Pharmacology - Endocrine Medications.txt

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Pharmacology - Endocrine Medications.txt
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  1. The nurse is teaching a client how to mix regular insulin and NPH insulin in the same syringe. Which action, if performed by the client, indicates the need for further teaching?
    1. Withdraws the NPH insulin first
    2. Withdraws the regular insulin first
    3. Injects air into NPH insulin vial first
    4. Injects an amount of air equal to the desired dose of insulin into each vial
    1. Withdraws the NPH insulin first
  2. The home care nurse visits a client recently diagnosed with diabetes mellitus who is taking Humulin NPH insulin daily. The client asks the nurse how to store the unopened vials of insulin. The nurse should tell the client to take which action?
    1. Freeze the insulin.
    2. Refrigerate the insulin.
    3. Store the insulin in a dark, dry place.
    4. Keep the insulin at room temperature.
    2. Refrigerate the insulin.
  3. Glimepiride (Amaryl) is prescribed for a client with diabetes mellitus. The nurse instructs the client to avoid consuming which food while taking this medication?
    1. Alcohol
    2. Organ meats
    3. Whole-grain cereals
    4. Carbonated beverages
    1. Alcohol
  4. Sildenafil (Viagra) is prescribed to treat a client with erectile dysfunction. The nurse reviews the client's medical record and should question the prescription if which data is noted in the client's history?
    1. Insomnia
    2. Neuralgia
    3. Use of nitroglycerin
    4. Use of multivitamins
    3. Use of nitroglycerin
  5. The health care provider (HCP) prescribes exenatide (Byetta) for a client with type 1 diabetes mellitus who takes insulin. The nurse should plan to take which most appropriate intervention?
    1. Withhold the medication and call the HCP, questioning the prescription for the client.
    2. Administer the medication within 60 minutes before the morning and evening meal.
    3. Monitor the client for gastrointestinal side effects after administering the medication.
    4. Withdraw the insulin from the prefilled pen into an insulin syringe to prepare for administration.
    1. Withhold the medication and call the HCP, questioning the prescription for the client.
  6. A client is taking Humulin NPH insulin and regular insulin every morning. The nurse should provide which instructions to the client? Select all that apply.
    1. Hypoglycemia may be experienced before dinnertime.
    2. The insulin dose should be decreased if illness occurs.
    3. The insulin should be administered at room temperature.
    4. The insulin vial needs to be shaken vigorously to break up the precipitates.
    5. The NPH insulin should be drawn into the syringe first, then the regular insulin.
    • 1. Hypoglycemia may be experienced before dinnertime.
    • 3.The insulin should be administered at room temperature.
  7. The home health care nurse is visiting a client who was recently diagnosed with type 2 diabetes mellitus. The client is prescribed repaglinide (Prandin) and metformin (Glucophage) and asks the nurse to explain these medications. The nurse should provide which instructions to the client? Select all that apply.
    1. Diarrhea may occur secondary to the metformin.
    2. The repaglinide is not taken if a meal is skipped.
    3. The repaglinide is taken 30 minutes before eating.
    4. A simple sugar food item is carried and used to treat mild hypoglycemia episodes.
    5. Metformin increases hepatic glucose production to prevent hypoglycemia associated with repaglinide.
    6.Muscle pain is an expected effect of metformin and may be treated with acetaminophen (Tylenol).
    • 1. Diarrhea may occur secondary to the metformin.
    • 2. The repaglinide is not taken if a meal is skipped.
    • 3. The repaglinide is taken 30 minutes before eating.
    • 4. A simple sugar food item is carried and used to treat mild hypoglycemia episodes.
  8. The community health nurse visits a client at home. Prednisone, 10 mg orally daily, has been prescribed for the client and the nurse teaches the client about the medication. Which statement, if made by the client, indicates that further teaching is necessary?
    1. "I can take aspirin or my antihistamine if I need it."
    2. "I need to take the medication every day at the same time."
    3. "I need to avoid coffee, tea, cola, and chocolate in my diet."
    4. "If I gain more than 5 pounds a week, I will call my health care provider (HCP)."
    1. "I can take aspirin or my antihistamine if I need it."
  9. A client with hyperthyroidism has been given methimazole (Tapazole). Which nursing considerations are associated with this medication? Select all that apply.
    1. Administer methimazole with food.
    2. Place the client on a low-calorie, low-protein diet.
    3. Assess the client for unexplained bruising or bleeding.
    4. Instruct the client to report side/adverse effects such as sore throat, fever, or headaches.
    5. Use special radioactive precautions when handling the client's urine for the first 24 hours following initial administration.
    • 1. Administer methimazole with food.
    • 3. Assess the client for unexplained bruising or bleeding.
    • 4. Instruct the client to report side/adverse effects such as sore throat, fever, or headaches.
  10. The nurse is monitoring a client receiving levothyroxine sodium (Synthroid) for hypothyroidism. Which findings indicate the presence of a side effect associated with this medication? Select all that apply.
    1. Insomnia
    2. Weight loss
    3. Bradycardia
    4. Constipation
    5. Mild heat intolerance
    • 1. Insomnia
    • 2. Weight loss
    • 5. Mild heat intolerance
  11. The nurse provides instructions to a client who is taking levothyroxine (Synthroid). The nurse should tell the client to take the medication at which time?
    1. With food
    2. At lunchtime
    3. On an empty stomach
    4. At bedtime with a snack
    3. On an empty stomach
  12. The nurse provides medication instructions to a client who is taking levothyroxine (Synthroid) and should tell the client to notify the health care provider (HCP) if which problem occurs?
    1. Fatigue
    2. Tremors
    3. Cold intolerance
    4. Excessively dry skin
    2. Tremors
  13. The nurse performs an admission assessment on a client who visits a health care clinic for the first time. The client tells the nurse that propylthiouracil (PTU) is taken daily. The nurse continues to collect data from the client, suspecting that the client has a history of which condition?
    1. Myxedema
    2. Graves' disease
    3. Addison's disease
    4. Cushing's syndrome
    2. Graves' disease
  14. The nurse is instructing a client regarding intranasal desmopressin (DDAVP). The nurse should tell the client that which occurrence is a side effect of the medication?
    1. Headache
    2. Vulval pain
    3. Runny nose
    4. Flushed skin
    3. Runny nose
  15. A daily dose of prednisone is prescribed for a client. The nurse provides instructions to the client regarding administration of the medication and should instruct the client that which time is best to take this medication?
    1. At noon
    2. At bedtime
    3. Early morning
    4. Any time, at the same time, each day
    3. Early morning
  16. Prednisone is prescribed for a client with diabetes mellitus who is taking Humulin NPH insulin daily. Which prescription change does the nurse anticipate during therapy with the prednisone?
    1. An additional dose of prednisone daily
    2. A decreased amount of daily Humulin NPH insulin
    3. An increased amount of daily Humulin NPH insulin
    4. The addition of an oral hypoglycemic medication daily
    3. An increased amount of daily Humulin NPH insulin
  17. A client with diabetes mellitus visits a health care clinic. The client's diabetes mellitus previously had been well controlled with glyburide (DiaBeta) daily, but recently the fasting blood glucose level has been 180 to 200 mg/dL. Which medication, if added to the client's regimen, may have contributed to the hyperglycemia?
    1. Prednisone
    2. Phenelzine (Nardil)
    3. Atenolol (Tenormin)
    4. Allopurinol (Zyloprim)
    1. Prednisone
  18. A client newly diagnosed with diabetes mellitus is instructed by the health care provider to obtain glucagon for emergency home use. The client asks a home care nurse about the purpose of the medication. What is the nurse's best response to the client's question?
    1. "It will boost the cells in your pancreas if you have insufficient insulin."
    2. "It will help promote insulin absorption when your glucose levels are high."
    3. "It is for the times when your blood glucose is too low from too much insulin."
    4. "It will help prevent lipoatrophy from the multiple insulin injections over the years."
    3. "It is for the times when your blood glucose is too low from too much insulin."
  19. Levothyroxine (Synthroid) is prescribed for a client diagnosed with hypothyroidism. Upon review of the client's record, the nurse notes that the client is taking warfarin (Coumadin). Which modification to the plan of care should the nurse review with the client's health care provider?
    1. A decreased dosage of levothyroxine
    2. An increased dosage of levothyroxine
    3. A decreased dosage of warfarin sodium
    4. An increased dosage of warfarin sodium
    3. A decreased dosage of warfarin sodium
  20. A client received 20 units of Humulin N insulin subcutaneously at 08:00. At what time should the nurse plan to assess the client for a hypoglycemic reaction?
    1. 10:00
    2. 11:00
    3. 17:00
    4. 23:00
    3. 17:00
  21. The nurse teaches a client newly diagnosed with type 1 diabetes about storing Humulin N insulin. Which statement indicates to the nurse that the client understood the discharge teaching?
    1. "I should keep the insulin in the cabinet during the day only."
    2. "I know I have to keep my insulin in the refrigerator at all times."
    3. "I can store the open insulin bottle in the kitchen cabinet for 1 month."
    4. "The best place for my insulin is on the window sill, but in the cupboard is just as good."
    3. "I can store the open insulin bottle in the kitchen cabinet for 1 month."
  22. Metformin (Glucophage) is prescribed for a client with type 2 diabetes mellitus. What is the most common side effect that the nurse should include in the client's teaching plan?
    1. Weight gain
    2. Hypoglycemia
    3. Flushing and palpitations
    4. Gastrointestinal disturbances
    4. Gastrointestinal disturbances
  23. A client arrives at the clinic complaining of fatigue, lack of energy, constipation, and depression. Hypothyroidism is diagnosed, and levothyroxine (Synthroid) is prescribed. What is an expected outcome of the medication?
    1. Alleviate depression
    2. Increase energy levels
    3. Increase blood glucose levels
    4. Achieve normal thyroid hormone levels
    4. Achieve normal thyroid hormone levels
  24. A client is seen in the clinic for complaints of thirst, frequent urination, and headaches. After diagnostic studies, diabetes insipidus is diagnosed. Desmopressin (DDAVP) is prescribed. The client asks why this medication was prescribed. Which is a correct statement by the nurse?
    1. It relieves the headaches.
    2. It increases water reabsorption.
    3. It stimulates the production of aldosterone.
    4. It decreases the production of the antidiuretic hormone.
    2. It increases water reabsorption.
  25. Growth hormone is prescribed for the client with pituitary dwarfism. Which statement is accurate related to the expected outcome of this medication?
    1. Growth begins in 4 to 5 years.
    2. Growth spurts will occur every 2 years.
    3. There will be an immediate increase in growth.
    4. An increase in height will begin in late adulthood.
    3. There will be an immediate increase in growth.
  26. Lispro insulin (Humalog) is prescribed for the client, and the client is instructed to administer the insulin before meals. When should the nurse instruct the client to administer the insulin?
    1. 45 minutes before eating
    2. 60 minutes before eating
    3. 90 minutes before eating
    4. Immediately before eating
    4. Immediately before eating
  27. The emergency department nurse is caring for a client admitted with diabetic ketoacidosis. The health care provider prescribes intravenous (IV) insulin. The nurse plans to prepare which type of insulin for the client?
    1. Insulin glargine (Lantus)
    2. Regular humulin (Humulin R)
    3. Isophane insulin NPH (Humulin N)
    4. 50% human insulin isophane/50% human insulin (Humulin 50/50)
    2. Regular humulin (Humulin R)
  28. Metformin (Glucophage) is prescribed for a client with type 2 diabetes mellitus. The nurse should tell the client that which is the mostcommon side effect of the medication?
    1. Weight gain
    2. Hypoglycemia
    3. Flushing and palpitations
    4. Gastrointestinal (GI) disturbances
    4. Gastrointestinal (GI) disturbances
  29. The diabetes nurse specialist conducts a teaching session to a group of nursing students regarding sulfonylureas, oral hypoglycemic medications used for type 2 diabetes mellitus. Which statement, describing the primary action of these medications, should the nurse include in the teaching session?
    1. "Sulfonylureas decrease insulin resistance."
    2. "Sulfonylureas inhibit carbohydrate digestion."
    3. "Sulfonylureas decrease glucose production by the liver."
    4. "Sulfonylureas promote insulin secretion by the pancreas."
    4. "Sulfonylureas promote insulin secretion by the pancreas."
  30. A client with diabetes mellitus calls the clinic and tells the nurse that he has been nauseated during the night. The client asks the nurse if the morning insulin should be administered. Which is the most appropriate nursing response?
    1. Omit the insulin.
    2. Administer half the prescribed dose.
    3. Administer the full dose as prescribed.
    4. Wait until noon before making a decision.
    3. Administer the full dose as prescribed.
  31. Fludrocortisone acetate (Florinef) is prescribed for a client with Addison's disease. The nurse prepares to administer the medication. What is the primary action of this medication?
    1. It promotes the excretion of water in the distal tubules of the kidney.
    2. It promotes the retention of potassium in the distal tubules of the kidney.
    3. It promotes the retention of hydrogen ions in the distal tubules of the kidney.
    4. It enhances the reabsorption of sodium and chloride ions in the distal tubules of the kidney.
    4. It enhances the reabsorption of sodium and chloride ions in the distal tubules of the kidney.
  32. The clinic nurse develops a plan of care for a client with emphysema who will be started on long-term corticosteroid therapy. Which specific instruction should the nurse include in the plan of care?
    1. Instruct the client to maintain a low-potassium diet.
    2. Encourage the client to consume a fluid intake of 3000 mL/day.
    3. Encourage the client to increase the amounts of sodium intake in the diet.
    4. Instruct the client to return to the clinic for monitoring of blood glucose levels.
    4. Instruct the client to return to the clinic for monitoring of blood glucose levels.
  33. The health care provider has prescribed Humulin R insulin 6 units and Humulin N insulin 20 units subcutaneously to be administered every morning. How should the nurse prepare to administer insulin?
    1. Shaking the Humulin N insulin vial to distribute the suspension
    2. Administering Humulin R and Humulin N insulin in separate syringes
    3. Drawing up the Humulin R first and then the Humulin N insulin in the same syringe
    4. Drawing up the Humulin N insulin first and then the Humulin R in the same syringe
    3. Drawing up the Humulin R first and then the Humulin N insulin in the same syringe
  34. A female client scheduled to undergo subtotal thyroidectomy is taking a potassium iodide solution (Lugol's solution). The client complains to the nurse that she experiences a brassy taste in her mouth when taking the medication. Which instruction should the nurse provide to the client?
    1. Dilute the medication in 8 ounces of water.
    2. Report the symptom to the health care provider (HCP).
    3. Continue to take the medication because the symptoms are normal.
    4. Take one half dose of the prescribed medication for the next 2 days.
    2. Report the symptom to the health care provider (HCP).
  35. The nurse is providing instructions to a client with a diagnosis of Addison's disease regarding the administration of prescribed glucocorticoids. The nurse should provide which instruction to the client?
    1. To stop the medication if side effects occur
    2. To avoid taking the medication if nausea occurs
    3. That minimal side effects will occur with use of this medication
    4. That an increased dose of medication may be needed during times of stress
    4. That an increased dose of medication may be needed during times of stress
  36. The nurse administers 20 units of Humulin N insulin to a hospitalized client with diabetes mellitus at 7:00 am. The nurse should monitor the client most closely for a hypoglycemic reaction at which time?
    1. 4:00 pm
    2. 9:00 am
    3. 10:00 am
    4. 12:00 midnight
    1. 4:00 pm
  37. A client is started on tolbutamide (Orinase) once daily. The nurse should instruct the client to monitor for which intended effect of this medication?
    1. Weight loss
    2. Resolution of infection
    3. Decreased blood glucose
    4. Decreased blood pressure
    3. Decreased blood glucose
  38. A client with diabetes insipidus asks the nurse about the purpose of a new medication, vasopressin (Pitressin). The nurse explains that this medication works by which mechanism?
    1. Decreasing peristalsis
    2. Producing vasodilation
    3. Decreasing urinary output
    4. Inhibiting contraction of smooth muscle
    3. Decreasing urinary output
  39. A client with previously well-controlled diabetes mellitus has had fasting blood glucose levels ranging from 180 to 200 mg/dL. The client takes glyburide (Diabeta) 5 mg orally daily. In reviewing the client's medication list, the home health care nurse suspects that which newly added medications could be contributing to the elevated blood glucose levels?
    1. Prednisone
    2. Ranitidine (Zantac)
    3. Ciprofloxacin (Cipro)
    4. Cimetidine (Tagamet)
    1. Prednisone
  40. A client must learn how to mix Humulin R and Humulin N insulin in the same syringe. The nurse should include which teaching point in the instructions to the client?
    1. Keep both bottles in the refrigerator at all times.
    2. Take all of the air out of the bottle before mixing.
    3. Draw up the Humulin N insulin into the syringe first.
    4. Rotate the Humulin N insulin bottle in the hands before mixing.
    4. Rotate the Humulin N insulin bottle in the hands before mixing.
  41. A client with aldosteronism is being treated with spironolactone (Aldactone). Which finding indicates to the nurse that the medication is effective?
    1. A decrease in body metabolism
    2. A decrease in sodium excretion
    3. A decrease in potassium excretion
    4. A decrease in aldosterone production
    4. A decrease in aldosterone production
  42. The nurse in the health care clinic is reviewing the record of a client with diabetes mellitus who was just seen by the health care provider (HCP). The nurse notes that the HCP has prescribed metformin (Glucophage). What preexisting disorder, if noted in the client's record, would indicate a need to collaborate with the HCP before instructing the client to take the medication?
    1. Foot ulcer
    2. Emphysema
    3. Hypertension
    4. Hypothyroidism
    2. Emphysema
  43. A client is started on tolbutamide (Orinase) once daily. When should the nurse tell the client to take the medication?
    1. At breakfast
    2. At suppertime
    3. Before going to bed at night
    4. Between breakfast and lunch
    1. At breakfast
  44. The nurse is monitoring a client receiving glipizide (Glucotrol). The nurse knows that which finding would indicate a therapeutic outcome for this client?
    1. A decrease in polyuria
    2. An increase in appetite
    3. A glycosylated hemoglobin of 10%
    4. A fasting blood glucose of 220 mg/dL
    1. A decrease in polyuria
  45. A sulfonamide is prescribed for a client with a urinary tract infection. The client has diabetes mellitus and is receiving tolbutamide (Orinase). Because the client will be taking these two medications, which prescription should the nurse anticipate for this client?
    1. Increased dosage of tolbutamide
    2. Decreased dosage of tolbutamide
    3. Increased dosage of sulfonamide
    4. Decreased dosage of sulfonamide
    2. Decreased dosage of tolbutamide
  46. A medication has been prescribed for a client with hypoparathyroidism for management of hypocalcemia. The client arrives at the clinic for follow-up evaluation and complains of chronic constipation since beginning the medication. The nurse provides information to the client regarding measures to alleviate the constipation and determines that the client needs additional information when the client makes which statement?
    1. "I will increase my daily fluid intake."
    2. "I will increase my activity level as tolerated."
    3. "I will increase my daily intake of high-fiber foods."
    4. "I will add ½ ounce of mineral oil to my daily diet."
    4. "I will add ½ ounce of mineral oil to my daily diet."
  47. An adult client with hypothyroidism is admitted to the hospital. On admission assessment, the nurse notes that the client is taking a maintenance dose of levothyroxine (Synthroid). The nurse transcribes the medication prescription knowing that which is the normal adult maintenance dose range of this medication?
    1. 0.025 to 0.05 mg daily
    2. 0.05 to 0.075 mg daily
    3. 0.075 to 0.1 mg daily
    4. 0.1 to 0.2 mg daily
    4. 0.1 to 0.2 mg daily
  48. The nurse is preparing a dose of 10 units of Humulin R and 35 units of Humulin N insulin for a client with type 1 diabetes mellitus. The nurse obtains an insulin syringe, gently rotates the insulin solutions, cleanses the tops of the vials of insulin, and injects an amount of air equal to the dose prescribed into each vial. What is the next nursing action?
    1. Draws up 10 units of Humulin R and checks the syringe contents with another nurse before drawing up the Humulin N insulin
    2. Draws up 10 units of Humulin R, draws up 35 units of Humulin N insulin, and checks the syringe contents with another nurse
    3. Draws up 35 units of Humulin N insulin and checks the syringe contents with another nurse before drawing up the Humulin R
    4. Draws up 35 units of Humulin N insulin, draws up 10 units of Humulin R, and checks the syringe contents with another nurse
    1. Draws up 10 units of Humulin R and checks the syringe contents with another nurse before drawing up the Humulin N insulin
  49. The nurse is preparing to care for a client admitted to the emergency department with a diagnosis of diabetic ketoacidosis (DKA). The nurse gathers supplies and obtains which type of insulin, anticipating that it will be initially prescribed for the client?

    1. A
    2. B
    3. C
    4. D
    1. A
  50. The nurse is preparing the client's morning Humulin N insulin dose. The nurse notices a clumpy precipitate inside the insulin vial. What is the most appropriate nursing action related to this finding?
    1. Draw the dose from a new vial.
    2. Draw up and administer the dose.
    3. Shake the vial in an attempt to disperse the clump.
    4. Warm the bottle under running water to dissolve the clump.
    1. Draw the dose from a new vial.
  51. A client has been taking glucocorticoids to control rheumatoid arthritis. Which laboratory abnormality is the client at risk for as a result of taking this medication?
    1. Increased serum glucose
    2. Decreased serum sodium
    3. Elevated serum potassium
    4. Increased white blood cells
    1. Increased serum glucose
  52. The nurse is completing a health history for an insulin dependent client who has been self-administering insulin for 40 years. The client reports experiencing periods of hypoglycemia followed by periods of hyperglycemia. What is the most likely cause for this pattern of blood glucose fluctuation?
    1. Eating snacks between meals
    2. Initiating the use of the insulin pump
    3. Injecting insulin at a site of lipodystrophy
    4. Adjusting insulin according to blood glucose levels
    3. Injecting insulin at a site of lipodystrophy
  53. Glyburide (DiaBeta) daily is prescribed for a client. What instruction will the nurse include in the client's teaching plan?
    1. The medication is used to prevent foot infections.
    2. Take the medication in the morning before breakfast.
    3. Expect skin color change from pink to yellow and also pale-colored stools.
    4. Contact the health care provider (HCP) immediately if an altered taste sensation is noted.
    2. Take the medication in the morning before breakfast.
  54. The client with a head injury has begun excreting copious amounts of dilute urine through the Foley catheter. The client's urine output for the previous shift was 3000 mL. The nurse expects that the health care provider will prescribe which medication?
    1. Dexamethasone
    2. Mannitol (Osmitrol)
    3. Desmopressin (DDAVP)
    4. Ethacrynic acid (Edecrin)
    3. Desmopressin (DDAVP)
  55. Propylthiouracil (PTU) is prescribed for a client with hyperthyroidism. The nurse provides instructions to the client regarding the medication and informs the client to notify the health care provider if which sign/symptom occurs?
    1. Fever
    2. Dry mouth
    3. Drowsiness
    4. Increased urination
    1. Fever
  56. A client who has been taking iodine solution (Lugol's solution, potassium iodide solution) is admitted to the emergency department, and an iodine overdose is suspected. Gastric lavage is initiated to remove the iodine from the stomach. In addition to treatment with gastric lavage, the nurse anticipates that which medication will be administered?
    1. Vitamin K
    2. Calcium gluconate
    3. Sodium thiosulfate
    4. Acetylcysteine (Mucomyst)
    3. Sodium thiosulfate
  57. Octreotide acetate (Sandostatin) is prescribed for a client with acromegaly. The nurse monitors the client, knowing that which side effect is associated with the administration of this medication?
    1. Polyuria
    2. Hypotension
    3. Constipation
    4. Abdominal pain
    4. Abdominal pain
  58. Cortisone acetate is prescribed for a client with adrenal insufficiency. The nurse provides instructions to the client regarding the medication. Which statement, if made by the client, indicates a need for further instruction?
    1. "I will limit my sodium intake."
    2. "I will avoid people with colds."
    3. "I will eat a good breakfast every day."
    4. "I will stop the medication when I feel better."
    4. "I will stop the medication when I feel better."
  59. A hospitalized client with diabetes mellitus receives Humulin N insulin in the morning. The nurse monitors the client for hypoglycemia, knowing that the peak action is expected to occur how soon after the medication administration?
    1. 2 to 4 hours after administration
    2. 4 to 12 hours after administration
    3. 12 to 16 hours after administration
    4. 18 to 24 hours after administration
    2. 4 to 12 hours after administration
  60. A client with diabetes mellitus is self-administering Humulin N insulin from a vial that is kept at room temperature. The client asks the nurse about the length of time an unrefrigerated vial of insulin will maintain its potency. What is the most appropriate response to the client?
    1. 2 weeks
    2. 1 month
    3. 2 months
    4. 6 months
    2. 1 month
  61. Somatropin (Humatrope), a growth hormone, is prescribed for a client. The nurse reviews the assessment data in the client's health record, knowing that the medication would be contraindicated for which client?
    1. A child with growth failure
    2. A child with pituitary dwarfism
    3. A 20-year-old with growth failure
    4. A child with growth hormone deficiency
    3. A 20-year-old with growth failure
  62. The nurse is caring for a client who is receiving growth hormone replacement therapy. The nurse monitors the client for which option as an adverse effect of this therapy?
    1. Hypocalciuria
    2. Hypoglycemia
    3. Hyperglycemia
    4. Hyperthyroidism
    3. Hyperglycemia
  63. A client arrives at the clinic complaining of fatigue, lack of energy, constipation, and depression. Following diagnostic studies, hypothyroidism is diagnosed and levothyroxine (Synthroid) is prescribed. The nurse informs the client that which is the expected outcome of the medication?
    1. Alleviate depression
    2. Increase energy levels
    3. Increase blood glucose levels
    4. Achieve normal thyroid hormone levels
    4. Achieve normal thyroid hormone levels
  64. A client diagnosed with hypothyroidism is taking levothyroxine (Synthroid). The client returns to the clinic 1 week after beginning the medication and tells the nurse that the medication has not helped. What is the appropriate nursing response to the client?
    1. A higher dosage is required.
    2. The medication may need to be changed.
    3. Full therapeutic effect may take 1 to 3 weeks.
    4. Full therapeutic effect may take up to 4 months.
    3. Full therapeutic effect may take 1 to 3 weeks.
  65. The nurse is preparing to administer an intravenous (IV) insulin injection. The vial of Regular insulin has been refrigerated. On inspection of the vial, the nurse finds that the medication is frozen. Which should the nurse do?
    1. Discard the insulin and obtain another vial.
    2. Wait for the insulin to thaw at room temperature.
    3. Check the temperature settings of the refrigerator.
    4. Rotate the vial between the hands until the medication becomes liquid.
    1. Discard the insulin and obtain another vial.
  66. The nurse is preparing to discharge a client who has had a parathyroidectomy. The discharge instructions include medication administration of oral calcium supplements that the client will need daily. Which statement by the nurse would be most appropriate regarding the oral calcium supplement therapy?
    1. Take the tablets following a meal.
    2. Store the tablets in the refrigerator to maintain potency.
    3. Avoid sunlight because the medication can cause skin color changes.
    4. Check the pulse daily; if it is less than 60 beats/min, do not take the tablets.
    1. Take the tablets following a meal.
  67. Thyroid replacement therapy is prescribed for the client diagnosed with hypothyroidism. The client asks the nurse when the medication will no longer be needed. Which is the appropriate nursing response?
    1. "It depends on the results of the laboratory tests."
    2. "Most clients require medication for about 1 year."
    3. "The medication will need to be continued for life."
    4. "You will need to ask your health care provider."
    3. "The medication will need to be continued for life."
  68. A nurse is caring for a client with a diagnosis of hyperthyroidism. Laboratory studies are performed and the serum calcium level is 12.0 mg/dL. Which medication should the nurse anticipate to be prescribed for the client?
    1. Calcitonin
    2. Calcium chloride
    3. Calcium gluconate
    4. Large doses of vitamin D
    1. Calcitonin
  69. A client newly diagnosed with diabetes mellitus is instructed by the health care provider to obtain glucagon for emergency home use. The client asks the home care nurse about the purpose of the medication. The nurse should instruct the client that the purpose of the medication is to treat which problem?
    1. Lipoatrophy from insulin injections
    2. Hypoglycemia from insulin overdose
    3. Hyperglycemia from insufficient insulin
    4. Lipohypertrophy from inadequate insulin absorption
    2. Hypoglycemia from insulin overdose
  70. A client with hyperthyroidism is scheduled for a subtotal thyroidectomy, and potassium iodide (SSKI) is prescribed. The nurse prepares to administer the medication, knowing that which is the therapeutic effect of this medication?
    1. Replaces thyroid hormone
    2. Prevents the oxidation of iodide
    3. Increases thyroid hormone production
    4. Suppresses thyroid hormone production
    4. Suppresses thyroid hormone production
  71. Potassium iodide (SSKI) is prescribed for a client with thyrotoxic crisis. The client calls a clinic nurse and complains of a brassy taste in the mouth. Which instruction should the nurse provide the client?
    1. Continue with the medication.
    2. Take half of the prescribed dose for the next 24 hours.
    3. Withhold the medication and notify the health care provider (HCP).
    4. Withhold the medication for the next 24 hours and then continue as prescribed.
    3. Withhold the medication and notify the health care provider (HCP).
  72. A nurse provides instructions to a client taking fludrocortisone acetate (Florinef acetate). The nurse instructs the client to notify the health care provider (HCP) if which manifestation occurs?
    1. Nausea
    2. Fatigue
    3. Weight loss
    4. Swelling of the feet
    4. Swelling of the feet
  73. Acarbose (Precose) is prescribed to treat a client with type 2 diabetes mellitus. Which instruction should the nurse provide when teaching the client about this medication?
    1. Take the medication at bedtime.
    2. Take the medication with the first bite of each regular meal.
    3. The medication will be used to treat symptoms of hypoglycemia.
    4. Headache and dizziness are the most common side effects of this medication.
    2. Take the medication with the first bite of each regular meal.
  74. A client is receiving somatropin (Humatrope). The nurse should monitor which most significant laboratory study during therapy with this medication?
    1. Lipase level
    2. Amylase level
    3. Blood urea nitrogen level
    4. Thyroid-stimulating hormone level
    4. Thyroid-stimulating hormone level
  75. Vasopressin (Pitressin) is prescribed for a client with diabetes insipidus. The nurse should be particularly cautious in monitoring a client receiving this medication if the client has which preexisting condition?
    1. Depression
    2. Endometriosis
    3. Pheochromocytoma
    4. Coronary artery disease
    4. Coronary artery disease
  76. Somatropin (Humatrope) is administered to a client with growth failure. A nurse monitors the client, knowing that which is the expected therapeutic effect of this medication?
    1. Promote weight gain.
    2. Increase bone density.
    3. Stimulate linear growth.
    4. Decrease the mobilization of fats.
    3. Stimulate linear growth.
  77. A nurse caring for a 23-year-old client newly diagnosed with type 1 diabetes mellitus teaches the client insulin administration. Which statement by the client indicates a need for further teaching?
    1. "It is not necessary for me to aspirate before injecting my insulin."
    2. "I will rotate my insulin injection between my arms, thighs, and abdomen on a daily basis."
    3. "I will perform a capillary blood glucose measurement before I administer my insulin regimen."
    4. "My glargine insulin is long-acting and should be administered once a day, but lispro insulin is given just before I eat."
    2. "I will rotate my insulin injection between my arms, thighs, and abdomen on a daily basis."
  78. The nurse is assigned to care for several male and female clients who take estrogen or progestins. The nurse knows that this group of clients is at increased risk for which complication of the medications?
    1. Sepsis
    2. Dehydration
    3. Deep vein thrombosis (DVT)
    4. Electrocardiographic changes
    3. Deep vein thrombosis (DVT)
  79. The nurse is instructing a client who is taking levothyroxine (Synthroid) and tells the client that full therapeutic benefits will be seen when?
    1. Immediately
    2. In 1 to 3 weeks
    3. Within 24 hours
    4. Within 3 to 5 days
    2. In 1 to 3 weeks
  80. The nurse is educating a client about medroxyprogesterone (Depo-Provera). The nurse should provide the client with which information about the medication?
    1. Should be taken once daily by mouth
    2. Should be administered intramuscularly every 3 months
    3. Should be taken immediately following sexual intercourse
    4. Provides some protection against sexually transmitted infections
    2. Should be administered intramuscularly every 3 months
  81. The nurse understands that which is the action of rosiglitazone (Avandia)?
    1. Reduces insulin resistance.
    2. Increases glucose secretion.
    3. Delays absorption of dietary carbohydrates.
    4. Increases insulin release from the pancreas.
    1. Reduces insulin resistance.
  82. A nurse is providing teaching regarding nateglinide (Starlix). A portion of the teaching involves time of administration, and the nurse should tell the client to take the medication at which time?
    1. Bedtime
    2. During lunch
    3. During breakfast
    4. Before each meal
    4. Before each meal
  83. A nurse is providing teaching regarding acarbose (Precose). The nurse should tell that client that which expected side effect(s) may occur with this medication?
    1. Tachycardia
    2. Hypoglycemia
    3. Tinnitus and decreased hearing
    4. Abdominal distention and diarrhea
    4. Abdominal distention and diarrhea
  84. The nurse understands that which is an advantage of insulin glargine (Lantus) over other extended-release insulins?
    1. Has a distinct peak
    2. Can be administered intravenously
    3. Carries a decreased risk of hypoglycemia
    4. Does not require finger-stick glucose monitoring
    3. Carries a decreased risk of hypoglycemia
  85. An 8-year-old boy is being treated with desmopressin (DDAVP). Understanding the purpose of this medication, the nurse should set which client goal?
    1. The boy will have 5 nights in sequence without enuresis.
    2. The boy will have increased urine output to 2400 mL per day.
    3. The boy will have an increase in white blood cell count to 4000 cells/mm3.
    4. The boy will have decreased use of the metered dose inhaler to three times per week.
    1. The boy will have 5 nights in sequence without enuresis.
  86. A nurse is caring for a client recently diagnosed with type 2 diabetes mellitus who has been prescribed glipizide (Glucotrol XL). What is the most important point for the nurse to include in teaching this client about this medication?
    1. Take the medication at least 1 hour after eating.
    2. Make sure to take the medication every 12 hours.
    3. Take measures to prevent and treat hyperglycemia.
    4. Swallow the medication whole and never crush or chew it.
    4. Swallow the medication whole and never crush or chew it.
  87. Insulin glargine (Lantus) is prescribed for a client with diabetes mellitus. The nurse should tell the client that it is best to take the insulin at which time?
    1. At bedtime
    2. 1 hour after each meal
    3. 15 minutes before the morning and evening meal
    4. Before each meal, on the basis of the blood glucose level
    1. At bedtime
  88. A client with diabetes mellitus taking daily Humulin N insulin has been started on therapy with dexamethasone (Decadron). The nurse anticipates that which adjustments in medication dosage will be made?
    1. A change to oral diabetic medications
    2. An increased dose of Humulin N insulin
    3. An increase in the amount of daily dietary calories
    4. A lower dose of dexamethasone (Decadron) than usual
    2. An increased dose of Humulin N insulin
  89. The nurse monitors the blood glucose level of the client who received Humulin N insulin at 7 am with an understanding that the client may experience a hypoglycemic reaction during which time frame?
    1. 9 am to 11 am
    2. 11 am to 7 pm
    3. 7 pm to 11 pm
    4. Midnight to 6 am
    2. 11 am to 7 pm
  90. The nurse evaluates that the family of a client newly diagnosed with diabetes mellitus correctly understands the reason for having glucagon on hand for emergency home use if the family indicates that the purpose of the medication is to treat which complication?
    1. Diabetic ketoacidosis
    2. Hypoglycemia from insulin overdose
    3. Hyperglycemia from insufficient insulin
    4. Hyperglycemia occurring on "sick days"
    2. Hypoglycemia from insulin overdose
  91. The nurse is teaching a client with hyperthyroidism regarding the prescribed medication propylthiouracil (PTU). The nurse determines that teaching has been successful if the client states to report which symptom to the health care provider (HCP)?
    1. Fever
    2. Fatigue
    3. Excitability
    4. Nervousness
    1. Fever
  92. The nurse teaches the client being discharged to home with a prescription for a daily dose of prednisone to take the medication at which best time?
    1. Any time of the day
    2. In the early morning
    3. In the middle of the day
    4. An hour before bedtime
    2. In the early morning
  93. The nurse monitors the client taking octreotide acetate (Sandostatin) for acromegaly for which most common side effect of this medication?
    1. Diarrhea
    2. Dyspnea
    3. Constipation
    4. Bradycardia
    1. Diarrhea
  94. A client with a history of coronary artery disease has developed diabetes insipidus as a result of cranial surgery. The client's medication therapy will include vasopressin (Pitressin). The nurse monitors this client most carefully for which sign/symptom that indicates an adverse effect of this medication?
    1. Depression
    2. Chest pain
    3. Joint stiffness
    4. Nagging cough
    2. Chest pain
  95. A client who has sustained an eye injury has been prescribed prednisolone. The nurse would most carefully monitor for side/adverse effects of this medication if the client has which health problem listed on the medical record?
    1. Cirrhosis
    2. Hypertension
    3. Diabetes mellitus
    4. Chronic constipation
    3. Diabetes mellitus
  96. A nurse is administering a prescribed dose of dexamethasone (Decadron) to a client following cranial surgery. Which would the nurse implement to assess for a common side effect of this medication?
    1. Monitor for hair loss.
    2. Assess for decreased skin turgor.
    3. Perform blood glucose monitoring.
    4. Monitor laboratory test results for hyperkalemia.
    3. Perform blood glucose monitoring.
  97. When teaching the client with adrenal insufficiency about cortisone (Cortone Acetate) the nurse should include which items? Select all that apply.
    1. Increase intake of sodium.
    2. Take the medication with food.
    3. Increase intake of potassium-rich foods.
    4. Stay away from people with active infections.
    5. Discontinue the medication when symptoms subside.
    6. Notify the health care provider if illness occurs or surgery is anticipated.
    • 2. Take the medication with food.
    • 3. Increase intake of potassium-rich foods.
    • 4. Stay away from people with active infections.
    • 6. Notify the health care provider if illness occurs or surgery is anticipated.

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