Exam 4

A nurse is caring for a client who has been diagnosed with Addison's disease. Which statement by the client demonstrates a need for additional instruction?

"I will take this prescription until it is completed."

A nurse is providing health education to a client who will be discharged home with a prescription for hydrocortisone. What instruction should the nurse convey to the client? "Make sure that you take this medication with food." "Take your medication in divided doses at each meal and at bedtime." "It's important to remember that dairy products will negate the benefits of this medication." "Make sure that you avoid taking over-the-counter calcium supplements while taking this medication."

"Make sure that you take this medication with food."

A nurse is caring for a client with Addison's disease who is receiving fludrocortisone with hydrocortisone. Which statements should be included when teaching appropriate medication administration? Select all that apply.

"Take both medications by 0900." "Measure your weight daily, and report a 5-pound weight gain in one week." "Keep all laboratory and provider appointments."

A nurse completing discharge counseling should advise a client taking desmopressin to notify the physician if which adverse reactions occur? (Select all that apply.)

-Changes in urine output -Abdominal cramps -Skin blanching

The nurse is caring for a client who has been prescribed a course of corticosteroids. The nurse knows that systemic corticosteroids may cause which side effects? (Select all that apply.)

-Hypertension -Glucose intolerance

What is true of the hormone vasopressin? (Select all that apply.)

-Vasopressin is secreted when body fluids must be conserved. -Vasopressin regulates the reabsorption of water from the kidney.

Question 2: (see full question) A patient is diagnosed with a simple goiter. The patient asks you what causes a goiter to occur. What would be your best response? You selected: A goiter is the result of too much TSH.

A goiter is the result of too much TSH. Explanation: Goiter (enlargement of the thyroid gland) is an effect of hyperthyroidism, which occurs when the thyroid is overstimulated by TSH. This can happen if the thyroid gland does not mak ... (more)

The health care provider suspects that a client has Addison's disease. The nurse knows that the provider will perform what test to confirm this diagnosis?

ACTH stimulation test

Binding of a hormone to a receptor on the target organ may result in the release of a "second messenger." What is the function of the second messenger?

Activation of intracellular structures

A patient with Addison's disease is receiving replacement therapy. Which intervention is most appropriate?

Administration of fludrocortisone acetate and hydrocortisone sodium succinate daily

The nurse is assessing a client who has developed severe hypoglycemia, and the client has never had troubles with blood sugar before. What condition does the nurse suspect is causing the hypoglycemia?

Adrenal insufficiency

The nurse is caring for a hospital client who has been prescribed fludrocortisone. The nurse has performed a general assessment of the client, including auscultation of the client's apical heart rate. How should the nurse best follow up assessment of an audible S3?

Contact the care provider promptly.

Question 2: (see full question) Which is an example of passive immunity? (Select all that apply.)

Correct response: • Administration of botulism immune globulin (BabyBIG) for the treatment of infant botulism. • Administration of crotalidae polyvalent immune Fab (CroFab) for the treatment of mild to moderate North American rattlesnake bite.

Question 8: (see full question) A nurse completing a pre-administration assessment on a 70-year-old client prior to the administration of levothyroxine (Synthroid) may confuse which of the following symptoms of hypothyroidism with which symptoms associated with the aging process? Select all that apply:

Correct response: • Confusion • Unsteady gait • Cold intolerance Explanation: The symptoms of hypothyroidism may be confused with symptoms associated with aging, such as depression, cold intolerance, weight gain, confusion, or unsteady gait.

Question 15: (see full question) A patient with a recent diagnosis of type 2 diabetes has begun taking metformin. This drug will help the patient achieve adequate blood sugar control through which of the following mechanisms? (Select all that apply)

Correct response: • Decreasing glucose production by the liver • Improving insulin sensitivity • Decreasing glucose absorption in the GI tract Explanation: Metformin decreases hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and use in skel ... (more)

Question 16: (see full question) The nurse is caring for a client who is receiving levothyroxine and educates the client to what adverse effects of this medication? (Select all that apply.)

Correct response: • Fever • Insomnia • Intolerance to heat Explanation: Adverse effects of levothyroxine include irritability, fever, weight loss, insomnia, and intolerance to heat.

Question 9: (see full question) During ongoing assessment of clients receiving insulin detemir (Levemir), the nurse assesses the client for symptoms of hypoglycemia that include which of the following? Select all that apply:

Correct response: • Headache Blurred Vision • Confusion • Diaphoresis Explanation: The symptoms of hypoglycemia include fatigue, weakness, nervousness, agitation, confusion, headache, diplopia, convulsion, dizziness, unconsciousness, hunger, nausea, diaphoresis, ... (more)

Question 3: (see full question) Which of the following are risk factors for type 2 diabetes that a nurse should recognize in a client? Select all that apply:

Correct response: • Impaired glucose tolerance • Obesity • History of gestational diabetes Explanation: A nurse should be able to identify all the risk factors for type 2 diabetes in a client. These include: obesity, older age, family history of diabetes, history of gestational diabe ... (more)

Question 13: (see full question) Which of the following is true in regard to the thyroid hormone replacement drug levothyroxine (Synthroid)? Select all that apply:

Correct response: • Levothryroxine (Synthroid) has a more uniform potency than other thyroid hormone replacement drugs. • Levothryroxine (Synthroid) is relatively inexpensive. Explanation: The following are true of the thyroid replacement drug levothyroxine (Synthroid): it is relatively inexpensive, requires once daily dosing, and has a more uniform potency than do o ... (more)

Question 11: (see full question) The nurse is teaching the parents of a child who has received immunizations and possible adverse effects. What would the nurse identify as common adverse effects? (Select all that apply.)

Correct response: • Nodule at the injection site • Fretfulness • Chills • Anorexia Explanation: Common adverse effects include moderate fever, rash, malaise, chills, fretfulness, drowsiness, anorexia, vomiting, irritability, and pain, redness, swelling, and nodule formation a ... (more)

Question 17: (see full question) A nurse is educating a group of nursing students about the contraindications of human immune globulin. Which among the following conditions are contraindications for human immune globin? Select all that apply.

Correct response: • Preexisting renal disease • Age more than 65 years • Diabetes mellitus Explanation: Human immune globulin intravenous (IGIV) product can cause renal impairment, osmotic nephrosis, and death as its complications. Hence it is contraindicated in individuals with acut ... (more)

Question 1: (see full question) Which are used to produce active immunity? (Select all that apply.)

Correct response: • Vaccines • Toxoids Explanation: The immunity produced by the administration of toxoids and vaccines is considered active immunity.

Question 1: (see full question) A nurse should take the following steps prior to administering insulin glargine (Lantus) to a client? Select all that apply:

Correct response: • Check the expiration date on the vial. • Check the physician's orders for the type and dosage of insulin. • Remove all air bubbles from the syringe barrel. Explanation: Prior to administering insulin glargine (Lantus) to a client, the nurse must complete the following pre-administration steps: carefully check the physician's order for the type and ... (more)

Question 2: (see full question) A nurse is providing patient education to a 13-year-old girl who was just diagnosed with type 1 diabetes mellitus. Which of the following statements by the patient will alert the nurse that special instructions regarding insulin are necessary?

Correct response: "I am on the middle school track team." Explanation: Because the patient is on the track team, she will have increased exercise at various times that will require increased insulin and special instructions related to hypoglycemia tha ... (more)

Question 1: (see full question) The nurse is discussing diabetes with a group of individuals who are at risk for the disease. Which statement by a participant indicates an understanding of the role of insulin in the disease?

Correct response: "Insulin assists glucose molecules to enter the cells of muscle and fat tissues." Explanation: Insulin appears to activate a process that helps glucose molecules enter the cells of striated muscle and adipose tissue. It also stimulates the synthesis of glycogen by the liver, ... (more)

Question 7: (see full question) What hormone, secreted with insulin, increases satiety and suppresses glucagon secretion?

Correct response: Amylin Explanation: Amylin, a hormone secreted with insulin, delays gastric emptying, increases satiety, and suppresses glucagon secretion, thus complementing the effects of insulin on the blood sugar ... (more)

Question 12: (see full question) The following patients are prescribed metformin. Which patient is likely at the greatest risk of having an adverse reaction to metformin?

Correct response: An alcoholic patient Explanation: Hypoglycemia is more common when metformin is administered concomitantly with other oral hypoglycemic agents, if caloric intake is deficient, or if the patient exercises strenuousl ... (more)

Question 6: (see full question) When reviewing sites for insulin administration with a client, which site, if stated by the client as an appropriate site, indicates the need for additional teaching?

Correct response: Buttocks Explanation: The buttocks would be an inappropriate site for administering insulin subcutaneously. The best sites include the upper arm, abdomen, and upper thigh

Question 10: (see full question) A patient with type 1 diabetes has been admitted to the hospital for orthopedic surgery and the care team anticipates some disruptions to the patient's blood glucose levels in the days following surgery. Which of the following insulin regimens is most likely to achieve adequate glycemic control?

Correct response: Doses of basal insulin twice daily with regular insulin before each meal Explanation: Subcutaneous insulin therapy for type 1 diabetes frequently consists of daily injections of mixtures of short-acting regular insulin with intermediate-acting insulins; multiple dos ... (more)

Question 19: (see full question) A nurse is reviewing the history of a child who is scheduled to receive immunizations during this health care visit. A history of what issue would alert the need for cautious use of a vaccine?

Correct response: Febrile convulsions Explanation: Caution is necessary any time a vaccine is given to a child with a history of febrile convulsions. Immune deficiency would contraindicate the use of vaccines. An allergy to a vacci ... (more)

Question 4: (see full question) Which of the following would a nurse expect to assess in a client experiencing hyperthyroidism?

Correct response: Flushed, warm skin Explanation: Clients with hyperthyroidism typically exhibit flushed, warm skin; hyperactive deep tendon reflexes; tachycardia; and intolerance to heat.

Question 11: (see full question) A client with diabetes has started thyroid hormone replacement therapy. The nurse should monitor closely for which effects?

Correct response: Hot, dry skin Explanation: The client with diabetes who begins thyroid replacement hormones should be monitored closely for signs of hyperglycemia: increased thirst, increased hunger, polyuria (increased uri ... (more)

Question 10: (see full question) A nurse is presenting an educational event about vaccines at a local elementary school. What would the nurse tell the attendees of the event about the administration of live vaccines and when they are generally contraindicated?

Correct response: In people who are receiving immune globulin for immune deficiency Explanation: The use of vaccines is contraindicated in the presence of immune deficiency because the vaccine could cause disease and the body would not be able to respond as anticipated if in a ... (more)

Question 14: (see full question) All of the following are specific physiological effects of thyroid hormones, EXCEPT:

Correct response: Increased pituitary secretion of TSH. Explanation: Some specific physiologic effects of thyroid hormones include increased rate of cellular metabolism and oxygen consumption, with a resultant increase in heat production; increased ... (more)

Question 7: (see full question) A male client presents to the emergency department with an asthma attack. He is treated and sent home with prednisone 10 mg on a taper and is encouraged to see his physician within 1 week. During an assessment of the chart, the nurse notices that the client is overdue for his tetanus booster. What would the nurse expect the physician to do?

Correct response: Order the booster Explanation: Immunizations are not contraindicated with short-term use (less than 2 weeks) or low-to-moderate doses (less than 20 mg/d) of prednisone.

Question 17: (see full question) As a participant in an educational event at a local senior center, the nurse is explaining the administration of vaccines. What group would the nurse identify as being ineligible for live-virus vaccines?

Correct response: People undergoing systemic, long-term corticosteroid therapy Explanation: Systemic corticosteroid therapy may depress the immune system to such a degree that patients lack a sufficient number of antibodies to safely receive a live-virus vaccine. Patients ... (more)

(see full question) After 48 hours of thyroid hormone replacement therapy, a client reports still having no appetite. Which is the nurse's best action?

Correct response: Reassure the client that more time is needed to see results. Explanation: The full effects of thyroid hormone replacement therapy may not be apparent for several weeks or more, but early effects may be apparent in as little as 48 hours. The health care p ... (more)

Question 18: (see full question) A nurse is working with a newly diagnosed diabetic patient on understanding hypoglycemia and insulin reactions. Which of the following actions would be most important for the patient to understand when planning the response to an insulin reaction?

Correct response: Take an oral dose of some form of glucose as soon as possible. Explanation: The initial action of the patient should be to take some form of oral glucose. It would also be appropriate to call the physician, but this will delay self-treatment and should be ... (more)

Question 1: (see full question) While you are talking with a client, she informs you that she has been under treatment for weight loss management. She indicates that she is taking antithyroid medication to increase weight loss. Included in your client education about antithyroid medication is:

Correct response: Taking excessive or unnecessary antithyroid medication may produce serious or life-threatening manifestations of toxicity. Explanation: The FDA has issued a BLACK BOX WARNING regarding the use of thyroid hormones for the treatment of obesity or weight loss, either alone or with other therapeutic agents. Significant ... (more)

Question 4: (see full question) What type of modification may be necessary for a client with diabetes mellitus who requires immunizations?

Correct response: The client will require increased doses of vaccines. Explanation: Clients who have diabetes mellitus may require increased dosage and more frequent administration of vaccines.

Question 7: (see full question) A client asks the nurse if she's taking a standard dose of thyroid hormone medication. What is the nurse's best response?

Correct response: The dose is based on your relief of symptoms from hypothyroidism. Explanation: Treatment of hypothyroidism is based on individualized doses of the hormone to treat symptoms, not by weight or a standard dosing algorithm. TSH levels are used to assist the presc ... (more)

Question 3: (see full question) Graves' disease is the most common cause of hyperthyroidism. Correct response: True Explanation: Graves' disease, a poorly understood condition that is thought to be an autoimmune problem, is the most common cause of hyperthyroidism.

Correct response: True Explanation: Graves' disease, a poorly understood condition that is thought to be an autoimmune problem, is the most common cause of hyperthyroidism.

Question 6: (see full question) The difference between toxoids and vaccines is:

Correct response: Vaccines induce antibody formation, which prevent the disease or cause a very mild form. Many vaccines produce long-lasting immunity. Toxoids are bacterial toxins or products modified to destroy toxicity. Toxoid immunization is not permanent; scheduled repeat doses (boosters) maintain immunity. Explanation: Vaccines are suspensions of microorganisms that have been killed or attenuated so that they can induce antibody formation while preventing or causing very mild forms of the disease ... (more)

Question 3: (see full question) The nurse is assisting a client who has just begun medication therapy for hypothyroidism. Which nursing assessment is most important in this client?

Correct response: Vital signs Explanation: Vital signs would be the most important assessment because cardiac difficulties may occur early in treatment for hypothyroidism

Question 4: (see full question) The nurse is assessing a patient receiving strong iodide solution. Which of the following would alert the nurse to the possible development of iodism? Select all that apply.

Correct response: • Metallic taste • Throat burning • Sore teeth Explanation: Signs of iodism include a metallic taste, burning mouth and throat, sore teeth and gums, head cold symptoms, stomach upset, and diarrhea. Salivary gland swelling is an adverse effe ... (more)

(see full question) A nurse educating a client and their family about levothyroxine (Synthroid) for the treatment of hypothyroidism should include which of the following information? Select all that apply:

Correct response: • Therapy is lifelong. • Weigh weekly and report significant changes to the physician. Explanation: A nurse educating a client and their family about levothyroxine (Synthroid) for the treatment of hypothyroidism should include the following: therapy is lifelong, take the dose in ... (more)

The nurse is assessing a patient with adrenocortical insufficiency. What presenting symptom supports the patient's diagnosis?

Decreased cardiac output

A nurse is assessing a patient with Addison's disease and finds the patient to have poor skin turgor and a weight loss of 5 pounds in the last 2 weeks. What is the primary action of the nurse?

Discuss the patient's medication therapy with the health care provider.

The nurse is caring for a patient who has been prescribed fludrocortisone and furosemide (Lasix). What assessment is essential to monitor for potential complications with this patient?

Electrolytes

The nurse would contact the physician prior to administering desmopressin to a client with a history of what condition?

Heart Attack

A patient has returned to the floor after having a thyroidectomy for thyroid cancer. The nurse knows that sometimes during thyroid surgery the parathyroid glands can be injured or removed. What laboratory finding may be an early indication of parathyroid gland injury or removal?

Hypocalcemia

A client diagnosed with metastatic cancer has developed adrenocortical insufficiency. What clinical manifestations would serve to support the diagnosis of adrenocortical insufficiency?

Hyponatremia Hyperkalemia Hypotension

A nurse is completing an assessment on a client diagnosed with adrenocortical insufficiency. What are the expected clinical manifestations? Select all that apply.

Lethargy Anorexia Weight loss

The patient receiving mineralocorticoid therapy usually has which nursing diagnosis as a priority?

Potential for alteration in skin integrity

Which laboratory value monitored in a patient receiving fludrocortisone acetate requires immediate action by the nurse?

Sodium 150 mEq/L

The patient being treated for Addison's disease that is responding to therapy would have which assessment finding? Decreased sodium Increased urinary output Weight loss Stable blood pressure

Stable blood pressure

The nurse is evaluating the therapeutic effects of fludrocortisone acetate (Florinef acetate). Which assessment finding best indicates that the medication is working? The patient's blood pressure has decreased from 130/90 to 100/90 mm Hg. The patient has +2 pitting edema of the ankles. The patient has no headaches. The patient's blood pressure is 130/90 mm Hg seated and 128/89 mm Hg when standing.

The patient's blood pressure is 130/90 mm Hg seated and 128/89 mm Hg when standing.

The nurse is assessing a child who is receiving growth hormone therapy. What would the nurse identify as suggesting glucose intolerance?

Thirst

Which laboratory values should the nurse review prior to the administration of hydrocortisone? Select all that apply. White blood cell count Glucose level Platelet count Cortisol level Magnesium level

White blood cell count Glucose level

Question 20: (see full question) A female client with a six-month-old infant has been prescribed propylthiouracil (PTU). What is the most important question the nurse should ask this client?

You selected: "Are you breast or bottle feeding?" Correct Explanation: Mothers taking PTU should not breastfeed their children (pregnancy category D). For the safety of the infant, the nurse should ask the client if she's breastfeeding. Taking thyro ... (more)

Question 20: (see full question) A 59-year-old man with type 2 diabetes is prescribed metformin. When the patient returns to the clinic, he reports that he has lost 8 pounds in a month. How should the nurse respond?

You selected: "Please continue taking the medication and monitoring your weight. This is an expected outcome of this drug therapy." Correct Explanation: The nurse should advise the patient to continue therapy as prescribed because weight loss is a beneficial adverse effect for type 2 diabetics. The patient need not seek a decrease ... (more)

Question 18: (see full question) A pregnant client asks about the safety of taking thyroid hormone replacement drugs during her pregnancy. What is the nurse's best response?

You selected: "Thyroid hormones are pregnancy category A drugs and should be taken during pregnancy." Correct Explanation: Thyroid hormones are classified as pregnancy category A and should be continued by hypothyroid women during pregnancy. Thyroid hormones are not used as treatment for obesity or inf ... (more)

Question 18: (see full question) If a nurse is administering immune globulin to a patient in the physician's office how long should the patient stay to be observed for hypersensitivity reactions? (Choose one)

You selected: 30 minutes Correct Explanation: The patient should be asked to stay in the physician's office for observation for about 30 minutes after the injection of immune globulin for any signs of hypersensitivity.

Question 6: (see full question) Which statements best indicates the client understands recommended vaccines following the 65th birthday?

You selected: A tetanus-diphtheria booster every 10 years, annual influenza vaccine, and a one-time administration of pneumococcal vaccine at 65 years of age Correct Explanation: Recommended immunizations for older adults have usually consisted of a tetanus-diphtheria (Td) booster every 10 years, annual influenza vaccine, and a one-time administration of pn ... (more)

Question 8: (see full question) A hospitalized client is about to receive immunological therapy and asks the nurse to explain the difference between passive and active immunity. In order to provide complete information, the nurse knows to include which information during the teaching session?

You selected: Active immunity occurs when a client receives a killed or weakened antigen that stimulates antibodies. These antibodies fight the antigen (for example, chickenpox vaccine). Correct Explanation: Active immunity occurs when a client receives a killed or weakened antigen that stimulates antibodies. These antibodies fight the antigen (for example, chickenpox vaccine). Passive ... (more)

A client has been admitted to the emergency department with a diverse constellation of signs and symptoms. What diagnostic finding is most consistent with a diagnosis of Addison's disease?

serum sodium 128 mEq/L (128 mmol/L)

Question 14: (see full question) A client is diagnosed with both hypothyroidism and adrenal insufficiency. If the adrenal insufficiency is not treated first, what may occur with the administration of thyroid hormone?

You selected: Acute adrenocortical insufficiency Correct Explanation: When hypothyroidism and adrenal insufficiency coexist, the adrenal insufficiency should be treated with a corticosteroid drug before starting thyroid replacement. Thyroid hor ... (more)

Question 9: (see full question) A client receives regular insulin at 8:00 AM. The nurse would be alert for signs and symptoms of hypoglycemia at which time?

You selected: Between 10:00 AM and 12:00 PM Correct Explanation: Regular insulin peaks in 2 to 4 hours, so the nurse would be alert for signs and symptoms of hypoglycemia at this time, which would be between 10:00 AM and 12:00 PM. If insul ... (more)

Question 16: (see full question) The nurse educator is teaching a class of community leaders about immunologic agents. The mayor voices concern on behalf of the leaders about bad reactions from vaccines. To minimize the concern, the nurse explains that adverse reactions from vaccines are usually mild. The nurse would include which mild reactions in the teaching plan?

You selected: Chills and fever Correct Explanation: Chills and fever are mild adverse reactions observed after administration of vaccines. Seizure, cardiac arrest, death, and brain damage are not considered mild adverse reactions.

Question 15: (see full question) More patients experience hyperthyroidism than hypothyroidism.

You selected: False Correct Explanation: Hypothyroidism is the most common type of thyroid dysfunction.

Question 1: (see full question) The nurse is preparing to administer levothyroxine to a client. Which assessment finding would cause the nurse to hold the medication?

You selected: Heart rate of 110 beats per minute Correct Explanation: Levothyroxine should be held if the client's heart rate is over 100 beats per minute.

Question 13: (see full question) A nurse is receiving post-exposure prophylaxis for hepatitis B. What would the nurse most likely receive?

You selected: Immune globulin Correct Explanation: Hepatitis B immune globulin would be used for post-exposure prophylaxis for hepatitis B. This vaccine would be used to prevent herpes zoster (shingles) in persons over the age of 6 ... (more)

A female client is living with HIV. She is exposed to measles. What is the treatment of choice in this case?

You selected: Immune globulin Correct Explanation: Persons with asymptomatic HIV infection should receive inactivated vaccines; those exposed to measles or varicella may be given immune globulin or varicella-zoster immune glo ... (more)

Question 4: (see full question) When administering insulin, which of the following would be most appropriate?

You selected: Insert the needle at a 45-degree angle for injection. Correct Explanation: The vial should be gently rotated and vigorous shaking is to be avoided to ensure uniform suspension of the insulin. Typically the area is pinched to allow access to the loose conn ... (more)

Question 8: (see full question) A young mother asks the clinic nurse about the "chickenpox" vaccine. The mother states that she and her husband have both had chickenpox, but that she wants to protect her child if she can. What should the nurse tell the mother about the recommendation for the chickenpox vaccine?

You selected: It is recommended for all children who have not been exposed to the varicella virus. Correct Explanation: Measles, mumps, rubella, varicella virus vaccine (ProQuad) 0.5 mL Sub-Q. Simultaneous immunization against measles, mumps, rubella, and varicella in children aged 12 months to 12 y ... (more)

Question 19: (see full question) As a diabetic educator, you are teaching a newly diagnosed diabetic about aspects of the disease process. What would you tell the patient about the body's control of glucose?

You selected: It is related to fat and protein metabolism Correct Explanation: The body's control of glucose is intricately related to fat and protein metabolism, balancing energy conservation with energy consumption to maintain homeostasis in a variety of si ... (more)

Question 18: (see full question) What type of vaccine is contraindicated in clients who have active malignant disease?

You selected: Live vaccines Correct Explanation: Clients with active malignant disease may be given killed vaccines or toxoids but should not be given live vaccines. (An exception is persons with leukemia who have not recei ... (more)

Question 5: (see full question) After teaching a class about the various drugs used to control blood glucose, the instructor determines that the teaching was successful when the class identifies which of the following as a biguanide?

You selected: Metformin Correct Explanation: Metformin is classified as a biguanide. Miglitol is an alpha-glucosidase inhibitor. Tolbutamide is a first generation sulfonylurea. Glipizide is a second generation sulfonylurea.

Question 9: (see full question) A nurse should be cautious not to administer levothyroxine (Synthroid) to a patient who has recently had which of the following?

You selected: Myocardial infarction Correct Explanation: A nurse should be cautious not to administer levothyroxine (Synthroid) to a patient who has recently had myocardial

Question 1: (see full question) A nurse should be cautious not to administer levothyroxine (Synthroid) to a patient who has recently had which of the following?

You selected: Myocardial infarction Correct Explanation: A nurse should be cautious not to administer levothyroxine (Synthroid) to a patient who has recently had myocardial infarction.

Question 13: (see full question) The physician prescribes glyburide for Tim, a newly diagnosed type 2 diabetic. The nurse knows that this medication acts by which mechanism?

You selected: Produces hypoglycemia by increasing insulin secretion from the pancreas Correct Explanation: The hypoglycemic action of glyburide results from the stimulation of pancreatic beta cells, leading to increased insulin secretion.

Question 7: (see full question) Thioamide antithyroid drugs treat hyperthyroidism by inhibiting the synthesis of thyroid hormone. What is the prototype of the thioamide anti-thyroid drugs?

You selected: Propylthiouracil Correct Explanation: Propylthiouracil is the prototype of the thioamide antithyroid drugs. Although propranolol is used to treat some symptoms of hyperthyroidism, it is an antiadrenergic, not an antith ... (more)

Question 5: (see full question) Your client is currently undergoing chemotherapy. She asks what type of immunizations that she should get at her annual physical, which is next week. Your best response is:

You selected: She should not be given live vaccines and should wait for 3 months after stopping chemotherapy to get the vaccines. Correct Explanation: Patients with active malignant disease may be given killed vaccines but should not be given live vaccines. When vaccines are used, they should be given at least 2 weeks before the ... (more)

Question 4: (see full question) A client is prescribed levothyroxine. The nurse understands that this drug contains which of the following?

You selected: T4 Correct Explanation: Levothyroxine is a synthetic salt of T4; desiccated thyroid contains both T3 and T4. Liothyronine contains T3. Iodine is an antithyroid agent. Calcitriol is a form of vitamin ... (more)

Question 2: (see full question) A patient is receiving a thyroid hormone to treat hypothyroidism. Which of the following would indicate to the nurse that the patient needs a reduced dosage of the drug?

You selected: Tachycardia Correct Explanation: Tachycardia suggests hyperthyroidism due to excessive thyroid hormone; this would require a reduction in dosage. Slowed reflexes would suggest hypothyroidism and drug ineffectivene ... (more)

(see full question) A client being treated with desmopressin exhibits confusion and drowsiness, and reports a headache. What is the nurse's best action?

You selected: Take the client's vital signs. Correct Explanation: Excessive dosage of desmopressin is manifested as water intoxication (fluid overload). Signs and symptoms include confusion, drowsiness, and headache. The nurse should assess the v ... (more)

Question 16: (see full question) An insulin dependent diabetic is having trouble with hypoglycemia late in the morning. During the health history, the nurse becomes aware of the most likely cause. What would cause the late morning hypoglycemia?

You selected: The patient jogs two miles in the morning before he goes to work. Correct Explanation: Physical exercise, such as jogging, changes insulin requirements and may result in a delayed hypoglycemic reaction. The fact that he likes to nap before dinner and has an early lun ... (more)

Question 8: (see full question) The pharmacology instructor is talking about the drug propylthiouracil (PTU). What would the instructor cite as the primary mode of action for propylthiouracil (PTU)?

You selected: To inhibit production of thyroid hormone Correct Explanation: PTU acts by inhibiting production of thyroid hormones and peripheral conversion of T4 to the more active T3. Therefore Options A, C, and D are incorrect.

Question 3: (see full question) To prevent chickenpox, a patient would receive a viral vaccine.

You selected: True Correct Explanation: Varicella virus vaccine is used for immunization against chickenpox infections in adults and children 12 months of age or older.

Question 5: (see full question) When describing the use of vaccines to a local community group, what would the nurse include?

You selected: Vaccines are used to provide active immunity. Correct Explanation: Vaccines provide active immunity. They promote the formation of antibodies against a specific disease. The person experiences an immune response without having to suffer the f ... (more)

Question 20: (see full question) The nurse is assisting a client who has just begun medication therapy for hypothyroidism. Which nursing assessment is most important in this client?

You selected: Vital signs Correct Explanation: Vital signs would be the most important assessment because cardiac difficulties may occur early in treatment for hypothyroidism.

Question 6: (see full question) To minimize the risk of adverse effects of glucagon when given to an unconscious diabetic patient, as the patient regains consciousness, the nurse should

You selected: administer carbohydrates. Correct Explanation: While it is important to monitor a patient for nausea and vomiting and help him or her into a more comfortable position, it is most important to administer supplemental carbohydrat ... (more)

Question 5: (see full question) The pathophysiology class is studying diabetes. A student asks the instructor what is considered a sign of a hypoglycemic reaction. The instructor's response would be:

You selected: diaphoresis. Correct Explanation: Diaphoresis and cool, clammy skin are signs of hypoglycemia. A fruity breath is seen with ketoacidosis. Flushing of the face is associated with hyperglycemia.

Question 4: (see full question) A nurse is providing patient education to the mother of a child receiving their first immunization. The nurse tells the mother that after the injection it is normal for the child to have:

You selected: pain, redness, and swelling at site of injection. Correct Explanation: Normal reactions to immunizations include pain, redness, and swelling at the site of the injection. Vomiting, diarrhea, high fever, sweating, lethargy, or drowsiness would not be e ... (more)

Question 2: (see full question) A male patient is to begin glyburide (Diabeta) for type 2 diabetes. Before the drug therapy begins, a priority action by the nurse will be to assess the patient's

You selected: use of alcohol. Correct Explanation: The nurse should assess the patient's alcohol consumption before therapy is initiated. Concomitant alcohol use increases the rate of glyburide metabolism and may cause a disulfiram ... (more)

Question 1: (see full question) Knowing that thyroid hormones are principally concerned with the increase in metabolic rate of tissues, which of the following symptoms would a nurse observe in a client with uncontrolled hypothyroidism? Select all that apply:

You selected: • Sleepiness • Bradycardia • Weight gain Correct Explanation: The signs and symptoms of hypothyroidism include: decreased metabolism, cold intolerance, low body temperature, weight gain, bradycardia, hypotension, lethargy, sleepiness, pale, c ... (more)

What situation most significantly affects the plan of care of a client prescribed hydrocortisone?

atrial fibrillation and treatment with warfarin

A nurse is caring for a 70-year-old patient who is taking desmopressin (DDAVP). The patient has a history of cardiovascular disease. The nurse will prioritize the assessment of:

electrolyte levels