Chapters 57-60 Evolve Questions

Which instruction should the nurse provide when teaching a patient to mix regular insulin and NPH insulin in the same syringe?

"Draw up the clear regular insulin first, followed by the cloudy NPH insulin."

A patient has been given instructions about levothyroxine [Synthroid]. Which statement by the patient indicates understanding of these instructions?

"I'll take this medication in the morning so as not to interfere with sleep."

The nurse is teaching the patient about oral steroid therapy. Which statement by the patient indicates a need for further teaching?

"When I am traveling for work I will take lower doses."

The patient states that when he takes hydrocortisone 24 mg in the morning, he is very tired by mid-afternoon. Which statement by the nurse is correct?

"You can take 16 mg in the morning and 8 mg in the afternoon."

A patient who took NPH insulin at 0800 reports feeling weak and tremulous at 1700. Which action should the nurse take?

Check the patient's capillary blood sugar.

A nurse administers dexamethasone [Decadron], 1 mg, at 11:00 PM to a patient who has suspected adrenal dysfunction. The nurse obtains blood for which of these laboratory tests at 8:00 AM the next morning?

Cortisol

Which finding in a patient taking levothyroxine [Synthroid] and warfarin [Coumadin] would require follow-up by a nurse?

Excessive bruising

Which manifestations should a nurse investigate first when monitoring a patient who is taking levothyroxine [Synthroid]?

Tachycardia

A patient who has diabetes insipidus is receiving desmopressin [DDAVP]. Which laboratory test should a nurse obtain to evaluate the effectiveness of the medication?

Urine specific gravity

A patient with Graves' disease is treated with iodine-131 therapy. Which statement by the patient would indicate understanding of the treatment's effects?

"I'll tell my doctor if I have fatigue, hair loss, or cold intolerance."

A teaching plan for a patient who is taking lispro [Humalog] should include which instruction by the nurse?

"Inject this insulin with your first bite of food, because it is very fast acting."

The healthcare provider orders octreotide [Sandostatin LAR] 250 mcg IM now. The available medication is octreotide [Sandostatin LAR] 1000 mcg/mL. The nurse plans to administer how much?

0.25 mL

Which nursing diagnosis should be the priority for a patient who is receiving desmopressin [DDAVP]?

Fluid volume imbalance

Which statements about levothyroxine [Synthroid] are correct?

Levothyroxine can be given by IV but is usually taken orally. Levothyroxine brands should not be changed if possible. Levothyroxine can affect the metabolism of other medications.

Which statement is the most important for a nurse to make to a patient who is taking methimazole?

"You need to notify your doctor if you have a sore throat and fever."

A patient is scheduled to start taking insulin glargine [Lantus]. On the care plan, a nurse should include which of these outcomes related to the therapeutic effects of the medication?

Blood glucose control for 24 hours

A patient in cardiac arrest receives vasopressin [Pitressin] during cardiopulmonary resuscitation (CPR). An increase in which finding would indicate a desired effect of the medication?

Blood pressure

Before administering metformin [Glucophage], the nurse should notify the prescriber about which laboratory value?

Creatinine (Cr) level of 2.1 mg/dL

A patient who has Cushing's syndrome is taking ketoconazole [Nizoral] as an adjunct treatment to brain radiation. A nurse should expect the patient to have which of these therapeutic responses?

Enhanced radiation effect to the brain

A pediatric patient has gigantism caused by excess growth hormone (GH). Which finding would indicate to the nurse that the patient has developed an additional complication related to this condition?

Enlarged heart on chest x-ray

The nurse is planning care for a patient with signs of acute adrenal insufficiency. What is the priority nursing diagnosis?

Fluid volume deficit

A nurse is caring for a patient with decreased triiodothyronine (T3) and thyroxine (T4) and elevated thyroid-stimulating hormone (TSH) levels. The nurse knows the patient is likely suffering from what?

Hypothyroidism

Which statements about hydrocortisone are correct? (Select all that apply.)

It is a synthetic steroid identical to cortisol. It is a preferred drug for adrenocortical insufficiency. It has glucocorticoid and mineralocorticoid actions.

A patient is taking fludrocortisone [Florinef]. A nurse should recognize that the patient is at risk for developing an electrolyte imbalance if the patient reports which symptom?

Muscle weakness

When assessing a patient who has Cushing's syndrome, a nurse associates which clinical manifestations with this disorder? (Select all that apply.)

Osteoporosis Moon face Glycosuria Mood swings

A nurse caring for a patient who has diabetic ketoacidosis recognizes which characteristics in the patient? (Select all that apply.)

Plasma osmolality of 300 to 320 mOsm/L Sudden onset, triggered by acute illness Altered fat metabolism leading to ketones

A patient who has type 2 diabetes is taking nateglinide [Starlix]. Which response should a nurse expect the patient to have if the medication is achieving the desired therapeutic effect?

Promotion of insulin secretion

A patient who has type 2 diabetes has a glycated hemoglobin A1c (HbA1c) of 10%. The nurse should make which change to the nursing care plan?

Refer the patient to a diabetes educator because the result reflects poor glycemic control.

Which outcome should a nurse establish for a patient who has acromegaly and is receiving octreotide [Sandostatin]?

Softening of facial features

A nurse assesses a patient who is taking pramlintide [Symlin] with mealtime insulin. Which finding requires immediate follow-up by the nurse?

Sweating

A patient is taking glipizide [Glucotrol] and a beta-adrenergic medication. A nurse is teaching hypoglycemia awareness and should warn the patient about the presence of which symptom?

Tachycardia

Which manifestation would the nurse most clearly associate with a tumor of the hypothalamus?

Unstable body temperature

A nurse should consider which diagnostic test a priority to obtain before a patient receives iodine-131?

Beta human chorionic gonadotropin (hCG) test

A patient is receiving desmopressin [DDAVP] for the treatment of diabetes insipidus. Which instruction is the priority for a nurse to give the patient?

"Reduce your water intake to prevent water intoxication."

The healthcare provider orders hydrocortisone sodium succinate [Solu-Cortef] 500 mg IV now. The available medication is hydrocortisone sodium succinate [Solu-Cortef] 1000 mg/mL. How many mL will the nurse administer?

0.5 mL

The healthcare provider orders 150 mcg of levothyroxine [Synthroid] PO every morning. The medication available is levothyroxine [Synthroid] 75 mcg tablets. How many tablets will the nurse administer?

2

Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) are products of which structure?

Anterior pituitary gland

nurse is developing a plan of care for a patient who has Addison's disease and is taking hydrocortisone [Cortef]. Which of these outcomes should receive priority in the plan?

At times of stress, the patient increases the glucocorticoid dose.

A patient newly diagnosed with type 1 diabetes asks a nurse, "How does insulin normally work in my body?" The nurse explains that normal insulin has which action in the body?

It promotes the passage of glucose into cells for energy.

An adult patient who has GH deficiency is receiving somatropin [Nutropin]. An increase in which finding would indicate to the nurse that the patient is improving?

Lean body mass

The patient reports that she had to switch pharmacies to save money. She noticed that her "thyroid pill" looks different. The nurse anticipates that the healthcare provider will order what?

Thyroid stimulating hormone (TSH)