Pharm II exam 1

A patient has been given Regular acting insulin at 6: 00 in the morning when is the nurse most concerned about the patients glucose level dropping? A) 8:00 am or 11: 00 am B) There is no peak with this drug so no cause for concern C) 6:30 am or 9:00 am D) 7:30 am or 10:00 am

A) 8:00 am or 11: 00 am - a nurse is most worried about blood glucose dropping when the drug reaches its peak

A nurse is teaching clients in an outpatient facility about the use of insulin to treat type 1 diabetes mellitus. For which of the following types of insulin should the nurse tell the clients to expect a peak effect 1 to 5 hours after administration? A) Regular insulin. B) NPH C) insulin glargine D) Insulin lispro

A) Regular insulin.- on exam

A nurse is caring for an older adult client in a long-term care facility who has hypothyroidism and a new prescription for levothyroxine. Which of the following dosage schedules should the nurse expect for this client? A) The client will start on a low dose, which will be gradually increased. B) The client will start at a high does, and the does will be tapered as needed C) The client will remain on the initial dosage during the course of treatment D) The client will start on a low does, which will be gradually increased

A) The client will start on a low dose, which will be gradually increased.

A patient has been prescribed methimazole (tapazole). Which of the following would indicate for the nurse to hold this drug and contact the provider? A) If the patient has an allergy to vitamin D B) A patient is currently taking propranolol C) A person who takes an aspirin daily D) A person who has an allergy to sulfa drugs

ANS: B) A patient is currently taking propranolol A) this has to do with Calcitrol C) this has to do with prednisone D) this has to do with anyone taking Glyburide and Chlorpropamide

A nurse is giving education to a patient about her newly prescribed medication, Calcitrol, to treat her hypocalcemia. Which of following adverse effects with this drug, does the nurse need to address with the patient? A) Water intoxication B) Constipation C) Flushing of the face D) Lactic Acidosis

ANS: B) Constipation A) has to do with Desmopressin C) has to do with Calcitonin salmon D) Has to do with metformin

A patient with hyperthyroidism is prescribed methimazole (Tapazole). Which of the following adverse effects to we need to watch out for? A ) Water intoxication B ) Dizziness C ) Bone marrow suppression D) Immuno suppression

ANS: C ) bone marrow supression A ) Water intoxication- happens in Desmopressin (DDAP) B ) Dizziness- happens in Bromocriptine D) Immuno suppression - happens in Prednisone

A nurse is explaining to a patient why the doctor prescribed to them Glyburide ( Diabeta) for their type 2 diabetes instead of the Chlorpropamide that their mother was prescribed when she was diagnosed. Which of the following statments made by the nurse are correct regarding this? A) " You can eat before you take this drug. " B) " This drug has a longer duration then Chlorpropamide" C) " This drug has a shorter duration then the Chlorpropamide" D) " This drug can be given orally whereas the other can only be given IM Depot."

ANS: C) " This drug has a shorter duration then the Chlorpropamide" - this makes it less likely to cause hypoglycemia

A nurse is caring for a patient who is on Bromocriptine ( parlodel). Which of the following is this nurses priority when caring for this patient? A) Checking Hemoglobin A1C B) Encouraging exercise C) Checking for orthostatic hypotension D) Monitoring urine output

ANS: C) Checking for orthostatic hypotension- an adverse effect of this drug is dizziness so you must assess BP and for safety and falls A) Checking Hemoglobin A1C- this is for Somatropin B) Encouraging exercise- this is for calcitrol D) Monitoring urine output - this is for desmopressin

The nurse administers prednisone orally at 8 am. When would the nurse expect the drug to reach peak effect? A) 9 to 10 am B) 12 to 1 pm C) 8:30 to 9:00 am D) 4 to 6 pm

Ans: A

The nurse instructs the patient with a new prescription to treat hyperthyroidism and includes the importance of regular lab studies to monitor for bone marrow suppression, which can be an adverse effect of this drug. What drug is the nurse teaching the patient about? A) Methimazole (Tapazole) B) Levothyroxine C) Strong Iodine product D) Potassium iodide (Thyro-Block

Ans: A

The nurse is caring for a patient with infertility related to hyperprolactinemia. What drug would the nurse recognize was ordered to treat this problem? A) Bromocriptine mesylate B) Somatropin C) Leuprolide D) Desmopressin

Ans: A Feedback: Bromocriptine mesylate is indicated for the treatment of female infertility associated with hyperprolactinemia. Somatropin is indicated for the treatment of growth failure, Turner​s syndrome, AIDS wasting and cachexia, and growth hormone deficiency in adults. Leuprolide is used as antineoplastic agent for treatment of specific cancers and for treatment of endometriosis and precocious puberty that results from hypothalamic activity. Desmopressin is used for the treatment of neurogenic diabetes insipidus, von Willebrand's disease, hemophilia; and is currently being studied for the treatment of chronic autonomic failure.

The nurse administers desmopressin (DDAVP) to the patient to treat diabetes insipidus. What assessment finding would indicate to the nurse that the desmopressin is producing a therapeutic effect? A) Decreased urine output B) Decreased water reabsorption C) Increased plasma osmolarity D) Decreased blood volume

Ans: A Feedback: Desmopressin produces its antidiuretic activity in the kidneys, causing the cortical and medullary parts of the collecting duct to become permeable to water, thereby increasing water reabsorption and decreasing urine formation. These activities reduce plasma osmolarity and increase blood volume.- on test

The nurse is caring for a patient with polycystic ovary syndrome. What antidiabetic drug would the nurse anticipate will be ordered? A) Metformin B) Acarbose C) Insulin D) Glyburide

Ans: A Feedback: Metformin and pioglitazone have proven effective in increasing insulin sensitivity and decreasing androgen and luteinizing hormone levels to break the cycle and allow ovulation to occur if pregnancy is desired. A fertility drug is often used with the antidiabetic agent. Other options are not appropriate because they are not indicated for treating polycystic ovary syndrome.

What assessment findings would the nurse expect to see in a patient who overdosed on levothyroxine (Synthroid)? A) Nervousness, tachycardia, tremors B) Somnolence, bradycardia, paresthesia C) Hyperglycemia, hypertension, edema D) Buffalo hump, constipation, sodium loss .

Ans: A Feedback: More pronounced adverse effects of levothyroxine would be seen including tremors, headache, nervousness, palpitations, tachycardia, allergic skin reactions, diarrhea, nausea, vomiting. Somnolence, bradycardia, and paresthesia would be more likely with insufficient drug intake, which would cause hypothyroidism and other symptoms. Hyperglycemia, edema, buffalo hump, constipation, or sodium loss would not be associated with excess thyroid hormone- on test

The nurse administers desmopressin to treat a patient with diabetes insipidus. Assessment of what laboratory studies would indicate the drug is working? A) Increased serum sodium levels B) Increased red blood cell count C) Decreased urine specific gravity D) Reduced urine glucose levels

Ans: A Feedback: Patients with diabetes insipidus (DI) produce large amounts of dilute urine with a decrease in serum sodium levels. Administering desmopressin would reduce urine output and allow sodium levels to rise. Urine specific gravity would increase as the urine production slows and urine becomes more concentrated. There is no impact on red blood cell production with diabetes insipidus or its treatment. The urine of a patient with DI does not contain glucose.- on test!

A nurse is providing patient education to a patient who has had corticosteroids prescribed. What drug will the nurse teach the patient to avoid while taking the corticosteroids? A) Aspirin B) Dimenhydrinate (Dramamine) C) Ibuprofen (Advil) D) Famotidine (Pepcid) .

Ans: A Feedback: Serum levels and effectiveness may decrease if corticosteroids are combined with salicylates. Dimenhydrinate, ibuprofen, and famotidine have not been found to produce drug​drug interaction

When providing patient teaching to the family of a 12-year-old child receiving Somatropin, the nurse stresses the need to notify prescriber if what manifestation occurs? A) Severe hip or knee pain B) Development of a bruise C) Severe hypertension D) Tachycardia

Ans: A Feedback: The adverse effects that most often occur when using a growth hormone (GH) include the development of antibodies to GH and subsequent signs of inflammation and autoimmune-type reactions, such as swelling and joint pain, and the endocrine reactions of hypothyroidism and insulin resistance. It would not be necessary to notify the physician for development of a bruise. The health care provider should always be notified if a patient develops severe hypertension or tachycardia but this would not be related to administration of somatropin so it would not be included in drug teaching.

What is the purpose of releasing hormones secreted by the hypothalamus? A) Stimulating or inhibiting release of hormones from the pituitary B) Stimulating organs within the body to secrete hormones C) Allowing the secretion of hormones from the hypothalamus D) Stimulating other glands to release hormones

Ans: A Feedback: The hypothalamus uses various hormones or factors to either stimulate or inhibit the release of hormones from the anterior pituitary. These do not stimulate other organs, the hypothalamus, or other glands to release hormones. - on test

What hormone does the posterior pituitary gland store and release? A) Antidiuretic hormone (ADH) B) Follicle-stimulating hormone (FSH) C) Growth hormone (GH) D) Thyroid stimulating hormone (TSH)

Ans: A Feedback: The posterior pituitary stores two hormones produced in the hypothalamus: ADH, also known as vasopressin and oxytocin. The posterior pituitary does not store FSH, GH, or TSH.

The nurse is caring for an obese woman who was just diagnosed with type 2 diabetes. When developing this patient's plan of care, what is the priority nursing diagnosis? A) Imbalanced nutrition: more than body requirements related to obesity B) Risk for unstable blood glucose related to ineffective dosing of antidiabetic agents C) Disturbed sensory perception related to glucose levels D) Ineffective coping related to diagnosis and therapy

Ans: A Feedback: The priority with this patient is to address her obesity because losing weight may eliminate the problem. Depending on the agent that is ordered, there may be risk for unstable blood glucose and the patient may need support to cope with the diagnosis but these are not the priority concern. Disturbed sensory perception is not indicated to be a problem at this time.

The nurse is teaching the patient who will require long-term corticosteroid therapy how to reduce the risk of infection. What suggestions will the nurse include? A) ​Avoid large crowds of people tightly packed together.​ B) ​Avoid working in areas with other people.​ C) ​Avoid exercising to reduce risk of injury.​ D) ​Avoid touching other people who may carry germs.​

Ans: A Feedback: With long-term therapy, the importance of avoiding exposure to infection​crowded areas, people with colds or the flu, activities associated with injury​should be stressed. If an injury or infection should occur, the patient should be encouraged to seek medical care. These patients do not need to avoid work, exercise, or touching others but they should use good hand hygiene to avoid infection from these sources.

The nurse is caring for a patient diagnosed with hyperparathyroidism who asks the nurse why parathyroid hormone (PTH) is important. The nurse explains that PTH performs what actions in the body? (Select all that apply.) A) Stimulation of osteoclasts B) Increased intestinal absorption of calcium C) Stimulation of calcitriol production D) Increased excretion of calcium from kidneys E) Decreased retention of vitamin D

Ans: A, B, C Feedback: PTH has many actions, including stimulation of osteoclasts or bone cells to release calcium from the bone, increased intestinal absorption of calcium, increased calcium reabsorption from the kidneys, and stimulation of cells in the kidney to produce calcitriol. PTH increases absorption of calcium from the kidney and increases retention of vitamin D.

The nurse is caring for a patient who has been receiving long-term growth hormone treatment to stimulate growth. What diagnostic testing would the nurse expect to see ordered as a standard part of the treatment plan? (Select all that apply.) A) Blood sugar level B) Serum electrolytes C) X-ray of the long-bones D) Nasal examination E) Bone density studies

Ans: A, B, C Feedback: Periodic radiography of the long bones, as well as monitoring of blood sugar levels and electrolytes, should be a standard part of the treatment plan for children who receive any of the hypothalamic or pituitary agents. There would be no indication for nasal assessment because growth hormone is not administered nasally. Bone density would not be impacted by these drugs.

The nurse is discharging a patient with a new prescription for levothyroxine. What would the nurse teach the patient to report to her health care provider? (Select all that apply.) A) Nervousness B) Insomnia C) Chest pain D) Loss of hair E) Nausea

Ans: A, B, C Feedback: Report chest pain, heart palpitations, nervousness, or insomnia. These adverse effects result from excessive stimulation and may indicate that drug dosage or intake of other stimulants needs to be reduced. Loss of hair is usually only seen in the first few months of therapy in children; nausea need not be reported unless it is persistent or interferes with adequate caloric intake - on test

The nurse admits a patient to the emergency department and recognizes the patient is in diabetic ketoacidosis (DKA) when what manifestations are assessed? (Select all that apply.) A) Fruity breath B) Edema C) Dehydration D) Agitation E) slow and deep respirations

Ans: A, C, E Feedback: Signs of impending dangerous complications of hyperglycemia such as DKA include the following: fruity breath as the ketones build up in the system and are excreted through the lungs; dehydration as fluid and important electrolytes are lost through the kidneys; slow and deep respirations (Kussmaul's respirations) as the body tries to rid itself of high acid levels; loss of orientation and coma rather than agitation are to be expected. Edema is not a sign of DKA.- on test

The nurse provides teaching regarding levothyroxine to a 55-year-old patient diagnosed with Hashimoto's disease. What statement made by the patient does the nurse interpret to mean that the drug teaching had been understood? A) ​I can take this medication at any time of day.​ B) ​I should take this medication on an empty stomach in the morning.​ C) ​I may take this with a sip of water in the morning.​ D) ​If I feel nauseated, I may take this drug with an antacid.​

Ans: B Feedback: Adults who require thyroid replacement therapy need to understand that this will be a lifelong need. An established routine of taking the tablet first thing in the morning may help the patient comply with the drug regimen. The drug should be taken on an empty stomach with a full glass of water. Antacids would slow or prevent absorption of the hormone replacement, so the patient should be corrected

An older adult patient taking high-dose corticosteroids to treat arthritis requests a pneumonia vaccine. What is the nurse's best response? A) ​Pneumonia vaccines are only given if you are at risk for serious pulmonary problems.​ B) ​Live virus vaccines cannot be given to people who are significantly immunosuppressed.​ C) ​Patients taking corticosteroids are well protected from viruses and do not need vaccines.​ D) ​Corticosteroids interact with the pneumococcal vaccine to create serious adverse effects.​

Ans: B Feedback: Corticosteroids block the inflammatory response and are very helpful in conditions such as arthritis. However, they also block the immune response, making a person immunosuppressed. The vaccine would not be given to this patient because of the increased risk for infection. An older adult would be considered at high risk for pneumonia so getting the vaccine would be encouraged if not for taking corticosteroids. Corticosteroids do not protect against viruses. The vaccine is contraindicated because of risk for infection and not because of a potential drug​drug interaction.- on test

The nurse suspects the diabetic patient may be having a hypoglycemic reaction when what manifestation is assessed? A) Dry, flaky skin B) Diaphoresis C) Flushing of the face D) Fruity breath

Ans: B Feedback: Diaphoresis and cool clammy skin are signs of hypoglycemia. A fruity breath is seen with ketoacidosis. Flushing of the face is associated with hyperglycemia.- on test

The nurse administers fludrocortisone (Florinef) to a patient diagnosed with salt-losing adrenogenital syndrome and then assesses for what therapeutic action? A) Development of hypokalemia and elevated serum glucose level B) An increase in sodium and water reabsorption and potassium excretion C) Headache, edema, weakness, arrhythmias, and hypertension D) Sodium and water depletion along with potassium retention

Ans: B Feedback: Fludrocortisone's therapeutic effects include an increase in sodium and water reabsorption with potassium excretion. Headache, edema, weakness, arrhythmias, and hypertension are adverse, and not therapeutic, effects. Hypokalemia is possible but glucose levels should not be impacted.

What patient will the nurse assess most closely for secondary hyperparathyroidism? A) The 12-year-old patient with hypothyroidism B) The 68-year-old patient with chronic renal failure C) The 35-year-old patient with diabetes mellitus D) The 48-year-old patient with hyperthyroidism

Ans: B Feedback: Secondary hyperparathyroidism occurs most frequently in patients with chronic renal failure. Primary hyperparathyroidism occurs more often in women between 60 and 70 years of age. Although hyperparathyroidism can occur at any age, the patient with diabetes or thyroid disorder would not be at higher risk for the disorder.

The nurse is caring for a patient with neurogenic diabetes insipidus and administers what drug to treat the condition? A) Metform B) Desmopressin (DDAVP, Stimate) C) Insulin D) Chlorpropaminde ( Diabinese)

Ans: B Feedback: Synthetic preparations of antidiuretic hormone (ADH), which are purer and have fewer adverse effects, are used to treat diabetes insipidus. Only one ADH preparation is currently available, desmopressin. Dexamethasone, methylprednisolone, and physostigmine would not be indicated for treatment of this disorder.- on the test

The nurse is teaching the patient, newly diagnosed with Graves's disease, about the normal functioning of the thyroid gland. What hormone will the nurse tell the patient controls production and release of thyroid hormones? A) Thyrotropin-releasing hormone (TRH) B) Thyroid-stimulating hormone (TSH) C) Tetraiodothyronine D) Triiodothyronine

Ans: B Feedback: Thyroid hormone production and release are regulated by the anterior pituitary hormone called thyroidstimulating hormone (TSH). The secretion of TSH is regulated by thyrotropin-releasing hormone (TRH), a hypothalamic regulating factor. Tetraiodothyronine and triiodothyronine are thyroid hormones produced by the thyroid gland because of TSH stimulation.

The nurse, caring for a patient experiencing stress, knows that activation of the stress reaction will cause the release of what? A) Glucose B) Aldosterone C) Adrenocorticotropic hormone (ACTH) D) Oxytocin

Ans: C

After administering somatropin (Saizen) to an 11-year-old patient with growth failure, what outcome would indicate that the drug should be stopped? A) Early sexual development B) Thyroid overactivity C) Closure of the epiphyses in long bones D) Gynecomastia

Ans: C Feedback: Closure of the epiphyses is a sign that the drug should be stopped. Early sexual development, thyroid overactivity, and gynecomastia would not be associated with this drug.- on test

The nurse is caring for a pregnant patient diagnosed with pregnancy-induced diabetes. What antidiabetic agent is best suited for administration to this patient? A) Metformin B) Acarbose C) Insulin D) Glyburide

Ans: C Feedback: Insulin therapy is the best choice for patients with diabetes during pregnancy and lactation, which are times of high stress and metabolic demands. Oral antidiabetic medications are contraindicated during pregnancy so metformin, acarbose, and glyburide are not the best choices.- on test

A child is diagnosed with hypothyroidism. The nurse anticipates an order for the drug of choice when treating children, which is what? A) Alendronate ( fosamax) B) Strong Iodine Product C) Levothyroxine (Synthroid) D) Methimazole (Tapazole)

Ans: C Feedback: Levothyroxine is the drug of choice in children because of its predictable bioavailability and reliability. Liothyronine and liotrix tend to have more adverse effects and, although they can be used in children, are not the drugs of choice. Methimazole is an antithyroid drug and is used to treat hyperthyroidism

A patient is taking leuprolide (Lupron) to treat prostatic cancer. The nurse caring for this patient is careful to monitor for what? A) Diarrhea B) Urinary retention C) Peripheral edema D) Increased appetite .

Ans: C Feedback: Peripheral edema is an identified adverse effect of leuprolide therapy. Constipation not diarrhea; urinary frequency not urinary retention; and anorexia not increased appetite are also identified adverse effects- maybe on the test

A patient is taking leuprolide (Lupron) to treat prostatic cancer. The nurse caring for this patient is careful to monitor for what? A) Diarrhea B) Urinary retention C) Peripheral edema D) Increased appetite

Ans: C Feedback: Peripheral edema is an identified adverse effect of leuprolide therapy. Constipation not diarrhea; urinary frequency not urinary retention; and anorexia not increased appetite are also identified adverse effects.

What glucocorticoids could the nurse only administer orally? A) Cortisone (Cortone Acetate) B) Hydrocortisone (Cortef) C) Prednisone (Deltasone) D) Triamcinolone (Aristocort)

Ans: C Feedback: Prednisone is available in oral form only and is used for replacement therapy for adrenal insufficiency, and treatment of allergic and inflammatory disorders. Cortisone can be administered orally or intramuscularly and is used for replacement therapy. Hydrocortisone, used for replacement therapy, is administered by the oral, IV, intramuscular, topical, ophthalmic, rectal, and intra-articular routes. Triamcinolone is administered by the oral, intramuscular, inhalant, intra-articular, and topical routes and is used for treatment of allergic and inflammatory disorders and in the management of asthma

The 2-year-old patient with asthma is placed on a short-term dose of prednisone. What important instruction will the nurse provide the patient about this drug? A) ​Increase intake of carbohydrates.​ B) ​The child may receive immunizations while on this drug.​ C) ​Do not stop this medication suddenly; you will have to taper dosage gradually.​ D) ​Reduce intake of protein until drug therapy is complete.​

Ans: C Feedback: Prednisone is usually ordered for short-term use with tapering dosage. It is important to instruct the parent to taper doses and to not just stop the drug suddenly when discontinuing from high doses so as to give the adrenal glands a chance to recover and produce adrenocorticoids. This is the priority instruction. Parents should also be told to wait to get the child immunizations until after drug therapy is completed. There is no need to alter carbohydrate or protein intake

The patient with hypothyroidism takes levothyroxine daily and has triiodothyronine (T3), thyroxine (T4), and thyroid-stimulating hormone (TSH) levels drawn in the laboratory to check appropriateness of prescribed dosage. What results would the nurse analyze as indicating the need for a higher dosage of medication? A) Elevated TSH, elevated T3, and reduced T4 levels B) Reduced TSH, elevated T3 and T4 levels C) Elevated TSH, reduced T3 and T4 levels D) Reduced TSH, T3, and T4 levels

Ans: C Feedback: TSH levels would be elevated to stimulate increased thyroid hormone secretion whereas T4 and T3 will be low, which indicates the need for a higher dosage of medication. If TSH level is low, it would indicate a reduction in dosage would be needed, particularly if T3 and T4 levels are elevated.

The nurse explains the role of the posterior pituitary gland is to do what? A) ​It synthesizes different hormones.​ B) ​It makes two hormones.​ C) ​It stores hormones.​ D) ​It controls most of the metabolic functions of the body.​

Ans: C Feedback: The posterior pituitary stores two hormones produced in the hypothalamus: antidiuretic hormone (ADH, also known as vasopressin) and oxytocin. The posterior pituitary is anatomically an extension of the hypothalamus and is composed mainly of nerve fibers. Although it does not manufacture any hormones itself, it stores and releases hormones synthesized in the hypothalamus. The hypothalamus of the brain and the pituitary gland interact together to control most metabolic functions of the body and to maintain homeostasis.

The nurse is instructing a patient how to mix NPH insulin with regular insulin in one syringe. The nurse tells the patient the mixture must be administered within how long after it is prepared? A) 5 minutes B) 10 minutes C) 15 minutes D) 20 minutes

Ans: C Feedback: Use caution when mixing types of insulin. Administer mixtures of regular and NPH or regular and lente insulins within 15 minutes after combining them to ensure appropriate suspension and therapeutic effect.

A patient presents at the clinic with complaints of weight loss despite an increased appetite. The nurse assesses this patient for what? A) Chronic thyroiditis B) Hypercalcemia C) Hypothyroidism D) Hyperthyroidism

Ans: D Feedback: Hyperthyroidism is manifested by increased metabolism and energy usage. It is not manifested by chronic thyroiditis, hyperglycemia, or hypothyroidism

With what patient would the nurse question the administration of human insulin? A) Gestational diabetes B) Type 2 diabetes controlled on oral antidiabetic agents with systemic infection C) Type 1 diabetes of many years D) Type 2 diabetes controlled by diet

Ans: D Feedback: Insulin is recommended for treatment of type 2 diabetes in patients whose diabetes cannot be controlled by diet or other pharmacotherapeutic agents. If the diabetes can be controlled by diet, the pancreas is still functioning and releasing insulin. Human insulin can be used in gestational diabetes, patients with type 2 diabetes controlled on oral antidiabetic agents with systemic infection, or patients with type 1 diabetes of many years standing.

What drug would the nurse appropriately administer to the patient to treat hypothyroidism? A) Alendronate ( fosamax) B) Methimazole C) Strong iodine product D) Levothyroxine

Ans: D Feedback: Levothyroxine (Synthroid, Levoxyl, Levothroid), a synthetic salt of thyroxine, is the most frequently used replacement hormone to treat hypothyroidism because of its predictable bioavailability and reliability. Propylthiouracil and methimazole would be used to treat hyperthyroidism; teriparatide is an antihypocalcemic agent.

The nurse is providing dietary teaching to the patient on long-term mineralocorticoid therapy and includes what teaching point? A) Decreasing sodium B) Increasing calcium C) Increasing vitamin D D) Increasing potassium

Ans: D Feedback: Mineralocorticoids cause sodium and water retention and potassium excretion. These patients benefit from a diet with increased potassium. They would not decrease sodium intake as the drug is often administered for the purpose of increasing serum sodium levels. Calcium and vitamin D intake would be the same for this patient as any other patient of similar age and gender.

A patient is admitted to the emergency department in diabetic ketoacidosis (DKA) with a blood glucose level of 485 mg/dL. The physician orders an initial dose of 25 U insulin IV. Which type of insulin will be administered? A) NPH insulin B) lantus insulin C) levenir insulin D) Regular insulin

Ans: D Feedback: Regular insulin is a short-acting insulin that manages the hyperglycemia and hyperkalemia resulting from DKA, which is a life-threatening complication that occurs with severe insulin deficiency. Furthermore, only regular insulin can be given IV and is the drug of choice in emergency situations. Humulin N, Humulin L, and NPH are intermediate-acting forms

The nurse is asked to explain how to administer somatropin (Saizen) to the mother of a 6-year-old. How would the nurse explain how this drug is administered? A) ​It requires only a very small needle and doesn't hurt much at all.​ B) ​There will no longer be any need to rotate sites because it uses a needleless system.​ C) ​This system will be used until your son gets older and is more tolerant of needles.​ D) ​This delivers a fine mist through the skin without needles and far less discomfort.​

Ans: D Feedback: Saizen uses the cool.click delivery system, which is a neon-colored, needle-free system that delivers the drug through the skin using a fine mist. Tests have shown a bioequivalency of this method with standard injection techniques, and the young patients who must use this drug are much less resistant to the dosing. There are no needles but site of injection still require rotation to avoid skin damage. The child does not have to go back to a needle system when he gets older.

The nurse administers somatropin to a child with impaired growth due to a deficiency of endogenous growth hormone during what period of growth and development? A) Before the start of elementary school B) Any time before age 18 C) Before the child reaches 5 feet in height D) Before epiphyses close

Ans: D Feedback: Somatropin is contraindicated in the presence of closed epiphyses so the drug can be given at any time before closure of the epiphyses. Age and height are not an indication impacting when the drug is given so long as the epiphyses remain open. - on test

A patient is at risk for thrombosis formation and is taking an oral anticoagulant. The patient has been newly diagnosed with hypothyroidism and placed on levothyroxine (Synthroid). What will the nurse monitor the patient for? A) Tachycardia B) Elevated body temperature C) Increased time spent sleeping D) Increased bruising and bleeding

Ans: D Feedback: The effectiveness of an oral anticoagulant is increased if it is used in combination with a thyroid hormone. This may lead to increased bleeding and the need to decrease the dosage of the oral anticoagulant. Tachycardia would be found with hyperthyroidism and the effect of levothyroxine is not increased with the drug combination. Increased time spent sleeping would indicate lowering of thyroid function and the treatment should increase thyroid function. Increased body temperature is associated with hyperthyroidism.

What outcome would best indicate the nurse's teaching was effective and that drug therapy was appropriate? A) The patient can explain how to take the medication. B) The patient demonstrates the correct procedure for monitoring blood sugar. C) The patient follows an appropriate diet. D) Blood glucose level is stable with no diabetic complications.

Ans: D Feedback: The single best indicator, and the goal of treatment, is to help the patient maintain a stable blood glucose level so as to be able to avoid any complications. For the patient to maintain a stable blood glucose level, he needs to understand how to take his medication, to check his blood sugar level, and to follow an appropriate diet, but the best indicator is the stable glucose level

Which of the following nursing considerations is a priority when assessing a patient who is taking the antihypercalcemic drug Alendrante ( fosamax)? A) Make sure the patient sits up for at least 30 minutes after taking this drug B) Listen to lung sounds 2 hours after giving this drug C) Monitor the patients input and out put D) X- ray the long bones of patients to check for closed epiphyses

Answer: A) Make sure the patient sits up for at least 30 minutes after taking this drug- the nurse must do this to ensure that esophageal erosion B) Listen to lung sounds 2 hours after giving this drug- this must be done when giving Fludrocortisone because it could cause fluid in the lungs C) Monitor the patients input and out put -this must be done when giving Desmopressin( DDVAP) because water intoxication is a advers effect of this drug D) X- ray the long bones and wrist of patient- this is an important assessment when giving Somatropin because it contraindicated for someone with close epiphysis.

A patient with sever allergies is prescribed Prednisone ( rayos), for which of the following statements made by the patient, would the nurse call the provide about? A) " I have an allergy to sulfonamides " B) " I am currently taking Propranolol." C) "I take 2 aspirins daily" D) " I take tums every day for ingestion"

Answer: C) "I take 2 aspirins daily" - you can not take salicylates with this drug because it could cause bleeding. A) " I have an allergy to sulfonamides "- this would be concerning if the patient was taking chlorpropamide or glyburide B) " I am currently taking Propranolol." - this would be concerning if the patient is taking Methimazole D) " I take tums every day for ingestion" -this would be concerning if the patient is taking Calcitonin salmon

A patient with diabetes insipidus is taking desmopressin (DDAVP). He or she is complaining of drowsiness, lightheadedness, and headache. What does the nurse suspect that he is experiencing? A) An allergic reaction B) Dehydration C) Depression D) Water intoxication

Answer: D Feedback: The adverse effects associated with the use of desmopressin include water intoxication (drowsiness, light-headedness, headache, coma, convulsions) related to the shift to water retention and resulting electrolyte imbalance. An allergic reaction, dehydration, or depression would not be associated with these symptoms and desmopressin.

A nurse is providing teaching to a client who has a new prescription for metformin. Which of the following adverse effects of metformin should the nurse instruct the client to report to the physician? A)Constipation B)Somnolence. C) Fluid retention D) Weight gain

B)Somnolence.( drowsiness)

A nurse is caring for a client who is taking somatropin to stimulate growth. The nurse should plan to monitor the client's urine for which of the following? A) Bilirubin B) Protein C) Calcium. D) Potassium

C) Calcium.

A nurse is administering Leuprolide to a young patient with precocious puberty. The nurse knows which of the following ways is how this drug is administered ? A) IV B) IM C) IM DEPOT D) oral

C) IM DEPOT

The nurse is providing patient education to a patient taking a prednisone and advises the patient to take his or her medication at what time of the day? A) At bedtime B) With the noon meal C) At 3:00 PM D) Immediately on awakening in the morning

D Feedback: Glucocorticoids should be taken immediately on awaking in the morning to mimic the normal diurnal pattern. The peak levels of cortisol usually come between 6:00 and 8:00 AM. The levels then fall off slowly and reach a low in the late evening with the lowest levels around midnight. For those patients who work night shifts, the schedule would be changed to accommodate their sleep pattern. Waiting until later in the day could result in sleeplessness- on test

A nurse is assessing a client who takes desmopressin for diabetes insipidus. For which of the following adverse effects should the nurse monitor? A) Hypovolemia B) Hyercalcemia C) Agitation D) Headache.

D) Headache.