ATI Pharmacology endocrine Questions
When talking to a patient who is about to begin glipizide (Glucotrol) therapy to treat type 2 diabetes mellitus, the health care professional should include which of the following instructions?
Avoid drinking alcohol -Alcohol can interact with glipizide, a sulfonylurea, causing a reaction similar to disulfiram (Antabuse), manifesting as nausea, palpitations, and flushing. Alcohol also increases the drug's hypoglycemic effects. The health care professional should tell the patient to avoid drinking alcohol.
A health care professional is caring for a patient who is about to begin insulin glargine (Lantus) therapy. The health care professional should recognize the need for additional precautions because the patient also takes which of the follow types of drugs?
Beta blockers -Patients who take insulin and also take beta blockers are at risk for failing to promptly recognize the symptoms of hypoglycemia because they mask symptoms such as tachycardia and tremors. They also increase hypoglycemic effects.
The nurse should expect that which of the following laboratory values is consistent with hyperglycemic hyperosmolar nonketotic syndrome?
Blood glucose 320 mg/dL (A blood glucose level greater than 250 mg/dL, which will cause spilling of ketones in the urine and development of metabolic acidosis.)
A nurse is reinforcing teaching with a client who has type 1 diabetes mellitus about exercise. Which of the following statements should the nurse include in the teaching?
"Wear a medical alert identification tag when you exercise."•
A health care professional administers pramlintide (Symlin) at 0800 to a patient who has type 1 diabetes mellitus. At which of the following times should the patient expect the drug to exert its peak action?
0820 -Pramlintide, an amylin mimetic, peaks 20 min after administration. The health care professional should monitor the patient for indications of hypoglycemia, such as diaphoresis and tremors.
Glycosylated hemoglobin refers to?
Hemoglobin that is connected to glucose. Since the life span of an RBC is 4 months, this value will not be affected by recent changes in the client's diet or medication.
A nurse is caring for a client who had a thyroidectomy to treat hyperthyroidism caused by an adenoma. Which of the following findings should the nurse report to the provider? (Select all that apply.)
1) Tachycardia and hypertension 2) Laryngeal stridor and hoarseness 3) A Positive Trousseau's sign (which is an indication of hypocalcemia.)
A nurse is reinforcing teaching with a client who has type 2 diabetes mellitus about the pathophysiology of the disease. Which of the following statements by the client indicates an understanding of the teaching?
"My cells are resistant to the effects of insulin."•
A health care professional should question the use of levothyroxine (Synthroid) for a patient who has
A myocardial infarction -Levothyroxine, a thyroid replacement hormone, can cause tachycardia, palpitations, and hypertension, especially when the patient requires a dosage adjustment; therefore, it is contraindicated for patients who have recently had a myocardial infarction
A nurse is reinforcing teaching with a client who has Addison's disease about healthy snack foods. Which of the following food choices by the client indicates an understanding of the teaching?
A turkey and cheese sandwich is high in protein, carbohydrates, and sodium. (The client who has Addison's disease requires a diet low in potassium and high in sodium, carbohydrates, and protein.)
A health care professional is caring for a patient who is about to begin taking pioglitazone (Actos) to treat type 2 diabetes mellitus. The health care professional should explain to the patient the need to monitor which of the following laboratory tests? (Select all that apply)
ALT LDL
A patient who is taking metformin (Glucophage) to treat type 2 diabetes mellitus plans to undergo angiography using iodine-containing contrast dye. The health care professional should recognize that an interaction between metformin and the IV contrast dye can increase the patient's risk for which of the following?
Acute renal failure -Metformin, a biguanide, can interact with iodine-containing contrast dye, causing acute renal failure and lactic acidosis. The health care professional should withhold metformin for 48 hr prior to and following the procedure. The health care professional should also monitor the patient for indications of acute renal failure or lactic acidosis, such as reduced urine output, hyperventilation, and abdominal pain.
A nurse is caring for a client who is postoperative following a parathyroidectomy to treat hyperparathyroidism. Which of the following laboratory values should the nurse expect to decrease as a therapeutic eect of the procedure?
Calcium
The parathyroid hormone regulates, what?
Calcium, phosphorus, and magnesium balance within the client's blood and bone by maintaining a balance between the mineral levels in the blood and the bone.
A nurse is preparing a 24-hour urine specimen for a client who is suspected to have pheochromocytoma. Which of the following laboratory tests from the 24-hour urine specimen should the nurse use to determine the client's condition?
Catecholamine metabolites
A nurse is assisting with the plan of care for a client who has Cushing's syndrome due to chronic corticosteroid use. Which of the following actions should the nurse include in the plan of care?
Check the client for hypertension, which can indicate fluid volume overload.
A nurse is checking laboratory values to determine if a client who has diabetes mellitus is adhering to the treatment plan. Which of the following tests should the nurse use to make this determination?
Checking glycosylated hemoglobin levels, or HbA1c, is an accurate method to determine if the client is routinely compliant.
A nurse is caring for a client who is postoperative following a bilateral adrenalectomy. The nurse should expect to administer glucocorticoids following the procedure to enhance which of the following therapeutic effects?
Compensate for decrease in cortisol levels.
Glucocorticoids
Cortisol, raises blood sugar levels
A nurse is collecting data from a client who has Graves' disease. Which of the following findings should the nurse expect the client to display?
Difficulty sleeping
When talking with a patient who is about to begin repaglinide (Prandin) therapy to treat type 2 diabetes mellitus, the health care professional should include which of the following instructions?
Do not drink more than 1L of grapefruit juice per day. -More than 1L of grapefruit juice per day can increase the hypoglycemic effects of repaglinide, a meglitinide. The health care professional should tell the patient to avoid drinking large amounts of grapefruit juice.
A health care professional is caring for a patient who is about to begin acarbose (Precose) therapy to treat type 2 diabetes mellitus. Which of the following instructions should the health care professional include when talking with the patient about the drug?
Eat more iron-rich foods. -Acarbose, an alpha-glucosidase inhibitor, can cause iron-deficiency anemia. The health care professional should tell the patient to increase his intake of iron-rich foods, such as red meat, spinach, and grains, and monitor the patient's CBC.
A health care professional is caring for a patient who is about to begin taking radioactive iodine-131 (Iodotope) to treat Graves' disease. Which of the following instructions should the health care professional include when talking with the patient about the drug?
Expect full effects in 2 to 3 months -The full therapeutic effects of radioactive iodine-131, an antithyroid drug, take 2 to 3 months, and with successful treatment, hypothyroidism can result.
A health care professional is caring for a patient who is about to begin levothyroxine (Synthroid) therapy to treat hypothyroidism. Which of the following instructions should the health care professional include when talking with the patient about taking the drug?
Expect life-long therapy with the drug. -Therapy with levothyroxine,a thyroid replacement hormone, usually continues for life because there are no other therapies that can restore thyroid function.
A nurse is checking a client who has Graves' disease for the development of thyroid storm. The nurse should report which of the following ndings to the provider?
Fever
Which of the following drugs should a health care professional have available for a patient who is experiencing an insulin overdose?
Glucagon (GlucaGen) -Glucagon, a hyperglycemic that can be given subcutaneously, IM, or IV, treats severe hypoglycemia from an insulin overdose in patients who are unconscious and for whom IV glucose is not readily available. If the patent does not respond to glucagon, the health care professional should administer a glucose solution IV.
When considering replacement therapy options for a patient who has chronic adrenocortical insufficiency, the primary care provider should choose which of the following drugs?
Hydrocortisone (Cortef) -Hydrocortisone, a glucocorticoid, provides replacement therapy for acute and chronic adrenocortical insufficiency, such as Addison's disease. Hydrocortisone is identical to cortisol, the primary glucocorticoid the adrenal cortex generates.
Hyperparathyroidism is associated with?
Hypercalcemia; therefore, a decrease in the calcium level indicates an improvement in the client's condition.
A nurse is monitoring a client who has syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which of the following findings should the nurse expect?
Hyponatremia, (caused by the excessive release of an antidiuretic hormone (ADH).)
A patient who is taking propylthiouracil (PTU) contacts the health care professional to report weight gain, drowsiness, and depression. The health care professional should suspect which of the following adverse reactions to the propylthiouracil?
Hypothyroidism -Propylthiouracil, an antithyroid drug, can cause hypothyroidism, manifesting as drowsiness, depression, weight gain, edema, and bradycardia. The health care professional should request that the primary care provider prescribe a lower dosage of the drug for the patient.
A nurse is collecting data from a client who has manifestations of acromegaly. Which of the following findings should the nurse expect?
Increased head size
A nurse is caring for a client who has type 2 diabetes mellitus and is displaying manifestations of hyperglycemia. Which of the following findings should indicate to the nurse that the client has hyperglycemia?
Increased urination, or polyuria, is a manifestation of hyperglycemia due to a deciency of insulin, which can lead to osmotic diuresis.
A health care professional is caring for a patient who is about to begin pramlintide (Symlin) therpay to treat type 1 diabetes mellitus. Which of the following instructions should the health care professional include when talking with the patient about using the drug?
Inject pramlintide before meals -The patient should inject pramlintide, an amylin mimetic, 20 min before a meal that contains at least 30 g of carbohydrates.
When talking with a patient who is about to begin exenatide (Byetta) therapy to treat type 2 diabetes mellitus, the health care professional should include which of the following instructions? (Select all that apply)
Inject the drug subcutaneously Expect the peak effect in 2 hr Use the drug as a supplement to an oral hypoglycemic
A nurse is reinforcing teaching with a client who has type 1 diabetes mellitus about hypoglycemia. Which of the following manifestations should the nurse include in the teaching?
Irritability, ( an early manifestation of hypoglycemia.)
What is the Somogyi effect?
It is a swing of a high blood glucose level in the morning, after an extremely low blood glucose level during the night. The swing is caused by the release of stress hormones to counter low glucose levels.
What is Pheochromocytoma?
It is a tumor of the adrenal gland that causes excess release of the catecholamines (epinephrine and norepinephrine), which are hormones that regulate blood pressure and heart rate.
A patient who is taking metformin (Glucophage) to treaet type 2 diabetes mellitus contacts the health care professional to report muscle pain. The health care professional should suspect which of the following adverse reactions?
Lactic acidosis -Metformin, a biguanide, can cause lactic acidosis, which is a life-threatening complication, manifesting as muscle aches, sleepiness, malaise, and hyperventilation. The patient should stop taking the drug and seek medical care immediately.
A health care professional is talking to a patient about self-injecting Regular insulin (Humulin). The health care professional should tell the patient to rotate injection sites to prevent which of the following?
Lipohyperthrophy -Lipohypertrophy, also called lipodystrophy, is a proliferation of fat at the sites of repeated insulin injections. It affects skin sensitivity and appearance. To prevent it, the patient should rotate injection sites, keeping them at least 1 inch apart, and avoid using the same spot within the same month.
A nurse is assisting with the plan of care for a community health screening for a group of clients who are at risk for type 2 diabetes mellitus. Which of the following clients should the nurse include in the screening?
Men & women who are obese.
A nurse is assisting with the plan of care for a client who is experiencing the Somogyi effect and takes intermittent-acting insulin. Which of the following actions should the nurse include in the plan?
Monitor the client's nighttime blood glucose levels.
A patient who is taking glipizide (Glucotrol) to treat type 2 diabetes mellitus contacts the health care professional to report feeling shaky, hungry, and fatigued. The health care professional should tell the patient to do which of the following?
Perform a fingerstick blood glucose check. -Glipizide, a sulfonylurea, can cause hypoglycemia, which can manifest as daiphoresis, shakiness, hunger, and fatigue. The health care professional should tell the patient to check her blood glucose level, and if it indicates hypoglycemia, consume a snack of 15 to 20 g of carbohydrates, retest in 15 to 20 min, and repeat if her blood glucose level is still low.
A nurse is caring for a client who has diabetes insipidus. For which of the following findings should the nurse monitor?
Polyuria, (Diabetes insipidus is characterized by increased thirst (polydipsia) and increased urination (polyuria))
A nurse is collecting data from a client who has Cushing's syndrome. Which of the following skin manifestations should the nurse expect to find?
Purple striae (streaks or stripes) on the chest and abdomen because cortisol destroys collagen under the skin.
A primary care provider should prescribe a lower dose of sitagliptin (Januvia) for a patient who has type 2 diabetes mellitus and who also has which of the following?
Renal impairment -Stagliptin, agliptin, requires cautious use with patients who have renal dysfunction and low creatine clearance because the kidneys eliminate the drug virtually intact. The primary care provider should prescribe a lower dose for this patient or prescribe a different hypoglycemic drug
A health care professional is caring for a patient who is taking repaglinide (Prandin) 15 to 30 min before each meal to treat type 2 diabetes mellitus. The patient asks the health care professional what to do if he skips a meal. Which of the following is the appropriate response?
Skip the dose. -To avoid a sudden and serious drop in blood glucose level, the patient should skip the dose of repaglinide, a meglitinide, whenever he skips a meal, and try to avoid skipping meals.
A health care professional is caring for a patient who is about to begin taking propylthiouracil (PTU) to treat hyperthyroidism. The health care professional should tell the patient to report which of the following adverse effects? (Select all that apply)
Sore throat Muscle pain Bradycardia Rash
A health care professional is caring for a patient who is about to begin y=taking somatropin (Genotropin). The health care professional should explain the need to monitor which of the following laboratory tests? (Select all that apply)
Urine calcium Blood glucose
To determine the effectiveness of desmopressin (DDAVP), a health care professiona should monitor a patient's
Urine output -Desmopressin, an antidiuretic hormone, is unlikely to alter skin integrity. Propylthiouracil (PTU), an antithyroid drug, is an endocrine-system drug that requires integumentary monitoring because it can cause a rash.
When talking with a patient about taking fludrocortisone to treat adrenocortical insufficiency, the health care professional should tell the patient to do which of the following to reduce the risk of adverse reactions? (Select all that apply)
Weigh yourself daily Report weakness or palpitations Have your blood pressure checked regularly
A health care professional is caring for a patient who is taking pioglitazone (Actos) to treat type 2 diabetes mellitus. The health care professional should monitor for which of the following findings that indicates an adverse effect?
Weight gain -Pioglitazone, a thiazolidonedione, can cause fluid retention. The health care professional should monitor weight or other indications of fluid retention or heart failure, including dyspnea, crackles, and wheezing.
Thyroid storm
a relatively rare, life-threatening condition caused by exaggerated hyperthyroidism.
hyperosmolar
a solution that has a concentration of the substance greater than that of a second solution.
Grave's Disease/ hyperthyroidism
an autoimmune disorder characterized by the excessive production of thyroid hormones. Thyroid Storm.
Catecholamines
hormones secreted by the adrenal medulla that affect the sympathetic nervous system in stress response. Dopamine, norepinephrine, epinephrine
Cushing's syndrome
hypersecretion of cortisol
Graves disease symptoms
symptoms include anxiety, hand tremor, heat sensitivity, weight loss, puffy eyes (Grave's ophthalmopathy) and enlarged thyroid.