Pharm exam 3 - PrepU
The nurse is preparing to administer prednisone. The nurse would expect to administer this agent by which route? Oral Intralesional Inhalation Intravenous
Oral
The hypothalamus is connected to which endocrine gland? Thalamus Cerebellum Pituitary Sebaceous
Pituitary
The wife of a client who is taking haloperidol calls the clinic and reports that her husband has taken the first dose of the drug and it is not having a therapeutic effect. An appropriate response by the nurse would be which? "Continue the prescribed dose. It may take several days to work." "I'll ask the nurse practitioner if the dosage can be increased." "I'll ask the nurse practitioner if the haloperidol can be discontinued and another drug started." "I'll report this to the nurse practitioner and see if he will add another drug to enhance the effects of the haloperidol."
"Continue the prescribed dose. It may take several days to work."
A client is prescribed calcitriol. Which instruction would be most important for the nurse to include in the teaching plan? "Take the drug with a magnesium antacid." "Limit your intake of dairy products." "Have your calcium levels checked periodically." "Take the drug with food if gastrointestinal issues occur."
"Have your calcium levels checked periodically."
What endocrine gland produces corticosteroids? Thyroid Adrenal Parathyroid Pituitary
Adrenal
What event triggers the release of insulin and glucagon from the pancreas? Localized calcium needs A need for increased oxygen in the blood Varying blood glucose levels A decrease in blood pressure
Varying blood glucose levels
The home care nurse is caring for an 80-year-old patient who is receiving carbidopa-levodopa, a dopaminergic drug used to treat Parkinson's disease. The nurse knows that this drug may place the patient at increased risk for: infection. falls. excessive sedation. uncontrolled bleeding.
falls
What is a common risk for epileptic seizures during late infancy to early childhood? head trauma fever medication overdose malnutrition
fever
A 12-year-old client who has been taking sertraline for the past 2 weeks has returned to the clinic to be seen. It will be critical for the nurse to assess for which? onset of suicidal ideation. weight loss. feelings of grandiosity. decreased sleep.
onset of suicidal ideation.
What are the functions of the antidiuretic hormone (ADH)? Select all that apply. reabsorption of water raising blood volume dilution of extracellular fluids inhibiting secretion of thyrotropin increasing arterial blood pressure
reabsorption of water raising blood volume dilution of extracellular fluids increasing arterial blood pressure
The nurse is teaching a patient who is prescribed calcitriol about the drug. Which patient statement indicates that the teaching was successful? "I need to have my calcium levels checked periodically." "I must take the drug on an empty stomach." "I need to use an antacid that contains magnesium to prevent problems." "I need to limit the amount of dairy products that I eat."
"I need to have my calcium levels checked periodically."
The nurse is caring for a client who is recovering in the hospital from a stroke. What statement by the client suggests a need for further education? "I'm eager to start rehabilitation because I want new nerves to grow as quickly as possible." "My losses in movement and sensation are distressing, but I know they can improve." "I know that my stroke has affected communication between nerves in my brain and the rest of my nervous system." "I know that it's my central nervous system that was most affected by the stroke."
"I'm eager to start rehabilitation because I want new nerves to grow as quickly as possible."
An older adult client has been using levothyroxine for several years on an outpatient basis. Which client statement should the nurse attribute to the decreased effect of levothyroxine? "I've been using a lot of antacids lately because of my indigestion." "My daughter and I have started the Atkins diet to try to lose some weight." "Overall, I'd say that I'm under a lot of stress lately." "I've stopped taking aspirin for my arthritis and started using acetaminophen."
"I've been using a lot of antacids lately because of my indigestion."
The nurse has just completed discharge instructions to a client who will be using a pen device to deliver his insulin dose. What statement by the client indicates a need for further instruction? "I need to turn the dial on the pen and listen for the locking ring before administering my insulin." "If I forget to take my insulin pen, I will be able to use the one that my wife uses." "I determine my dosage by the number of clicks that I hear." "This will make it easier for me to give my own insulin because of my poor eyesight."
"If I forget to take my insulin pen, I will be able to use the one that my wife uses."
The results of a client's plasma corticotropin (ACTH) stimulation test have confirmed a diagnosis of Addison disease. The nurse has consequently provided health education around the necessity of hormone replacement therapy. The client has asked the nurse, "How long am I going to have to take these medications?" How should the nurse best respond? "In order to manage this condition, you'll need to take these for the rest of your life." "You'll have to take these until you can pass the corticotropin stimulation test without them." "You'll have to take these until your kidneys regain their normal level of function." "You'll need to take these until your symptoms have been stable for at least 6 months."
"In order to manage this condition, you'll need to take these for the rest of your life."
A client has been taking fluoxetine (Prozac) for the last ten days. Today the client the clinic reporting not feeling any better. What is the nurse's best response to this client? "It may take another two to three weeks before the medication is completely effective." "I realize this is frustrating but most medications for mood disorders aren't fully effective for two to three months." "I will tell the healthcare provider and see if there is another medication that would be better." "Please come to the clinic immediately so you can be reassessed for suicidal thoughts."
"It may take another two to three weeks before the medication is completely effective."
A client's medication regimen for treatment of anxiety has been changed from a benzodiazepine to buspirone (BuSpar). The client asks the nurse what makes this medication safer than the benzodiazepine the client has taken. What is the nurse's best response? "It will not produce sedation like benzodiazepines." "It produces anticonvulsant action to prevent convulsions." "It produces muscle relaxant effects to decrease back pain." "It provides you with a sleep additive to decrease insomnia."
"It will not produce sedation like benzodiazepines."
A client has been diagnosed with partial seizures and has been prescribed carbamazepine. When providing health education about the safe and effective use of this medication, what should the nurse teach the client? "It's safest if you avoid drinking alcohol while you're taking this drug." "It's important to take a dose as soon as possible if you feel a seizure is coming." "I'll be showing you how to safely self-inject this drug." "I'll explain the foods that you should avoid while you're taking this drug."
"It's safest if you avoid drinking alcohol while you're taking this drug."
A client, prescribed hydrocortisone, states, "I know quite a few different people who have had unpleasant side effects of steroids." How should the nurse best respond to the client's concern? "It's true, that hydrocortisone can affect nearly every body system, but your health care team will monitor you thoroughly for indications of adverse reactions." "Most often, when people experience side effects of hydrocortisone it's because they've not following the instructions closely." "There are indeed quite a few diverse side effects of hydrocortisone, but they're mostly very minor." "In the past, this was often the case, but modern corticosteroids are largely free of side effects."
"It's true, that hydrocortisone can affect nearly every body system, but your health care team will monitor you thoroughly for indications of adverse reactions."
A client's medication regimen for treatment of anxiety has been changed from a benzodiazepine. The client asks the nurse what likely prompted the health care provider to change the medication. What is the nurse's best response? "Your provider may have been concerned about causing depression." "Your provider may have been worried about the possibility of convulsions." "Long-term use of benzodiazepines can result in dependency." "Long-term use of benzodiazepines can cause insomnia."
"Long-term use of benzodiazepines can result in dependency."
What statement would be appropriately included in the teaching concerning type 2 diabetes? "Regular exercise makes your body better able to use the insulin it produces." "Until you need to start insulin injections, you do not have to check your blood sugar." "Clients with type 2 diabetes always progress to insulin injections if they do not follow dietary guidelines." "If you drink alcohol, it may be necessary for you to increase your oral antidiabetic medication."
"Regular exercise makes your body better able to use the insulin it produces."
A pregnant client asks about the safety of taking thyroid hormone replacement drugs during her pregnancy. What is the nurse's best response? "Continue thyroid medication only if you have a history of heart disease." "Thyroid hormones are pregnancy category A drugs and should be taken during pregnancy." "Take thyroid hormones if you gain more than the recommended amount of weight during pregnancy." "You don't need thyroid hormones anymore if you took fertility drugs."
"Thyroid hormones are pregnancy category A drugs and should be taken during pregnancy."
A child is to receive a topical corticosteroid agent. Which statement by the parents indicates a need for additional teaching? "We'll apply the cream in a thin layer over the area, using a small amount." "We need to cover the area snugly with plastic wrap to prevent scratching." "We'll keep the cream away from any open areas that might develop." "We'll avoid putting the cream on any areas where the skin is abraded."
"We need to cover the area snugly with plastic wrap to prevent scratching."
The nurse is teaching parents of a pediatric client diagnosed with ADHD. Teaching has been about the disorder and its treatment. The nurse determines that teaching has been effective when the parents state which? "We need to remember that our son is not a bad kid; he just has difficulty with impulse control and attention." "We need to be careful so he doesn't develop a substance abuse problem as he grows older." "We should stop the medication after 2 months to see how effective it is in really controlling his symptoms." "We should set up regular routines for him but not worry if he violates the limits once in a while."
"We need to remember that our son is not a bad kid; he just has difficulty with impulse control and attention."
A black, male client routinely takes haloperidol to manage his psychosis. Recently, he presented to the health care provider's (HCP's) office with signs of tardive dyskinesia, and his HCP modified the drug regimen over time. The client will now take the drug olanzapine and discontinue the haloperidol. What will the nurse tell the client to help decrease his anxiety about the new drug regimen? "The signs of tardive dyskinesia will diminish over time." "Black clients always experience tardive dyskinesia with antipsychotics." "When compared with haloperidol, olanzapine has been associated with fewer extrapyramidal reactions in black clients." "The olanzapine does not produce side effects in black males."
"When compared with haloperidol, olanzapine has been associated with fewer extrapyramidal reactions in black clients."
An adult client is preparing to begin corticosteroid treatment for rheumatoid arthritis. When teaching this client about the appropriate use of corticosteroids, the nurse should include what teaching point? "You will likely gain some weight after you start taking this drug." "Try to eat as many organic and natural foods as possible while taking this drug." "You might have some slight bleeding in your stool after you start this drug." "Ensure that you vary the times that you take your drug in order to maximize effectiveness."
"You will likely gain some weight after you start taking this drug."
The client is scheduled to get a breakfast tray at 07:00. At what time should the client receive a prescribed dose of insulin lispro? 06:00 06:20 06:45 07:00
06:45
How long does a patient need to wait after stopping a phenelzine before starting paroxetine? 14 days 1 day 7 days 10 days
14 days
A client is receiving an SSRI. The nurse would inform the client that the full benefits of the drug may not occur for which time period? 1 week 2 weeks 3 weeks 4 weeks
4 weeks
A nurse is providing care on a psychiatric unit with many clients that take antidepressants. What client factor would the nurse have to consider when administering these medications? A client has dysphagia A client has an intense fear of injections A client has a history of pulling out her IV cannula A client actively resists IM injections
A client has dysphagia
A nurse who gives care on a neurological floor is working with several clients. Which client should the nurse prioritize for further assessment and possible interventions? A client receiving pregabalin who is not responsive to verbal stimuli A client who will be discharged on carbamazepine and who requires education A client being treated with phenobarbital whose blood pressure is 106/69 mmHg A client who is anxious about undergoing electroencephalography to investigate a recent absence seizure
A client receiving pregabalin who is not responsive to verbal stimuli
The neurological nurse is caring for a diverse group of clients. For which client would the role of the blood-brain barrier be most significant during treatment? A client who has been diagnosed with an infection of brain tissue A client who had an ischemic stroke 36 hours ago and is being stabilized A client who has ataxia resulting from cerebellar damage A client being treated for a closed head injury
A client who has been diagnosed with an infection of brain tissue
A male client has a history of hepatic dysfunction secondary to alcoholism. Based on the client's diagnostic history, what would the nurse expect his health care provider to order? A higher dose of the antidepressant A lower dose of the antidepressant More frequent doses of the antidepressant No antidepressants, because they would be contraindicated for this client.
A lower dose of the antidepressant
A client is diagnosed with diabetes insipidus. The health care provider orders desmopressin, which the nurse knows is the synthetic equivalent of what hormone? PTH ACTH ADH PTCH
ADH
Deficiency of which hormone causes excessive and frequent urination and excessive thirst? Prolactin deficiency ADH deficiency TSH deficiency ACTH deficiency
ADH deficiency
When describing desmopressin to a group of students, the instructor explains that it is a synthetic form of: oxytocin. adrenocorticotropic hormone. thyroid hormone. antidiuretic hormone.
Antidiuretic hormone
A client who has been taking medication for a seizure disorder is asking the nurse about getting pregnant. Why is pregnancy discouraged in women who are being treated for seizure disorders? Seizure disorders are genetic. Seizure disorders are familial. Antiepilepsy drugs decrease fertility. Antiepilepsy drugs are teratogenic.
Antiepilepsy drugs are teratogenic.
A client with dementia has been very agitated lately. What type of medication might the provider prescribe to help with the agitation? Antidepressant Antibiotic Antipsychotic Narcotic
Antipsychotic
What might occur if a client inadvertently receives a benzodiazepine intra-arterially? CNS depression Blurred vision Urinary retention Arteriospasm
Arteriospasm
A female client is admitted to the hospital with hypoglycemia, nausea, muscle weakness, and depression. What is the most likely cause? Hypertension Cushing disease Addison disease Stroke
Addison disease
A client is experiencing acute anxiety and the nurse has received an order for diazepam 4 mg PO STAT. What is the nurse's best action? Administer the medication as prescribed Contact the prescriber to confirm the dose Contact the prescriber to confirm the route Ensure flurazepam is available
Administer the medication as prescribed
A client has been diagnosed with Parkinson's disease and the primary health care provider has prescribed levodopa(100 mg)-carbidopa(10 mg) PO q8h. What is the nurse's best action? Administer the medication as prescribed and monitor for therapeutic and adverse effects Contact the provider to question the frequency Contact the provider to question the dose Contact the provider to question the route
Administer the medication as prescribed and monitor for therapeutic and adverse effects
A nurse is reviewing the structure and function of the blood--brain barrier . This anatomical feature would have the greatest effect on what aspect of nursing care? Administering antibiotics to treat brain infections Assessing a client's cranial nerve function Determining the site of damage after a traumatic brain injury Obtaining accurate electroencephalography readings
Administering antibiotics to treat brain infections
Sodium retention and potassium excretion are modulated by which hormone? Melatonin Aldosterone Gastrin Calcitonin
Aldosterone
Damage to which lobe of the pituitary gland would result in problems related to the function of stimulating hormones? Anterior Posterior Intermediate Lateral
Anterior
A client who began treatment for type 2 diabetes 8 months ago is now meeting with a diabetic nurse for a scheduled follow-up. How can the nurse best assess the client's glycemic control since beginning treatment? Assess the most recent hemoglobin A1C levels. Arrange to have the client's random blood glucose measured. Dialogue with the client about implemented management strategies. Review and discuss the data contained in the client's written blood glucose log.
Assess the most recent hemoglobin A1C levels.
The nurse is performing an assessment of a client's neurologic system. What nursing assessment best addresses the functioning of the client's limbic system? Assessing the client's mood and affect Assessing the client's balance Assessing the client's complex thinking and judgment Assessing the client's vision and hearing
Assessing the client's mood and affect
What would a nurse identify as being responsible for carrying information from the nerve to the effector cell? Dendrite Axon Soma Ganglia
Axon
Stimulation of what would result from thyroid hormone secretion? Stomach acid production Basal metabolic rate Male secondary sex characteristics Pancreatic juice secretion
Basal metabolic rate
The nurse is caring for a client who is receiving an intravenous barbiturate. What assessment should the nurse prioritize? Blood pressure Oxygen saturation Assessment for bleeding Anaphylaxis
Blood pressure
The nurse is caring for a 12-year-old child who has been hospitalized with depression, and the health care provider has elected to treat the child with a TCA. The nurse understands that what laboratory test will be routinely ordered by the provider? CBC and chemistry panel and plasma drug levels Hemoglobin and hematocrit and plasma drug levels Chest x-ray and plasma drug levels Blood pressure, ECG, and plasma drug levels
Blood pressure, ECG, and plasma drug levels
A home care nurse is caring for a 70-year-old female client who has been diagnosed with osteoporosis. When developing a plan of care for this client, the nurse should include measures to prevent what complication of the disease? Low estrogen levels Bone fracture Hypocalcemia Bone hardening
Bone fracture
Which would a nurse identify as a component of the hindbrain? Thalamus Limbic system Brain stem Cerebrum
Brain stem
Which hormone counterbalances the effect that the parathyroid hormone has on serum calcium levels? Aldosterone Calcitonin Estrogen Thyroid hormone
Calcitonin
Which hormone would the nurse identify as important in decreasing serum calcium levels? Calcitonin Melatonin Gastrin Thyroid hormone
Calcitonin
Parathyroid hormone increases serum levels of which electrolyte? Potassium Sodium Magnesium Calcium
Calcium
Rapid administration of IV calcium may result in which of the following conditions? Select all that apply. Cardiac arrhythmias Nephrotoxicity Ototoxicity Tissue irritation Hypotension
Cardiac arrhythmias Tissue irritation Hypotension
The nurse has administered gabapentin to a client. Following administration, the nurse should assess the client for what possible adverse effect? Tetany Hypertension Paradoxical seizures Central nervous system (CNS) depression
Central nervous system (CNS) depression
A patient exhibiting an uncoordinated gait has presented at the clinic. The nurse knows that what brain structure has the function of balance and coordination? Cerebellum Pons Medulla Midbrain
Cerebellum
The CNS structure involved in all higher order functions, including conscious processes containing both motor and sensory areas, is the: thalamus. hypothalamus. cerebral cortex. corpus callosum.
Cerebral cortex
The client reports taking a phenothiazine antipsychotic. What medication does the nurse suspect the client has been prescribed? Theophylline Haloperidol Chlorpromazine Thiothixene
Chlorpromazine
Which antipsychotic medications have antiemetic effects? (Select all that apply.) Lithium (Eskalith) Aripiprazole (Abilify) Chlorpromazine (Thorazine) Prochlorperazine (Compazine) Clozapine (Clozaril)
Chlorpromazine (Thorazine) Prochlorperazine (Compazine)
What aspect of a client's health is most likely to cause insomnia? Hypothyroidism Morbid obesity Chronic pain Type 2 diabetes
Chronic pain
A female client visits the health care provider's office after routine labs are drawn. The nurse notes that her A1C is 9. How does the nurse interpret this finding? Client is in good glycemic control. Client's average blood glucose is above normal. Client's blood glucose levels are not consistent. Client's blood glucose demonstrates longstanding hypoglycemia.
Client's average blood glucose is above normal
The nurse is aware that somatropin is not appropriate for the person who exhibits growth impairment and what other condition? Skeletal height below the 10th percentile for age Closure of the epiphyseal plate Lack of lean body mass Decreased number of red blood cells
Closure of the epiphyseal plate
The nurse should not administer sedatives or hypnotic drugs to which client? Client with a history of asthma Comatose client Woman of childbearing age Client with an egg allergy
Comatose client
Which would a nurse expect to assess in a patient with an adrenocortical hormone deficiency? (Select all that apply.) Confusion Hyperkalemia Hyponatremia Purpura Renal calculi
Confusion Hyperkalemia Hyponatremia
A nurse is caring for 70-year-old patient who is undergoing anticholinergic drug therapy. The nurse should assess for which condition when caring for this elderly patient? Confusion and disorientation Choreiform movements Suicidal tendencies Psychotic episodes
Confusion and disorientation
The primary function of the thyroid gland includes: Control of cellular metabolic activity Facilitation of milk ejection Reabsorption of water Reduction of plasma level of calcium
Control of cellular metabolic activity
Which would be used to diagnose adrenal function? Corticotropin Chorionic gonadotropin Thyrotropin alfa Menotropins
Corticotropin
The adrenal cortex influences glucose levels through the production of which hormone? Renin Calcitonin Cortisol Secretin
Cortisol
A client prescribed a selective serotonin reuptake inhibitor has begun taking St. John's wort daily. The nurse should teach the client that this combination may result in what adverse reaction? Worsened symptoms of depression Development of blood dyscrasias Dangerous drug interactions Hemostatic instability
Dangerous drug interactions
Which symptom, if found in the patient being treated for Cushing's disease, indicates medication therapy is therapeutic? Moon face Truncal obesity Osteoporosis Decreased peripheral edema
Decreased peripheral edema
What best describes the blood-brain barrier? Nonfunctional boundary Defensive mechanism Blood delivery mechanism Vital function control center
Defensive mechanism
A nurse is preparing medication information for the spouse of a client diagnosed with cerebral edema. Which medication should the nurse include in this information? dexamethasone beclomethasone triamcinolone cytosine
Dexamethasone
Which medications is classified as a long-acting glucocorticoid? Cortisone Dexamethasone Prednisone Triamcinolone
Dexamethasone
Desmopressin is used to treat which endocrine disorders? Growth failure Parkinson's disease Diabetes mellitus Diabetes insipidus
Diabetes insipidus
Lack of antidiuretic hormone (ADH) produces which disease process? Diabetes mellitus Diabetes insipidus Acromegaly Hyperthyroidism
Diabetes insipidus
A head injury has resulted in the hospitalization of a client. Nursing assessments confirm that the client is producing substantial amounts of dilute urine and is consuming large amounts of liquids. Considering the history and assessment findings support the possibility of what metabolic disorder? Hyperprolactinemia Diabetes mellitus (DM) Diabetes insipidus (DI) Pituitary adenoma
Diabetes insipidus (DI)
A client is prescribed risperidone for the treatment of schizophrenia. The client is voiding three times each night and is always thirsty. Based on the adverse effects of risperidone, what should the nurse suspect is triggering the client's reported polyuria and polydipsia? Urinary tract infection Diabetes mellitus Renal calculi Hyperthyroidism
Diabetes mellitus
Glucocorticoids should be used with caution in patients with what disease process? Hypotension Hepatic disease Diabetes mellitus Pneumonia
Diabetes mellitus
A nurse has noted that a newly admitted client has been taking ramelteon for the past several weeks. The nurse is justified in suspecting that this client was experiencing what problem prior to starting this drug? Somnambulism Difficulty falling asleep at night Early morning waking Frequent nighttime awakenings
Difficulty falling asleep at night
A client's left adrenal medulla has been injured in a motor vehicle accident. What is a possible implication of this injury? Disruptions in the levels of norepinephrine and epinephrine Dopamine deficiency Impaired action potential Disruption of the sodium-potassium pump
Disruptions in the levels of norepinephrine and epinephrine
The nurse is educating a client who will be adding an injection of pramlintide to his insulin regimen. What information is most important for the nurse to share with this client to ensure safe medication administration? Pramlintide should only be injected in the hip. Inject pramlintide in the same site where insulin is administered. Do not give pramlintide in the same site where insulin is administered. Mix pramlintide in the same syringe with insulin.
Do not give pramlintide in the same site where insulin is administered.
Which factor should the clinician reassess when combination therapy is ineffective? The frequency of the seizures Drug-drug interactions Drug side effects The patient's age and gender
Drug-drug interactions
The pediatric nurse understands that growth hormone (GH) deficiency can cause which disorder? Diabetes insipidus Somatropin deficiency syndrome (SDS) Dwarfism Acromegaly
Dwarfism
Mineralocorticoids directly affect: blood glucose levels. blood gas values. electrolyte levels. cholesterol levels.
Electrolyte levels
Which is released in response to decreased oxygenated blood flowing through the kidneys? Erythropoietin Glucagon Calcitonin Aldosterone
Erythropoietin
Which hormones are produced by the ovaries? (Select all that apply.) Testosterone Estrogen Melatonin Progesterone Renin
Estrogen Progesterone
A nurse is caring for a patient with depression. Which symptom should the nurse closely monitor for in the patient? Drowsiness Extreme sadness Severe headache Dilated pupils
Extreme sadness
More patients experience hyperthyroidism than hypothyroidism. True False
False
The nurse is providing education to a client who has been prescribed therapy with an antidiabetic medication. During teaching, the nurse will caution the client against heavy intake of which herb? Garlic Anise Basil Oregano
Garlic
A hospitalized client's serum glucose level is 160mg/dL. Which hormone is most likely being secreted and leading to this elevated lab value? Thyroid-stimulating hormone Luteinizing hormone Growth hormone Glucocorticoid
Glucocorticoid
Which action by the new nurse would alert the charge nurse that more education is needed for the new nurse, after administering an anxiolytic to a client? Having the client walk to the bathroom Raise the side rails Place the call light within reach Dim the lights
Having the client walk to the bathroom
A male client tells the nurse he is going to stop taking his medication because he is always having fine tremors and slurred speech. These reactions are preventing him from teaching art classes like he used to do. The nurse knows that what action could help him? He could talk with his health care provider and ask to have his medication dosage decreased, or change his medication to a second-generation antipsychotic. He could stop taking his medication and see if he still has schizophrenia. He could learn to teach other classes via online education so that he wouldn't have to talk out loud. He could tell his health care provider that the antipsychotics are not working and he needs a larger dose, or another medication added.
He could talk with his health care provider and ask to have his medication dosage decreased, or change his medication to a second-generation antipsychotic.
The nurse is preparing to administer a scheduled dose of levothyroxine to a client. What assessment should the nurse perform prior to giving the drug? Level of consciousness and orientation Oxygen saturation level Heart rate Respiratory rate
Heart rate
The nurse is preparing to administer levothyroxine to a client. Which assessment finding would cause the nurse to hold the medication? Respiratory rate of 16 Temperature of 99.3°F Heart rate of 110 beats per minute Blood pressure of 107/64
Heart rate of 110 beats per minute
A clinic nurse is following a 9-year-old boy who is taking somatropin. What will the nurse monitor periodically? Antidiuretic hormone (ADH) levels Height Dehydration Water retention
Height
A client 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? Hyponatremia Hypophosphatemia Hypocalcemia Hypokalemia
Hypocalcemia
The health care provider has ordered a change of prescription from rapid-acting insulin to an intermediate-acting type. Which adverse effect must the nurse closely monitor for in the client? Bradycardia Lipodystrophy Hypoglycemia Hypotension
Hypoglycemia
The nurse has just completed client education relative to chronic adrenocortical insufficiency and corticosteroid medication treatment. What statement indicates the client requires further instruction? I will call my health care provider if I develop a fever. I need to minimize my exposure to anyone who may be ill. I will report any weight gain above 5 pounds in 1 week to my health care provider. I will start this medication when I am feeling ill or tired.
I will start this medication when I am feeling ill or tired.
The nurse is planning the care of a client who has been diagnosed with a cerebellar disorder. What should the nurse prioritize in this client's plan of care? Implement falls precautions. Reorient the client as needed. Monitor the client for seizure activity. Assess mood and affect once per shift.
Implement falls precautions.
A client, prescribed dextroamphetamine for attention deficit hyperactivity disorder (ADHD) has developed a common adverse effect of the medication since beginning therapy. Which initial intervention should the client be encouraged to implement? Take an over-the-counter (OTC) laxative daily. Increase fiber intake. Take diphenoxylate hydrochloride. Take metronidazole.
Increase fiber intake.
Which would a nurse expect to find as a primary effect of cortisol secretion? Increased glucose levels Increased potassium levels Increased sodium levels Increased red blood cell production
Increased glucose levels
What is the most likely goal for oxytocin therapy? Slow the progression of labor. Stop preterm labor. Promote lactation. Induce uterine contractions.
Induce uterine contractions
A nurse is reviewing a bipolar client's serum lithium level, which is 1.8 mEq/L. What is the nurse's best action? Inform the prescriber and monitor for GI and CNS effects Inform the prescriber and perform a focused respiratory assessment Contact the prescriber and request a supplementary dose of lithium Facilitate a transfer to the intensive care unit
Inform the prescriber and monitor for GI and CNS effects
The nurse is formulating a care plan for a client with a seizure disorder. Which intervention would be an appropriate for the nurse to include? Informing the client and family that unrealistic expectations can occur Informing the client and family that seizure control is not gained immediately Informing the client and family that seizure control is gained immediately Informing the client and family that excessive frustration is to be expected
Informing the client and family that seizure control is not gained immediately
When administering insulin, what would be most appropriate? Shake the vial vigorously to ensure thorough mixing before drawing up the dose. Firmly spread the skin of the area of the intended site of injection. Insert the needle at a 45-degree angle for injection. Massage the injection site firmly after removing the needle and syringe.
Insert the needle at a 45-degree angle for injection
A nurse at a health care facility is assigned to administer insulin to the patient. Which intervention should the nurse perform before administering each insulin dose? Inspect the previous injection site for inflammation. Keep prefilled syringes horizontally. Check for symptoms of myalgia or malaise. Do not administer insulin kept at room temperature.
Inspect the previous injection site for inflammation.
After reviewing information about different insulin preparations, a nursing student demonstrates understanding of the information when the student identifies which medication as an example of a long-acting insulin? insulin glargine insulin lispro insulin aspart isophane insulin suspension
Insulin glargine
Melanocyte-stimulating hormone (MSH) affects which system? Reproductive Gastrointestinal Integumentary Respiratory
Integumentary
A client has been taking citalopram for 2 weeks and has expressed a desire to discontinue it, stating, "I don't feel any better than I did before I started these pills." What should the nurse teach the client? It may take up to two more weeks before the client feels better Improvements are likely evident to others even if not to the client The drug requires six to eight weeks before it reaches peak levels The client's pessimism is likely a symptom of the underlying depression
It may take up to two more weeks before the client feels better
Which cells release erythropoietin and renin in response a decrease in the pressure of the blood entering the glomerulus? Pancreatic cells White blood cells Juxtaglomerular cells Nerve cells
Juxtaglomerular cells
While not being designated as endocrine glands, several organs within the body secrete hormones as part of their normal function. Which organ secretes hormones that are involved in increasing blood pressure and volume and maturation of red blood cells? Kidneys Cardiac atria Placenta Liver
Kidneys
A nurse is performing patient education for a woman who has just been prescribed a bisphosphonate. Which diagnostic and history findings would have prompted the woman's care provider to prescribe a bisphosphonate? Height in the lowest quartile of the population and a history of joint pain Low bone density and a family history of osteoporosis Reports of cold intolerance, recurrent constipation, and evidence of diverticular disease Labile moods and short-term memory deficits
Low bone density and a family history of osteoporosis
Serotonin abnormalities are thought to be involved in the following disorders: Epilepsy and strokes. Attention deficit disorder. Mental depression and sleep disorders. Severe anxiety and hyperactivity.
Mental depression and sleep disorders.
A male client's health care provider orders antipsychotic medications for him. He experiences little or no side effects from the medications and is able to function successfully in both his home and work environments. Six weeks later, he is diagnosed with hepatitis B. He begins to experience adverse reactions to his medications. A possible reason for the adverse reactions might be that, in the presence of liver disease, what may happen? Metabolism may be accelerated and drug elimination half-lives shortened, causing an increased risk of adverse effects. Metabolism may be slowed and drug elimination half-lives shortened, with resultant accumulation and increased risk of adverse effects. Metabolism may be slowed and drug elimination half-lives prolonged, with resultant accumulation and increased risk of adverse effects. Metabolism may be accelerated and drug elimination half-lives prolonged, with resultant accumulation and increased risk of adverse effects.
Metabolism may be slowed and drug elimination half-lives prolonged, with resultant accumulation and increased risk of adverse effects.
A client is scheduled to undergo a bronchoscopy for the investigation of a bronchial mass. What benzodiazepine should the clinic nurse anticipate administering for conscious sedation? Triazolam Midazolam Oxazepam Chlordiazepoxide
Midazolam
The limbic system seems to control emotions and is located in which part of the central nervous system? Pons Cerebellum Midbrain Hypothalamus
Midbrain
The physiology instructor is teaching the class about neurotransmitters and their functions. According to the instructor, what is regulated by serotonin receptors? Intelligence Heart rate Mood Reflexes
Mood
The endocrine system is closely connected to which system? Gastrointestinal Nervous Integumentary Cardiac
Nervous
A client is brought to the emergency department after taking an overdose of levothyroxine. When assessing this client, what adverse effects would the nurse expect to find? Nervousness and tachycardia Drowsiness and bradycardia Skin rash and itching Slow speech and mental dullness
Nervousness and tachycardia
A nurse is reviewing the structure and function of the nervous system in preparation for working on a neurological floor. What characteristic of neurons should the nurse identify? Neurons convey action potentials to other neurons without being in physical contact. Dendrites are roughly equal in size to axons. Neurons are unique among body cells because they do not have a nucleus. The ability to generate new nerves after injury ceases near puberty.
Neurons convey action potentials to other neurons without being in physical contact.
A client admitted to the hospital with hyperthyroidism treated with propylthiouracil suddenly develops a skin rash. Which action would the nurse implement first? Provide soothing cream to affected areas. Avoid using soap to cleanse affected areas. Record weight and report weight gain or loss. Notify the primary health care provider.
Notify the primary health care provider
A nurse is caring for a patient with diabetes mellitus who is receiving an oral antidiabetic drug. Which of following ongoing assessments should the nurse perform when caring for this patient? Assess the skin for ulcers, cuts, and sores. Observe the patient for hypoglycemic episodes. Monitor the patient for lipodystrophy. Document family medical history.
Observe the patient for hypoglycemic episodes.
Which hormone causes the "let-down" reflex in lactating women? Oxytocin Antidiuretic hormone Growth hormone Follicle-stimulating hormone
Oxytocin
A female client is diagnosed with type 1 diabetes. She suddenly reports feeling weak, shaky, and dizzy. What should the nurse's first response be? Administer 1 amp of 50% dextrose IV. Administer 10 units of regular insulin subcutaneously. Perform a blood sugar analysis. Have the client drink a glass of orange juice.
Perform a blood sugar analysis.
A hospital client's current medication administration record specifies oral administration of propylthiouracil (PTU) every 8 hours. What sign or symptom may have originally prompted the care provider to prescribe this drug? persistent tachycardia orthostatic hypotension visual disturbances tinnitus
Persistent tachycardia
Which gland was traditionally considered the master gland? Pituitary Thyroid Parathyroid Adrenal
Pituitary
Which is an important function of serotonin? Coordination of impulses Prevention of over-excitability Prevents depression Promotion of motivation
Prevents depression
After teaching a group of students about hormones secreted by the anterior pituitary gland, the instructor determines that additional teaching is needed when the students identify which hormone? Prolactin-inhibiting factor Luteinizing hormone Adrenocorticotropic hormone Thyroid stimulating hormone
Prolactin-inhibiting factor
A client is receiving lamotrigine as treatment for partial seizures. Which assessment finding would lead the nurse to stop the drug immediately? Rash Somnolence Anorexia Confusion
Rash
A client is admitted to the intensive care unit with diabetic ketoacidosis. The nurse knows that the client will be placed on an intravenous insulin drip. The only type of insulin that can be administered intravenously is: NPH. Lente. Regular. Ultralente.
Regular
The nurse is preparing to administer insulin intravenously to a client with a blood glucose level over 600 mg/dL (33.33 mmol/L). What type of insulin will the nurse most likely give? NPH insulin Lente insulin Ultralente insulin Regular insulin
Regular insulin
A nurse is caring for a patient with Addison disease. What therapy is recommended for this patient? (Select all that apply.) Replacement of adrenocorticoids Replacement of mineralocorticoids Replacement of sex hormones Replacement of ACTH Replacement of 11-deoxycortisol inhibitors
Replacement of adrenocorticoids Replacement of mineralocorticoids
While taking the vital signs of a hospitalized client admitted for seizure control due to epilepsy, the nurse notices a bloody toothbrush on the client's bedside table and scattered bruising over the client's extremities. What is the nurse's best action? Document the findings and offer the client a soft-bristled toothbrush. Notify the charge nurse about reporting suspected physical abuse. Tell the client to ask for assistance when ambulating so as to prevent bruising. Report the findings to the primary health care provider immediately.
Report the findings to the primary health care provider immediately.
A client has had an injury to the cerebellum. The nurse is collecting data from the client and family to document in preparing an individualized nursing care plan. Which is the best description of the function of the cerebellum that has to be considered when collecting data from the client? Regulates body temperature Regulates sleep wake cycle Influences release of hormones from the pituitary Responsible for muscle control
Responsible for muscle control
What best describes hormones? Produced in large quantities Secreted directly into the bloodstream Require time to be broken down Travel via ducts to receptor sites
Secreted directly into the bloodstream
After teaching a group of nursing students about antidepressants, the instructor determines that the teaching was successful when the students identify which as inhibiting the reuptake of serotonin? Selective serotonin reuptake inhibitors Tricyclic antidepressants Monoamine oxidase inhibitors Atypical antidepressants
Selective serotonin reuptake inhibitors
The nursing instructor is talking with their clinical group about the central nervous system. What should the instructor tell the students about the function of the spinal cord? Provides centers for planned action Extends through the whole vertebral column Serves as a conduit for impulses to and from the brain Supports the skeletal system
Serves as a conduit for impulses to and from the brain
Which laboratory value monitored in a patient receiving fludrocortisone acetate requires immediate action by the nurse? Hemoglobin 14 g/dL Creatinine 1.1 mg/dL Sodium 150 mEq/L Potassium 4.5 mEq/L
Sodium 150 mEq/L
Which agent would the nurse identify as a growth hormone agonist? Bromocriptine Octreotide Somatropin Pegvisomant
Somatropin
When assessing a client's medication history, the use of which herb would alert the nurse to the potential for adverse reactions when taken with antidepressants? St. John's wort Ginseng Feverfew Eucalyptus
St. John's wort
The nurse is caring for a teenage client who has recently been prescribed a selective serotonin reuptake inhibitor. What assessment should the nurse prioritize? Venous thromboembolism (VTE) Cardiac rate and rhythm Hypomanic state Suicidal ideation
Suicidal ideation
The nurse is working in a home care setting. A female client is prescribed oral corticosteroids by her health care provider secondary to a diagnosis of Addison disease. What is the nurse's responsibility in this situation? Supervising and monitoring the administration of the drug Administering all doses of the oral medication Administering all doses of the oral medication for the first month of use Teaching all family members to administer the medication
Supervising and monitoring the administration of the drug
A signal has reached the terminus of a client's nerve and is in the space where the nerve is closest to the effector cell in a muscle. At what location is this signal? Synapse Schwann cell Neuron Soma
Synapse
A client being treated with desmopressin exhibits confusion and drowsiness, and reports a headache. What is the nurse's best action? Administer the next dose of desmopressin. Take the client's vital signs. Encourage increased oral fluid intake. Hold the prescribed diuretic.
Take the client's vital signs
A patient with partial seizures has been prescribed succinimides at a health care facility. The patient experiences GI upset after succinimides administration. What should the nurse instruct the patient to do? Take the drug once only at bedtime. Take the drugs before meals. Take the drug with food or milk.
Take the drug with food or milk.
During a general health assessment, a client indicates taking thyroid medication to increase weight loss. What statement should be the basis of the nurse's response? While taking thyroid medication, the client needs to take a calcium supplement as well. While taking thyroid medication, the client needs to take additional dietary supplements of iodine as well. Taking thyroid medication will not contribute to weight loss but only result in a redistribution of fat deposits. Taking excessive or unnecessary thyroid medication may produce serious or life-threatening manifestations of toxicity.
Taking excessive or unnecessary thyroid medication may produce serious or life-threatening manifestations of toxicity.
The nurse observes that a client with a long history of chlorpromazine therapy demonstrates lip smacking and appears to be chewing continually. The nurse should recognize that this client is likely experiencing what adverse effect of the medication? Tardive dyskinesia Akathisia Dystonia Neuroleptic malignant syndrome
Tardive dyskinesia
A teenage male client has not developed facial hair, a deeper voice, or other secondary sex characteristics. What hormone would the nurse expect would be checked for this client? Testosterone Estrogen Progesterone Melatonin
Testosterone
What areas are mainly responsible for coordinating internal and external responses? Thalamus and hypothalamus Pituitary and adrenal glands Temporal and frontal lobes Pia mater and dura mater
Thalamus and hypothalamus
A client is being treated with clozapine. What should the nurse monitor most closely? White blood cell count Urine quantity and quality Cardiac enzymes AST, ALT and bilirubin
White blood cell count
A client has suffered an injury to the limbic system. What assessment finding should the nurse attribute to this injury? The client exhibits bizarre behavior and unpredictable emotions The client has an unsteady gait and experiences frequent falls The client has short term memory loss with intact long term memory The client's respiratory rate is irregular
The client exhibits bizarre behavior and unpredictable emotions
A client is prescribed topiramate. The nurse cautions the client to avoid the intake of alcohol for which reason? The client is at risk for increased CNS depression. A disulfiram-like reaction can occur. The client's risk for dependence is increased. The combination may lead to a hypertensive crisis.
The client is at risk for increased CNS depression.
A female client is diagnosed with renal insufficiency. The nurse develops a teaching plan based on the diagnosis and antipsychotic drug usage. The client asks the nurse why it is so important to have renal function tests routinely. The nurse replies that if renal function test results become abnormal, what may be a consequence? The drug may need to be lowered in dosage or discontinued. The drug will be discontinued immediately. The drug will be continued with caution. The drug dosages will be increased to increase absorption.
The drug may need to be lowered in dosage or discontinued.
A female client has been diagnosed with depression. She also has a history of alcoholism. She has been sober now for 4 months, but at her last physical examination, the health care provider noted right-upper-quadrant tenderness and elevated liver enzyme levels. The provider has prescribed sertraline to treat the client's depression. Which factor would need to be considered prior to administering this medication? She should have an ultrasound of the liver to check for disease. The medication should be started at a lower dose due to liver dysfunction, and the client should be monitored for side effects. The client should have monthly evaluation of liver function to monitor the disease progression. The client should not take any medications because of her liver dysfunction.
The medication should be started at a lower dose due to liver dysfunction, and the client should be monitored for side effects.
Which patient should not receive mitotane as ordered? The patient with a heart rate of 100 beats per minute The patient experiencing shock The patient diagnosed with adenocarcinoma The patient feeling dizzy
The patient experiencing shock
For clients taking clozapine, it is necessary to monitor what lab test for the first 6 months? Liver enzymes Hemoglobin White blood cells PT/PTT
White blood cells
Following an assessment by her primary care provider, a 70-year-old resident of an assisted living facility has begun taking daily oral doses of levothyroxine. Which assessment finding should prompt the nurse to withhold a scheduled dose of levothyroxine? The resident has not eaten breakfast because of a recent loss of appetite. The resident's apical heart rate is 112 beats/minute with a regular rhythm. The resident had a fall during the night while transferring from her bed to her bathroom. The resident received her annual influenza vaccination the previous day.
The resident's apical heart rate is 112 beats/minute with a regular rhythm.
When describing the difference between endocrine and exocrine glands, which would the instructor include as characteristic of endocrine glands? The secretions are released directly into the bloodstream. The glands contain ducts that produce the hormones. The secreted hormones act like target cells. The glands play a minor role in maintaining homeostasis.
The secretions are released directly into the bloodstream.
A 52-year-old male client is being treated for Parkinson's disease. The nurse is aware that Parkinson's disease results in several physical manifestations. What occurs in the neurons that causes these symptoms? There is an increase in dopamine in the terminal nerve endings. There is an imbalance between dopamine and acetylcholine. There is an increased level of GABA at the striatum. There is a decrease in stimulation of the nigrostriatal neural tracts.
There is an imbalance between dopamine and acetylcholine.
What is the major reason that monoamine oxidase inhibitors (MAOs) are rarely used in clinical practice today? They are under a scheduled drug classification. They are ineffective in treating depression or anxiety disorders. They can cause gastrointestinal (GI) bleeding and esophageal varices. They may cause dangerous interactions with some foods and drugs.
They may cause dangerous interactions with some foods and drugs.
The nurse is assessing a child who is receiving growth hormone therapy. What would the nurse identify as suggesting glucose intolerance? Injection site pain Fatigue Thirst Cold intolerance
Thirst
Which diagnosis places a client at risk for developing diabetes insipidus (DI)? Traumatic head injury Type 1 diabetes mellitus Somatotropin deficiency syndrome (SDS) Parkinson's disease
Traumatic head injury
Renin is released by the kidneys to increase blood pressure and vascular volume. True False
True
The nurse is assisting a client who has just begun medication therapy for hypothyroidism. Which nursing assessment is most important in this client? Vital signs Skin Vision Pain
Vital signs
Which test should be scheduled every week for a patient taking clozapine? Serum lithium WBC count Blood glucose pH level
WBC count
What is the most effective method to determine a client's ability to self-administer their prescribed nasal desmopressin? Watch them administer a scheduled dose of the medication. Ask them to describe the correct method of administration. Evaluate the current level of serum antidiuretic hormone (ADH). Provide the client with both written and oral instructions on the delivery method.
Watch them administer a scheduled dose of the medication.
Deficiency of which hormone causes polyuria and polydipsia? melanocyte-stimulating hormone (MSH) antidiuretic hormone (ADH) thyroid-stimulating hormone (TSH) adrenocorticotropic hormone (ACTH)
antidiuretic hormone (ADH)
A client is prescribed midazolam in combination with an opioid in the preoperative phase of a laparoscopic cholecystectomy. What does the administration of midazolam assist in minimizing? oral secretions anxiety hypotension muscle tone
anxiety
A client reports sensing an unusual smell just prior to experiencing a tonic-clonic seizure. What term is used to describe this event? aura spasm spasticity epilepsy
aura
A nurse is working with a client who is taking an MAOI. What would be the most important instruction to the client? avoid use of soy sauce in the diet. adhere to combination drug therapy. discuss the cultural significance of taking an MAOI. avoid taking the drug on an empty stomach.
avoid use of soy sauce in the diet.
What causes the release of adrenocorticotropic hormone in response to a client's psychological and physiological stress? growth hormone release-inhibiting hormone corticotropin-releasing hormone or factor (CRH or CRF) growth hormone-releasing hormone (GHRH) thyrotropin-releasing hormone (TRH)
corticotropin-releasing hormone or factor (CRH or CRF)
What is the prototype for the classification of drugs referred to as benzodiazepines? alprazolam lorazepam diazepam clonazepam
diazepam
The anterior pituitary gland produces seven hormones. Of the hormones produced by the anterior pituitary gland, which one acts directly on their target tissues? Select all that apply. adrenocorticotropic hormone (ACTH) thyroid-stimulating hormone (TSH) follicle-stimulating hormone (FSH) growth hormone (GH) prolactin
growth hormone (GH) prolactin
The nurse is caring for a client who has been diagnosed with narcolepsy. Which problem could the client experience related to the disease? loss of visual acuity impulsivity hallucinations insomnia
hallucinations
A nurse is caring for a patient who is taking haloperidol. The patient has orders for a new drug, and the nurse notes that it is highly protein bound. The nurse will plan care based on a(n): decreased risk for toxic effects of haloperidol therapy. increased risk for toxic effects of haloperidol therapy. decreased risk for muscular contractions and spasms. high drug efficacy of haloperidol.
increased risk for toxic effects of haloperidol therapy.
Somatostatin, a hormone produced by the anterior pituitary gland, is responsible for: stimulating milk production. inhibiting release of growth hormone (GH). inhibits release of prolactin (PRL). stimulating melanin.
inhibiting release of growth hormone (GH).
A 46-year-old male client sustained a closed head injury four hours ago. He now presents to the emergency department because he is having difficulty breathing. This is a result of swelling around the: thalamus. cerebrum. hypothalamus. medulla oblongata.
medulla oblongata.
A black box warning alerts health care providers to risks in young adults 18 to 24 years of age when taking antidepressant medications. Which symptoms of concern should be included? paranoia, rapid speech, and difficulty with concentration statements or resignation and futility and a desire to die alternating periods of hypomania and depression reports of headaches, sleepiness, and apathy
statements or resignation and futility and a desire to die
What type of seizure activity is characterized by generalized tonic-clonic convulsions lasting for several minutes during which the client does not regain consciousness? status epilepticus akinetic motor febrile
status epilepticus
While caring for a client who is receiving antipsychotic therapy, the nurse observes lip smacking, a darting tongue, and slow and aimless arm movements. The nurse interprets this as: tardive dyskinesia. akathisia. pseudoparkinsonism. dystonia.
tardive dyskinesia.
The control mechanisms for most metabolic functions of the body, as well as the maintenance of homeostasis, is the function of: the anterior pituitary gland. the hypothalamus and the pituitary gland. the posterior pituitary gland. hypothalamic hormones.
the hypothalamus and the pituitary gland.
A client is acutely ill with a brain abscess and the family has questioned why the client is not receiving intravenous antibiotics. When providing education to the family, the nurse should explain: the structure and function of the blood-brain barrier. the lack of blood perfusion in many areas of the brain. the effect that macrophages in the CNS have on medications. the role of cerebral spinal fluid (CSF) in pharmacokinetics.
the structure and function of the blood-brain barrier.
An adolescent taking oral contraceptives has been prescribed an anticonvulsant medication. The nurse should tell the client to do which? use another form of birth control, such as condoms. watch for signs of hyperglycemia, such as increased thirst, hunger, and urination. be aware that these two drugs will interact and increase seizure activity initially. stop driving due to the increased depressant effects and excessive drowsiness.
use another form of birth control, such as condoms.
The nurse is caring for a client taking insulin. The nurse realizes the client is experiencing symptoms of hypoglycemia when the client displays: increased pulse rate and fruity smelling breath. decreased respiratory rate and hot, dry skin. weakness, sweating, and decreased mentation. increased thirst and increased urine output.
weakness, sweating, and decreased mentation.
