to breath is a hallmark sign of diabetic ketoacidosis. The body breaks down fats for energy, producing ketones, which are released in the breath, giving it a fruity or acetone-like odor.
C. A blood glucose level below 40 mg/dL would indicate hypoglycemia, not DKA. In DKA, blood glucose levels are typically elevated (above 250 mg/dL).
D. Malignant hypertension refers to extremely high blood pressure with organ damage, and is not directly related to diabetic ketoacidosis.

A. Restrict fluid intake. B. Administer oral corticosteroids. C. Provide a low-carbohydrate diet. D. Weigh the client daily.

Correct Answer is B

Explanation

A. Restrict fluid intake: This is incorrect. Clients with Addison’s disease are at risk for dehydration, especially during an Addisonian crisis. Fluids should be encouraged to help maintain blood pressure and fluid balance, rather than restricting fluid intake.
B. Administer oral corticosteroids: This is the correct action. Clients with Addison's disease have insufficient cortisol production, especially during times of stress or illness. Oral corticosteroids, such as hydrocortisone, are given to replace the deficient hormones and prevent or manage an Addisonian crisis.
C. Provide a low-carbohydrate diet: This is incorrect. Clients with Addison’s disease should have a balanced diet that includes adequate carbohydrates to support energy needs, especially during stress or illness. A low-carbohydrate diet could lead to further complications like hypoglycemia.
D. Weigh the client daily: While daily weight measurements can be helpful in monitoring for fluid retention or loss, it is not a primary intervention for preventing or managing Addisonian crisis. The most critical action is providing the necessary corticosteroid replacement therapy.

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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 diabetic ketoacidosis. Which of the following manifestations should the nurse expect?

Correct Answer is B

Explanation

A nurse is caring for a client who has Addison's disease and is at risk for Addisonian crisis. Which of the following actions should the nurse take?

Correct Answer is B

Explanation

Which of the following assessment findings indicates an emergency and the need for immediate action on the part of the nurse?

Which condition may be observed due to incorrect fluid replacement with hypotonic fluids in patients with diabetic ketoacidosis?

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