Which of the following manifestations are associated with pheochromocytoma?
Hypotension.
Tachycardia.
Headaches.
Weight gain.
Palpitations.
Tremors.
Correct Answer : B,C,E,F
Choice A rationale
Hypotension is typically not associated with this condition because the tumor hypersecretes catecholamines like epinephrine and norepinephrine. These substances induce potent vasoconstriction and increase systemic vascular resistance, leading to severe hypertension rather than low blood pressure. Patients often experience paroxysmal or sustained elevations in blood pressure that can exceed 200/110 mmHg. Therefore, hypotension would only occur in rare cases of catecholamine depletion or during specific medical crises.
Choice B rationale
Tachycardia is a classic manifestation resulting from the stimulatory effects of excessive catecholamines on cardiac beta-1 adrenergic receptors. This stimulation increases the heart rate and myocardial contractility significantly. The patient may report a racing heart or a rapid pulse even while at rest. This sympathetic overactivity is a hallmark of the clinical triad, which also includes headache and diaphoresis, and it requires careful monitoring to prevent potential cardiac complications or arrhythmias.
Choice C rationale
Headaches are one of the most common presenting symptoms and are usually described as severe, pounding, and sudden in onset. This occurs due to the acute and dramatic increase in systemic arterial blood pressure caused by the sudden release of catecholamines from the adrenal medulla or extra-adrenal chromaffin tissue. The resulting cerebral vasodilation and increased intracranial pressure contribute to the intense pain. It is often the symptom that prompts the patient to seek medical evaluation.
Choice D rationale
Weight gain is unlikely because the chronic excess of catecholamines increases the basal metabolic rate and promotes glycogenolysis and lipolysis. Most patients actually experience unexplained weight loss despite having a normal or increased appetite. The hypermetabolic state induced by the tumor mimics hyperthyroidism in some aspects, leading to increased energy expenditure. Therefore, significant weight gain would be an atypical finding and might suggest a different underlying metabolic or endocrine disorder.
Choice E rationale
Palpitations occur as a direct result of the chronotropic and inotropic effects of catecholamines on the myocardium. The patient becomes acutely aware of their heartbeat, which they often describe as a forceful thumping or fluttering in the chest. These episodes can occur spontaneously or be triggered by physical exertion, emotional stress, or pressure on the tumor. Palpitations are frequently accompanied by anxiety or a sense of impending doom during a catecholamine surge.
Choice F rationale
Tremors are caused by the overstimulation of the nervous system and skeletal muscles by circulating epinephrine and norepinephrine. This increased sympathetic tone leads to fine or coarse muscle tremors, often visible in the hands. The excessive stimulation of beta-2 receptors in the skeletal muscles contributes to this fine motor instability. Tremors are frequently associated with other signs of autonomic hyperactivity, such as diaphoresis and nervousness, forming part of the systemic response to the tumor.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Systemic lupus erythematosus is an autoimmune disease where ultraviolet radiation can trigger systemic flares and skin lesions. Photosensitivity occurs because UV light causes keratinocyte apoptosis, leading to an inflammatory response. Applying sunscreen with an SPF of 50 or higher provides a critical barrier against UV-A and UV-B rays. This helps prevent the exacerbation of symptoms like the malar rash and systemic organ involvement. Consistent protection is a cornerstone of managing this chronic condition to maintain remission.
Choice B rationale
Restricting sun exposure only during summer months is insufficient because ultraviolet rays are present year-round, even on cloudy days or during winter. Reflections from snow or water can also intensify exposure. SLE patients require constant protection because their immune systems are hypersensitive to any level of UV radiation. Limiting precautions to a single season leaves the patient vulnerable to flares during the rest of the year. Effective management requires a permanent lifestyle modification involving daily sun avoidance and skin protection.
Choice C rationale
Engaging in outdoor activities without restrictions is dangerous for a client with SLE. High levels of UV exposure can induce a flare that impacts the kidneys, heart, and joints. Patients are advised to avoid peak sunlight hours, usually between 10: and 16:, when UV radiation is strongest. Unrestricted exposure increases the cumulative damage to cellular DNA, which in lupus patients leads to increased autoantibody production. Education must emphasize the necessity of seeking shade and wearing protective clothing.
Choice D rationale
While vitamin D is essential for bone health, SLE patients should not seek sun exposure to obtain it due to the high risk of disease exacerbation. Instead, vitamin D levels should be managed through dietary intake and oral supplementation. Serum 25-hydroxyvitamin D levels should be monitored to stay within the normal range of 30 to 100 ng/mL. Sunlight as a source of vitamin D is contraindicated because the potential for a life-threatening lupus flare outweighs the benefit of cutaneous synthesis.
Correct Answer is B
Explanation
Choice A rationale
Hyperglycemia can occur due to the stress response or steroid therapy, but it is not the most critical complication specific to the surgical site. While blood glucose monitoring is standard, it does not address the immediate risks of intracranial pressure changes or cerebrospinal fluid leaks. Postoperative glucose levels are generally managed within 70 to 110 mg/dL, yet this intervention remains secondary to neurological monitoring in the acute phase.
Choice B rationale
Frequent neurological assessment is the priority because hypophysectomy involves entering the cranial cavity near vital structures. The nurse must monitor for signs of increased intracranial pressure, meningitis, or cerebrospinal fluid leakage, which presents as a halo sign on dressings. Assessing level of consciousness, pupil reactivity, and motor strength allows for the early detection of life-threatening complications like intracranial hemorrhage or cerebral edema following the manipulation of the pituitary gland and surrounding tissues.
Choice C rationale
The pituitary gland produces adrenocorticotropic hormone, and its removal necessitates lifelong hormone replacement to prevent adrenal crisis. While administering these medications is vital for long-term stability and metabolic function, it is a scheduled pharmacological intervention rather than a primary monitoring task for acute surgical complications. Preventing an adrenal crisis is essential, but the immediate postoperative focus is on the stability of the central nervous system and the surgical site.
Choice D rationale
Pulmonary hygiene is a standard postoperative intervention to prevent atelectasis and pneumonia. However, patients undergoing hypophysectomy must avoid coughing or blowing their nose, as these actions increase intracranial pressure and can cause a cerebrospinal fluid leak. Therefore, while deep breathing is encouraged, it must be performed carefully without vigorous coughing. This makes it less critical than direct neurological monitoring for the specific risks associated with this particular neurosurgical procedure.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.