D&D Exam 1

Which would the nurse anticipate to be used for the prevention of nausea from motion sickness?

Scopolamine

The adrenal cortex influences glucose levels through the production of which hormone?

Cortisol

Sodium retention and potassium excretion are modulated by which hormone?

Aldosterone

Which would be used to diagnose adrenal function?

Corticotropin

What cardiac adverse effects should the nurse assess for when caring for a client prescribed hydrocortisone? Select all that apply.

Changing in blood pressure Cardiac arrest

Which is released in response to decreased oxygenated blood flowing through the kidneys?

Erythropoietin

Which agent would a nurse expect to administer to a client with hypothyroidism?

Levothyroxin

Which part of the brain is responsible for autonomic functioning such as ventilation, cardiac conduction, and vomiting?

Medulla Oblongata

Which hormone is important for milk production in a lactating woman?

Prolactin

Which patient should not receive mitotane as ordered?

The patient is in shock

Graves' disease is the most common cause of hyperthyroidism.

True

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."

A 53-year-old man has been treated for severe asthma for several years with prednisone. Recently, his health care provider has initiated alternate-day therapy for him. The client tells the nurse that he would rather take the medication every day to prevent confusion. Which would be the best response by the nurse?

"This schedule allows rest periods so that adverse effects are decreased but the anti-inflammatory effects continue."

A client is prescribed a proton pump inhibitor to treat erosive gastritis. How soon will the client's symptoms most likely be resolved?

1 to 2 weeks

A client is diagnosed with diabetes insipidus. The healthcare provider orders desmopressin, which the nurse knows is the synthetic equivalent of what hormone?

ADH

A client is receiving hydrocortisone 40 mg by mouth daily for treatment of severe autoimmune inflammation. Which nursing intervention is the most important to implement?

Assess daily blood glucose

A female client is admitted to the hospital with hypoglycemia, nausea, muscle weakness, and depression. What is the most likely cause?

Addisons Disease

A primary health care provider has prescribed levothyroxine to a client with hypothyroidism. Which information would the nurse include in the teaching plan to promote an optimal response to the drug therapy?

Administer the medication before breakfast

When describing the possible adverse effects associated with omeprazole therapy, which of the following would the nurse identify as least common?

Alopecia

A common drug regimen for eradication of H. pylori includes a proton pump inhibitor (PPI) and two antibiotics. What is one of the preferred antibiotics?

Amoxicillin

Which finding should alert the nurse to a potential Cushing's syndrome manifestation presented by a client prescribed long-term corticosteroid therapy?

Buffalo hump

Which hormone would the nurse identify as important in decreasing serum calcium levels?

Calcitonin

A patient has hypocalcemia secondary to hypoparathyroidism. Which would the nurse expect to be ordered?

Calcitrol

Parathyroid hormone increases serum levels of which electrolyte?

Calcium

The nurse should review which lab result before advising a client about taking the first dose of ibandronate (Boniva)

Calcium

Liothyronine is a thyroid hormone used in replacement therapy for hypothyroidism. The drug must be used with extreme caution in patients with:

Cardiac problems

A caregiver of a 1-year-old asks the nurse if they can give the diphenoxylate that was prescribed for an older sibling to the child. Which is the nurse's best response?

Children younger than 1 year of age should not be given this medication."

A client is to undergo fertility treatment and is to receive an agent that induces ovulation because her ovaries are functioning. Which agent would this most likely be?

Chorionic gonadotropin

Which would a nurse anticipate as having antiandrogenic effects?

Cimetidine

A nurse is caring for an elderly patient who has been administered cimetidine. Which intervention should the nurse perform?

Closely monitory for confusion and dizziness

A 29-year-old woman has been prescribed alosetron (Lotronex) for irritable bowel syndrome. Before starting the drug therapy, the nurse will advise the client about which adverse effect(s)?

Constipation

An older adult's has been taking a calcium-based antacid on an increasingly frequent basis. When teaching this client, the nurse should include suggestions for the prevention of which adverse effect?

Constipation

The nurse should warn a client taking aluminum- and calcium-containing antacids about which adverse effects?

Constipation

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

Decrease cardiac output

Glucocorticoids should be used with caution in patients with what disease process?

Diabetes Mellitus

Lack of antidiuretic hormone (ADH) produces which disease process?

Diabetes insipidus characterized by large amounts of dilute urine and excessive thirst.

What question is important for the nurse to ask a client who is scheduled to receive a first dose of radioactive iodine for hyperthyroidism?

Do you have any trouble swallowing

What recommendations should be included in client teaching as a means of avoiding constipation?

Drink plenty of fluids Be active and exercise daily. Eat foods high in bulk or roughage.

A client reports to the nurse about needing to strain to defecate. The client adds that defecating is very painful. What laxative will the nurse suggest to the prescriber based on the painful defecation?

Ducostate

Which herbal supplement taken with ketoconazole can cause hepatotoxicity?

Echinacea

During initial therapy with levothyroxine (Synthroid), what are some of the most common reactions a nurse might observe in a client? (Select all that apply.)

Elevated body temp weight loss Tachycardia Insomnia

A client with a complex medical history states that the primary care provider has changed the client's proton pump inhibitor from omeprazole to esomeprazole. The client is unsure of the rationale for this change in medication and has raised this question with the nurse. What rationale is most plausible?

Esomeprazole has fewer drug interactions.

Which of the following are effects that a client might experience while taking diphenoxylate (Lomotil)? Select all that apply:.

Euphoric effects Sedative effects Slowed GI effects

After administering octreotide to a patient, the nurse is assessing the patient for possible adverse effects. Which might the nurse find?

Flatulence Acute RUQ pain Sinus bradycardia

A client is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH) and has been prescribed a medication to affect the posterior pituitary gland's production of antidiuretic hormone (ADH). Which nursing assessment is critical to this client's safety?

Fluid balance

The anterior pituitary gland produces seven hormones. Two of these act directly on their target tissues. They are:

Growth Hormone, and prolactin

A nurse is assessing a patient receiving hydrocortisone for possible side effects. Which findings indicate the patient may have dose limiting side effects?

Heart failure Low BP

A client presents at the clinic reporting weight loss despite an increased appetite. For which condition should this client be assessed?

Hyperthyroidism

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?

Hypocalcemia

The nurse is assessing a client with adrenocortical excess resulting from long-term use of corticosteroids. What is not a side effect related to this client's corticosteroid use?

Hypotension

The main connecting link between the nervous system and the endocrine system is the:

Hypothalamus

A nurse is teaching a client about omeprazole, which has been prescribed as part of a regimen to treat an H. pylori infection. What statement, made by the client, suggests that the client understands proper use of the drug?

I need to swallow to whole drug

A female client is prescribed ranitidine in addition to the antacid that she already takes for gastric reflux. Which statement made by the client indicates that she understood the teaching provided about taking these medications?

I'll take ranitidine two hours before an antacid

The nurse just completed client education relative to chronic adrenocortical insufficiency and corticosteroid medication treatment. Which statement indicates the client requires further instruction?

Ill start taking the medication when I'm feeling tired or ill

Carter, age 2, is diagnosed with cystic fibrosis; the physician places him on pancrelipase. What would be the most appropriate diagnosis for Carter related to his medication regimen?

Imbalanced nutrition: less than body requirements, related to impaired digestion secondary to insufficient pancreatic enzymes

The results of a client's plasma corticotropin (ACTH) stimulation test have confirmed a diagnosis of Addison's 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."

Which would a nurse expect to find as a primary effect of cortisol secretion?

Increased glucose levels

In pharmacology class the students are learning about the mechanism of action of different laxatives. What would the students learn about the mechanism of action of psyllium hydrophilic mucilloid?

Increasing mass and water content of stool

A client arrives at the walk-in clinic reporting vomiting and a burning sensation in the midepigastric region. The nurse suspects that the client has peptic ulcer disease. Which is a potential cause of peptic ulcer disease?

Infection with H. pylori

The nurse should be aware that ranitidine achieves a therapeutic effect by which means?

Inhibit the secretion of gastric acid

Somatostatin, a hormone produced by the anterior pituitary gland, is responsible for:

Inhibiting the release of growth hormone

A client, who has been prescribed insulin, asks the nurse how the insulin will help get the glucose into the cells. What information will be the foundation for the nurse's response?

Insulin reacts to specific receptor sites on the cell membrane The reaction at the receptor site stimulate the nucleotide cyclic adenosine monophosphate (cyclic AMP) The reaction that occurs changes the cell membrane's permeability to glucose The reaction allows the insulin to produce the desired effect within seconds

A pregnant client asks about the safety of taking thyroid hormone replacement drugs during her pregnancy. What is the nurse's best response?

Is a class A drug and should be taken while pregnant

A prescriber adds psyllium to the medication administration record for a client experiencing diarrhea. Which is the best rationale for the addition of psyllium?

It absorbs toxins and water, decreasing fluidity of stools.

A client is diagnosed with liver disease. How would this affect the metabolism of the drugs used to treat the client's hypothyroidism?

It would be prolonged

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

The nurse is teaching a client about the ACTH which has been prescribed. The nurse determines the session is successful when the client correctly points out they will need to avoid which medication?

Live vaccines

A 34-year-old teacher is being seen at the primary care group. The client is undergoing diagnostics for an alteration in thyroid function. What physiologic function is affected by the altered thyroid function?

Metabolic rate

A nurse is preparing to administer a scheduled dose of levothyroxine to an elderly client who is being treated in the hospital for a respiratory infection. Prior to administering the drug, the nurse should perform what assessment?

Monitor BP and pulse

A nurse is administering hydrocortisone cypionate (Cortef) to a child. What nursing intervention is essential?

Monitor the patient height and weight

The nurse should advise clients taking laxatives of which of the following adverse effects? Select all that apply

Nausea Perianal irritation Bloating Cramps

The endocrine system is closely connected to which system?

Nervous

Medications are given post-operatively to prevent or treat severe nausea and vomiting associated with the surgery. What serotonin receptor antagonist would the nurse expect the surgeon to order?

Ondansteron

The nurse is preparing to administer prednisone. The nurse would expect to administer this agent by which route?

Oral

The nurse is reviewing the drug trimethobenzamide in preparation for administration. The nurse understands that this drug can be administered by which route?

Oral Intramuscular

The nurse is assessing the patient on mitotane therapy. Which assessment finding requires action by the nurse?

Orthostatic hypotention

A client diagnosed with excessive parathyroid production is prone to develop:

Osteopenia

Based on the metabolic action of glucocorticoids, a client who is on long-term glucocorticoid therapy is at risk of developing what disease?

Osteoporosis

After reviewing the hormonal secretion of the pituitary gland, the students demonstrate understanding when they identify which hormone as being released by the posterior lobe?

Oxytocin

An instructor is preparing a teaching plan for a class on the various pituitary hormones. Which hormone would the instructor include as being released by the posterior pituitary gland?

Oxytocin

A 35-year-old man is at his follow-up visit for GERD. Antacids have not been effective for his reflux, and the health care provider is prescribing a proton pump inhibitor. Why might the provider prescribe a PPI rather than an H2RA?

PPIs suppress acid more strongly and for a longer tim

A 15-year-old child has difficulty falling asleep on a nightly basis. The health care provider suspects a lack of melatonin. What endocrine gland secretes melatonin?

Pineal gland

Which gland was traditionally considered the master gland?

Pituitary gland

A client is scheduled for a colonoscopy. The nurse knows that the preferred drug for bowel cleansing before this procedure is:

Polyethylene glycol-electrolyte solution (NuLYTELY)

A 7-year-old child is diagnosed with adrenocortical insufficiency and has been prescribed prolonged steroid therapy. Which is a steroid used for prolonged therapy?

Prednisone

A male client is diagnosed with Addison's disease. What daily medication would the nurse expect to be administered?

Prednisone

A postoperative pediatric patient is experiencing nausea and vomiting. What is the antiemetic drug of choice in children?

Promethazine

A client is diagnosed with Helicobacter pylori infection. The health care provider will order amoxicillin and what other type of medication?

Proton pump inhibitors

An older client has been prescribed omeprazole for the treatment of gastroesophageal reflux disease (GERD). What explanation should the nurse provide when asked by the client why they are not being treated with famotidine?

Proton pump inhibitors, like omeprazole, produce fewer adverse effects among the older population.

Psyllium (Metamucil) is a bulk-forming laxative available over-the-counter and frequently used. The nurse knows that which of these statements regarding use of psyllium is correct?

Psyllium is useful in critically ill patients who experience constipation.

A nurse educating a client on the antacid calcium carbonate (Mylanta) should warn the client of which of the following adverse reactions? Select all that apply:

Rebound hyperacidity Headache Confusion

The client has Maalox ordered for administration before meals. Which condition is contraindicated with the administration of Maalox?

Renal dysfunction

When a client experiences consistent hypotension, an increase in which hormone would likely help raise the blood pressure?

Renin

An older adult client with early-stage Alzheimer's disease has had hydroxyzine prescribed for nausea. When planning this client's care, the nurse should consequently identify what risk nursing diagnosis?

Risks for falls

The following data identified during a nursing assessment and interview. When considering risks for the development of a peptic ulcer, which situation should the nurse discuss with the client?

Self medicates with a nonsteroidal anti-inflammatory drug (NSAID) daily.

A client who takes aluminum hydroxide with magnesium hydroxide (Mylanta) frequently for upset stomach, heartburn, and sour stomach is seen regularly in the clinic. The nurse should assess:

Serum phosphate levels

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

Sodium 150

Which would the nurse identify as being secreted by the hypothalamus?

Somatostatin

Which agent would the nurse identify as a growth hormone agonist?

Somatotropin

Which needs to be used in a child prior to the closure of the bone epiphyses in order to exert its effects?

Somatropin

A client is prescribed calcitonin. The nurse would teach the client to administer the drug by which route?

Subqutaneously

A client who is taking magnesium citrate experiences sweating, palpitations, and flushing. The nurse understands that this is most likely related to which of the following?

Sympathetic stress reaction due to intense GI tract neurostimulation

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

Take the patients vital signs

To minimize adrenal suppression, when should the nurse encourage a client to take his or her daily dose of prescribed prednisone?

Take your medications in the morning

A client has been admitted to the hospital with dehydration and hypokalemia secondary to severe diarrhea. Why might the care team be reluctant to aggressively treat a client's diarrhea by slowing gastrointestinal (GI) peristalsis?

The body may be ridding itself of toxins

A client is scheduled for a diagnostic test to measure blood hormone levels. The nurse expects that this test will determine:

The function of the endocrine glands

An adult client has been prescribed oral prednisone for the treatment of an acute dermatological condition. When teaching this client about this course of treatment, what teaching point should the nurse emphasize?

The importance of warning off the medication, not abruptly stoping

A nurse is organizing the care of a child who takes somatotropin. The desired outcome the nurse should prioritize in the planning of this child's care is that the client will

demonstrate an increase in linear growth

Which patient should not receive ketoconazole (Nizoral) as ordered for Cushing's disease?

The patient with elevated liver function tests

Which is a likely cause of diarrhea experienced by an older adult?

laxative abuse

Which characteristic is universally shared by all hormones?

They are chemical in nature They are produced in the body They are secreted directly into the bloodstream They are produced in small quanities​

A nurse tells a patient to take a prescribed glucocorticoid in the morning based on the understanding that:

This time mimics the normal peak diurnal concentration levels.

Which would be the initial substance responsible for thyroid hormone regulation?

Thyrotropin-releasing hormone

Melanocyte stimulating hormone plays a role in human nerve growth and development

True

Metoclopramide is classified as a nonphenothiazine antiemetic

True

Pancrelipase would most likely be used to treat a patient with cystic fibrosis.

True

The use of calcium carbonate is associated with the development of acid rebound.

True

What is the rationale for using two antimicrobials when treating a Helicobacter pylori infection?

Two antimicrobials are needed to prevent the emergence of drug-resistant H. pylori organisms

The nurse is caring for a male client who has benign prostatic hypertrophy. The nurse would be alert for what complication if this client is given promethazine for treatment of nausea?

Urinary retention

A 23-year-old female client is prescribed misoprostol (Cytotec). Which client teaching intervention is most important?

Use effective contraceptive measures

What event triggers the release of insulin and glucagon from the pancreas?

Varying blood glucose levels

A nurse is providing client education to a female client who is taking fludrocortisone. The nurse will instruct the client to monitor what at home?

Weight gain

A female client has GERD and is taking ranitidine (Zantac). She continues to have gastric discomfort and asks whether she can take an antacid. Which is an appropriate response by the nurse?

Yes, but be sure to wait at least 2 hours to take the antacid after you take the ranitidine.

A child has been referred to a pediatric endocrinologist and has begun treatment with octreotide acetate. What nursing diagnosis should be noted in the plan of nursing care for a child prescribed octreotide acetate?

altered growth and development

When considering the tendency of antiemetic agents to cross the placenta, which assessment question should the nurse initially ask every childbearing aged woman before initiating the therapy?

are you pregnant

When reviewing a newly admitted client's previous medication record, the nurse notes that the client has previously been treated with aprepitant. The nurse is justified in suspecting that this client's medical history includes which therapy/treatment?

chemotherapy

After teaching a client about the adverse effects of leuprolide, the nurse determines that additional teaching is needed when the client identifies what as an adverse effect?

chills

Which agent would a nurse identify as the prototype histamine-2 receptor antagonist?

cimetidine

A client experiencing diarrhea asks the nurse about over-the-counter (OTC) antidiarrheals. Which OTC should not be taken with aspirin?

bismuth subsalicylate

What is the mechanism of action of hydroxyzine (Vistaril), an antihistamine, that enables it to have antiemetic effects?

blocks acetylcholine receptors

Because of the possible adverse effects of long-term proton pump inhibitor (PPI) use, the nurse practitioner should focus on what assessment in a 72-year-old client?

bone density

Before administering alosetron, the nurse should ensure that the client has been made aware of what potentially severe adverse effect?B

bowel obstruction

How should the critical care nurse most accurately titrate the dose and frequency of administration of an intragastric drip of an antacid through a nasogastric tube?

by aspirating stomach contents and measuring the pH

After teaching a group of nursing students about laxatives, the instructor determines that the teaching was successful when the students identify which example of an irritant laxative?

cascara sagrada bisacodyl

What causes the release of adrenocorticotropic hormone in response to a client's psychological and physiological stress?

corticotropin-releasing hormone or factor (CRH or CRF)

After administering desmopressin to a client with diabetes insipidus, which would the nurse identify as indicating drug effectiveness?

decreased reports of thirst

A community health nurse is conducting a health promotion session with a group from a local seniors' center. The nurse has addressed the issue of laxative overuse in this population. The nurse should highlight what consequence of the overuse of laxatives?

dependence

Mineralocorticoids directly affect:

electrolyte levels

The nurse is performing an assessment of a client receiving methylprednisolone. Which symptom should be reported as a possible side effect of the drug?

fever

A male patient is taking misoprostol (Tagamet). Which adverse effect is more likely to occur with cimetidine than with other histamine2 receptor antagonists?

gynecomastia

What is a principal effect of cortisol?

increase glucose

Ranitidine and cimetidine are both H2RAs used in the treatment of peptic ulcer disease. Of the two, ranitidine is preferred in critically ill clients because it is less likely to:

interfere with the metabolism of other drugs

A 7.5-year-old female has received a diagnosis of precocious puberty from the pediatric endocrinologist. The nurse should prepare to educate the child and her parents on what drug?

leuprolide acetate Leuprolide is useful for the treatment of central precocious puberty in children.

What medication is prescribed for the treatment of infertility?

menotropins

Which of the following would a nurse expect as most likely to be used in combination with antibiotics for treatment of Helicobacter pylori infection?

omeprazole

The nurse is preparing to administer cascara to a client. The nurse anticipates administering this drug by which route?

oral

A client is taking nonsteroidal anti-inflammatory agents for arthritis of the knees and hips. Which disease is a result of cellular destruction of the gastrointestinal tract from this medication?

peptic ulcer disease

The client diagnosed with peptic ulcer disease states, "I've never been a really anxious type of person, so I never thought I'd develop ulcers." The nurse has responded with health education addressing the etiology of peptic ulcer disease (PUD). What causative factors should the nurse cite? Select all that apply.

physiologic or psychological stress cigarette smoking infections nonsteroidal anti-inflammatory drugs

A client is scheduled for a colonoscopy in the morning. The nurse will provide information concerning which laxative?

polyethylene glycol-electrolyte solution

A 52-year-old man is suffering from a deficiency of exocrine pancreatic secretions and is prescribed pancrelipase (Pancrease MT). Before the medication therapy begins, the nurse will assess for allergies related to

pork

An older adult resident of a long-term care facility has been prescribed calcium citrate to address decreasing bone density. The nurse should review the resident's medication administration record knowing that what medication may decrease the effects of calcium?

prednisone

An older adult client is administered dimenhydrinate. Which is the priority nursing intervention for this client?

protect from injury

A client has a magnesium-based antacid prescribed for administration as needed. Which condition contraindicates the administration of this classification of medications?

renal dysfunction

Which patient should not start hydrocortisone therapy as ordered at 8 a.m.?

sepsis

A 75-year-old client is treating an ulcer with antacids. Based on the client's age, the nurse expects the health care provider to prescribe a dose of antacid that compares with the average prescribed dose in what way?

smaller than the average dose

A client is being discharged with Senokot as a prescribed medication. Which statement should be included in the teaching plan about the medication?

the meds will make ur urine discolored

The nurse is caring for a 42-year-old client who recently had a total hysterectomy that involved removal of her ovaries. What statement by the client suggests that she understands her risk of developing osteoporosis?

the surgery increases my risk for the disease

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

thirst