front 1 Which patient should the nurse expect to be most
likely to be treated with somatropin?
- A. A 7-year-old diagnosed with growth hormone
deficiency
- B. A 10-year-old of short stature who has
severe asthma
- C. An 8-year-old with Prader-Willi
syndrome Incorrect
- D. A 17-year-old who is 5 feet
tall
| back 1 - A. A 7-year-old diagnosed with growth hormone deficiency
- For this medication to be used, the patient has to be diagnosed
with a growth hormone deficiency, and the epiphyses must not be
fused, so the child needs to be young. Severe respiratory
conditions, Prader-Willi syndrome, and age of 17 years are
contraindications to this medication.
|
front 2 What assessment finding indicates to the nurse that vasopressin has
been effective?
- A. Increased serum albumin levels
- B. Increased
urine specific gravity
- C. Decreased adrenocorticotropic
hormone levels
- D. Relief of pain
| back 2 - B. Increased urine specific gravity
- Vasopressin causes
decreased water excretion in the renal tubule, thus increasing urine
specific gravity. It is used to treat diabetes insipidus, which
presents with a low urine specific gravity. This medication does not
affect serum albumin, decrease adrenocorticotropic hormone levels,
or decrease pain.
|
front 3 The nurse admitting a patient with acromegaly anticipates
administering which medication?
- A. Desmopressin
- B. Corticotropin
- C.
Somatropin
- D. Octreotide
| back 3
Octreotide suppresses growth hormone that causes acromegaly |
front 4 Which patient statement demonstrates understanding of the nurse’s
teaching for levothyroxine?
- A. “I will take this medication first thing in the
morning.”
- B. “I will double my dose if I gain more than 1
pound/day.”
- C. “It is best to take the medication with food
to prevent gastrointestinal upset.”
- D. “I can expect to see
relief of my symptoms within 1 week.”
| back 4 - A. “I will take this medication first thing in the
morning.”
- Levothyroxine increases basal metabolism and thus
wakefulness. It should be taken first thing in the morning. The
patient should not increase the dose. The medication is absorbed
best on an empty stomach. Depending on the symptoms, some symptoms
may take weeks to improve.
|
front 5 What nursing diagnosis is a priority for a patient
receiving desmopressin (DDAVP)?
- A. Risk for injury
- B. Alteration in
comfort
- C. Fluid volume excess
- D. Knowledge
deficit
| back 5
Desmopressin (DDAVP) is a form of antidiuretic hormone, which
increases sodium and water retention, leading to an alteration in
fluid volume. Although the other nursing diagnoses may be appropriate,
they are not a priority using Maslow hierarchy of needs. |
front 6 The nurse is caring for a patient who has just started taking
levothyroxine. What assessment finding is a priority
for the nurse to address?
- A. Heart rate 55 beats/min
- B. Intolerance to
cold
- C. Weight gain of 3 pounds in the last week
- D.
Irritability
| back 6 - D. Irritability Correct
- Irritability is a symptom of
hyperthyroidism. This could be a sign that the medication dose is
too high. A lowered heart rate, weight gain, and intolerance to cold
could be symptoms of hypothyroidism and are expected in this
patient, who just began medication therapy.
|
front 7 The nurse is caring for a patient who is taking levothyroxine and
warfarin. Which intervention is a priority for the nurse?
- A. Monitor the patient for cardiac dysrhythmias.
- B.
Monitor the patient for increased risk of bleeding.
- C.
Weigh patient daily for excessive weight loss.
- D. Assess
peripheral pulses and Homans sign daily.
| back 7 - B. Monitor the patient for increased risk of bleeding.
- Levothyroxine can compete with protein-binding sites of warfarin
(Coumadin), allowing more warfarin to be unbound or free, thus
increasing the effects of warfarin and the risk of bleeding. This
combination does not place the patient at an increased risk of
dysrhythmias, weight loss, or deep vein thrombosis.
|
front 8 A patient receiving propylthiouracil (PTU) asks the nurse how this
medication will help relieve symptoms. Which statement is the nurse’s bestresponse?
- A. “PTU inactivates any circulating thyroid hormone,
thus decreasing signs and symptoms of hyperthyroidism.”
- B.
“This medication inhibits the formation of new thyroid hormone,
thus gradually returning your metabolism to normal.”
- C.
“PTU helps the thyroid gland use iodine and synthesize hormones
better.”
- D. “This medication stimulates the pituitary gland
to secrete thyroid-stimulating hormone, which inhibits the
production of hormones by the thyroid gland.”
| back 8 - B. “This medication inhibits the formation of new thyroid
hormone, thus gradually returning your metabolism to normal.”
- Propylthiouracil (PTU) is an antithyroid medication used to
treat hyperthyroidism. It works by inhibiting the synthesis of new
thyroid hormone. It does not inactivate hormone already
present.
|
front 9 The patient is taking an antithyroid medication. Which foods should
the nurse teach the patient to avoid eating?
- Chicken salad sandwich with mayonnaise, vegetable soup,
milk
- Ham and cheese omelet, rye toast with butter, orange
juice
- Hamburger on sesame roll, salad with French dressing,
milk Incorrect
- Shrimp cocktail, boiled lobster, spinach
salad without dressing, water Correct
| back 9 - Shrimp cocktail, boiled lobster, spinach salad without
dressing, water
- Seafood contains high amounts of iodine.
The other choices do not. The nurse instructs a patient taking an
antithyroid medication to avoid foods high in iodine.
|
front 10 What should the nurse include in the plan of care for the patient
beginning prednisone therapy?
- Administer the medication early evening to coincide with
the natural secretion pattern of the adrenal cortex.
- Plan
to keep a strict, unchanging schedule to prevent adverse
reactions.
- Take the medication with food to diminish the risk
of gastric irritation.
- Take the medication only every other
day to decrease the risk of adrenal hyperplasia.
| back 10 - Take the medication with food to diminish the risk of gastric
irritation.
- Glucocorticoids can cause gastric distress and
should be administered with food. The normal circadian secretion of
the adrenal cortex is early morning to wake the person up, not early
evening. These medications should be tapered off slowly to prevent
adrenal crisis. The patient takes the medication daily.
|
front 11 A patient asks the nurse to explain the action of glucocorticoids.
Which statement is the nurse’s best response?
- “Glucocorticoids influence carbohydrate, lipid, and protein
metabolism.”
- “Glucocorticoids are produced in decreased
amounts during times of stress.”
- “Glucocorticoids decrease
serum sodium and glucose levels.”
- “Glucocorticoids
stimulate defense mechanisms to produce immunity.”
| back 11 - “Glucocorticoids influence carbohydrate, lipid, and protein
metabolism.”
- Glucocorticoids play a major role in
carbohydrate, lipid, and protein metabolism within the body. They
are produced in increasing amounts during stress. They increase
sodium and glucose levels and suppress the immune system.
|
front 12 The nurse is caring for several patients who will be receiving
glucocorticoid therapy. Which patient should be assessed first
based on clinical diagnosis?
- Uncontrolled diabetes mellitus
- Chronic
rheumatoid arthritis
- Recovering from septic shock
- Exacerbation of asthma controlled using oxygen therapy.
| back 12 - Uncontrolled diabetes mellitus Correct
- A common side
effect of steroid therapy is hyperglycemia. The patient with
uncontrolled diabetes mellitus could suffer a severe hyperglycemic
episode. The other clinical diagnoses presented do not required
immediate action.
|
front 13 When assessing for potential side effects of fludrocortisone, what is
a priority for the nurse to monitor?
- Serum sodium levels for potential hyponatremia
- Serum calcium levels for hypercalcemia
- Serum potassium
levels for hypokalemia
- Intake and output for potential
fluid volume deficit
| back 13 - Serum potassium levels for hypokalemia
- Fludrocortisone
has mineralocorticoid properties, resulting in sodium and fluid
retention along with potassium excretion.
|
front 14 A nurse is providing discharge teaching for a patient receiving
glucocorticoids. Which medication should the nurse expect to be
included for pain management?
- Aspirin
- Acetaminophen
- Ibuprofen
- Naproxen sodium
| back 14 - Acetaminophen
- Acetaminophen does not cause gastric
distress as do aspirin, ibuprofen, naproxen sodium, and
glucocorticoids.
|
front 15 The patient is receiving corticotropin for ACTH deficiency. Which
statement by the patient indicates a need for
additional teaching?
- “I can administer the drug subcutaneously.”
- “When
my symptoms are resolved, I can discontinue the drug.”
- “I
need to eat foods high in potassium.”
- “The drug may
suppress symptoms of infection.”
| back 15 - “When my symptoms are resolved, I can discontinue the
drug.”
- The patient should not discontinue the drug
abruptly; the dose of the drug must be tapered over several days.
Hypokalemia is possible, so eating foods high in potassium is
correct. The drug can be administered subcutaneously.
|
front 16 After administering corticotropin, what assessments are
priorities for the nurse? (Select all that apply.)
- Acid and alkaline phosphatase levels
- C-reactive
protein levels
- Changes in vision
- Glucose
levels
- Intake and output
- Serum sodium levels
| back 16 Changes in vision, Glucose levels, Intake and output, Serum sodium levels
Corticotropin can cause cataracts and glaucoma, so the nurse needs
to monitor for changes in vision. Corticotropin stimulates the release
of adrenal hormones, which can lead to sodium and fluid retention as
well as hyperglycemia. Corticotropin can cause sodium and fluid
retention, so that intake and output should be monitored. Serum sodium
levels should be monitored, as sodium retention can be a result of
corticotropin administration. C-reactive protein, acid and alkaline
phosphatase levels are not indicated for monitoring. |
front 17 The parents of an 11-year-old boy ask about growth hormone therapy
for their child who is shorter than his 10-year-old sister. The nurse
will tell the parents that growth hormone
a. does not affect
other hormones when given.
b. is available as an oral tablet to
be taken once daily.
c. is given after tests prove that it is
necessary.
d. may be given until the child's desired height is reached. | back 17 c. is given after tests prove that it is necessary. |
front 18 The nurse is caring for a patient who is receiving growth hormone.
Which assessment will the nurse monitor daily?
a. Complete blood
count
b. Height and weight
c. Renal function
d. Serum glucose | |
front 19 The parents of a 16-year-old boy who plays football want their child
to receive growth hormone to improve muscle strength. What will the
nurse tell the parents?
a. "Growth hormone may be used to
improve strength in young athletes."
b. "If the
epiphyses are not fused, growth hormone may be an
option."
c. "Small doses of growth hormone may be used
indefinitely for this purpose."
d. "Using growth
hormone to build muscle mass is not recommended." | back 19 d. "Using growth hormone to build muscle mass is not recommended." |
front 20 Which would be a contraindication for hormone therapy with somatropin
(Genotropin) in a school-age child?
a. Asthma
b.
Dwarfism
c. Enuresis
d. Prader-Willi syndrome | |
front 21 A child exhibits acromegaly caused by a tumor that cannot be
destroyed with radiation. Which medication will most likely be used to
treat this child?
a. Bromocriptine mesylate (Parlodel)
b.
Octreotide acetate (Sandostatin)
c. Somatrem (Protropin)
d.
Somatropin (Genotropin) | back 21 a. Bromocriptine mesylate (Parlodel) |
front 22 The nurse is caring for a patient who has hypothyroidism. To assist
in differentiating between primary and secondary hypothyroidism, the
nurse will expect the provider to order which drug?
a.
Liothyronine sodium (Cytomel)
b. Liotrix (Thyrolar)
c.
Methimazole (Tapazole)
d. Thyrotropin (Thytropar) | back 22 d. Thyrotropin (Thytropar) |
front 23 The nurse administers intravenous corticotropin (Acthar) to a
patient. A serum cortisol level drawn 60 minutes later shows no change
in serum cortisol levels from prior to the dose. What is the nurse's
first action?
a. Notify the provider to discuss a possible
non-functioning adrenal gland.
b. Recognize the need for an
increased dose to treat pituitary insufficiency.
c. Request an
order for a second dose of corticotropin to treat cortisone
deficiency.
d. Request an order to repeat the serum cortisol
level in 1 to 2 hours | back 23 a. Notify the provider to discuss a possible non-functioning adrenal gland. |
front 24 The nurse provides teaching for a patient receiving corticotropin.
The nurse will instruct the patient to contact the provider if which
condition occurs?
a. Bruising
b. Constipation
c.
Myalgia
d. Nausea | |
front 25 The nurse is caring for a patient who has experienced head trauma in
a motor vehicle accident. The patient is having excessive output of
dilute urine. The nurse will notify the provider and will anticipate
administering which medication?
a. Calcifediol (Calderol)
b.
Corticotropin (Acthar)
c. Prednisolone (AK-Pred)
d.
Vasopressin (Pitressin) | back 25 d. Vasopressin (Pitressin) |
front 26 The nurse is preparing to administer piperacillin to a patient to
treat an infection caused by pseudomonas. The nurse learns that the
patient receives corticotropin to treat multiple sclerosis. The nurse
will request an order for
a. a different antibiotic.
b.
blood glucose monitoring.
c. cardiac monitoring.
d. serum electrolytes. | |
front 27 The nurse is caring for a patient who is receiving desmopressin
acetate (DDAVP). Which assessments are important while caring for this
patient?
a. Blood pressure and serum potassium
b. Heart rate
and serum calcium
c. Lung sounds and serum magnesium
d.
Urine output and serum sodium | back 27 d. Urine output and serum sodium |
front 28 A 35-year-old woman reports lethargy, difficulty remembering things,
facial edema, dry skin, and cessation of menses. The nurse notes a
heart rate of 60 beats per minute and a weight increase of 5 pounds
from a previous visit. The nurse will notify the provider of which
possible condition?
a. Cretinism
b. Early menopause
c.
Hyperthyroidism
d. Myxedema | |
front 29 A patient is admitted to the hospital to treat hypothyroidism. For
rapid improvement in symptoms, the nurse will expect to administer
which medication?
a. Levothyroxine sodium (Synthroid)
b.
Liothyronine (Cytomel)
c. Liotrix (Thyrolar)
d. Thyroid
desiccated (Armour Thyroid) | back 29 b. Liothyronine (Cytomel) |
front 30 A patient who takes warfarin (Coumadin) and digoxin (Lanoxin)
develops hypothyroidism and will begin taking levothyroxine
(Synthroid). The nurse anticipates which potential adjustments in
dosing for this patient?
a. Decreased digoxin and decreased
warfarin
b. Decreased digoxin and increased warfarin
c.
Increased digoxin and decreased warfarin
d. Increased digoxin and
increased warfarin | back 30 c. Increased digoxin and decreased warfarin |
front 31 A patient who takes the oral antidiabetic agent metformin
(Glucophage) will begin taking levothyroxine (Synthroid). The nurse
will teach this patient to monitor for
a. hyperglycemia.
b.
hypoglycemia.
c. hyperkalemia.
d. hypokalemia. | |
front 32 A patient who has hyperthyroidism will begin treatment with an
antithyroid medication. The patient asks the nurse about dietary
requirements. The nurse will counsel the patient to avoid which
food(s)?
a. Fava beans
b. Foods high in purine
c.
Grapefruit
d. Shellfish | |
front 33 The nurse is caring for a patient who is being treated for
hypothyroidism. The patient reports insomnia, nervousness, and
flushing of the skin. Before notifying the provider, the nurse will
perform which action?
a. Assess serum glucose to evaluate
possible hypoglycemia.
b. Check the patient's heart rate to
assess for tachycardia.
c. Perform an assessment of hydration
status.
d. Take the patient's temperature to evaluate for infection. | back 33 b. Check the patient's heart rate to assess for tachycardia. |
front 34 A patient with Graves disease exhibits tachycardia, heat intolerance,
and exophthalmos. Prior to surgery, which drug is used to alter
thyroid hormone levels?
a. Liotrix (Thyrolar)
b. Propranolol
(Inderal)
c. Propylthiouracil (PTU)
d. Thyroid (Thyrotab) | back 34 c. Propylthiouracil (PTU) |
front 35 A patient has hypocalcemia caused by parathyroid hormone deficiency.
Which medication will the nurse anticipate giving to this
patient?
a. Calcitonin
b. Calcitriol
c. Calcium
d.
Vitamin D | |
front 36 A patient is receiving a glucocorticoid medication to treat an
inflammatory condition, and the provider has ordered a slow taper in
order to discontinue this medication. The nurse explains to the
patient that this is done to prevent which condition?
a.
Acromegaly
b. Adrenocortical insufficiency
c. Hypertensive
crisis
d. Thyroid storm | back 36 b. Adrenocortical insufficiency |
front 37 A patient is taking prednisolone and fludrocortisone (Florinef). When
teaching this patient about dietary intake, the nurse will instruct
the patient to consume a diet
a. high in carbohydrates.
b.
high in fat.
c. high in protein.
d. low in potassium. | |
front 38 A patient who takes high-dose aspirin to treat arthritis will need to
take prednisone to treat an acute flare of symptoms. What action will
the nurse perform?
a. Observe the patient for
hypoglycemia.
b. Monitor closely for increased urine
output.
c. Observe the patient for hypotension.
d. Request
an order for enteric-coated aspirin. | back 38 d. Request an order for enteric-coated aspirin. |