endocrine study questions
A nurse is educating the parents of a child who has a new diagnosis of Prader-Willi Syndrome (PWS) and has been prescribed somatropin. Which of the following statements by a parent indicates understanding of the teaching?
"we will use a different spot for injection each time we give the medication" (this is to prevent atrophy of the tissues)
A nurse is caring for a client who is about to begin taking pioglitazone to treat type 2 diabetes mellitus. The nurse should explain to the client about the need to monitor which of the following laboratory values? (Select all that apply.)
ALT ( drug can cause liver injury. client report jaundice dark colored urine or abdominal pain) LDL (can cause elevated HDL which is great but LDL increase can be detrimental)
A nurse is teaching a client who has a prescription for glipizide therapy to treat type 2 diabetes mellitus. Which of the following instructions should the nurse include?
Avoid drinking alcohol (alcohol can interact with glipizide causing nausea palpitations and flushing. Also increases the drugs hypoglycemia effects)
A nurse is caring for a client who is about to begin insulin glargine therapy. The nurse should identify the need for additional precautions because the client also takes which of the following types of drugs?
Beta blockers (risk for failing to prompt recognize signs of hypoglycemia because beta blockers mask symptoms like tachycardia and tremors and can increase hypoglycemic effects)
A nurse is providing teaching to a client who is about to begin levothyroxine therapy to treat hypothyroidism. Which of the following instructions should the nurse include?
Expect lifelong therapy (There are no other therapies that can restore thyroid function)
Which of the following should a nurse have available for a client who is experiencing insulin toxicity?
Glugagon (can be give subcutaneously IM or IV to treat insulin toxicity)
A client is about to start taking somatropin. You plan to evaluate the effectiveness of this drug with which of the following assessments?
Height and weight (this is a growth hormone and should gradually increase weight and height so monitor these on an ongoing basis)
When considering replacement therapy options for a client who has chronic adrenocortical insufficiency, a nurse should recognize that the provider will choose which of the following drugs?
Hydrocortisone (provides replacement therapy because it is identical to cortisone the primary glucocorticoid the adrenal cortex generates)
You are caring for a client who is taking levothyroxine to treat hypothyroidism. The client reports palpitations weight loss and diarrhea. You suspect which of the following adverse effects of this drug?
Hyperthyroidism (is the dose exceeds what the client requires it can cause hyperthyroidism so what for and report anxiety insomnia tachycardia palpitations diarrhea and weight loss)
A nurse at a provider's office is assessing a client who has been taking hydrocortisone for adrenal insufficiency. The client reports fatigue and feeling overwhelmed by personal responsibilities. Which of the following findings should the nurse identify as an indication the provider might need to increase the client's dosage?
Hypotension (fatigue and hypotension are signs of adrenal insufficiency and during times of stress the dose may need to be increased to prevent adrenal insufficiency. All findings should be reported to the provider)
A nurse is caring for a client who is taking propylthiouracil (PTU) and reports weight gain, drowsiness, and depression. The nurse should identify that the client is experiencing which of the following adverse reactions to the drug?
Hypothyroidism (antithyroid drugs can cause hypothyroidism which manifests as drowsiness depression weight gain edema and bradycardia, RN request lower dose if client reports these symptoms)
A client is about to start taking hydrocortisone to treat adrenocortical insufficiency. You should instruct the client to do which of the following to help reduce the risk for adverse effects of this drug?
Increase calcium and vitamin d intake Take the drug with food Record weight regularly Report increased stress
When talking with a client about self administering regular insulin (humbling R) you should include which of the following instructions?
Inject the insulin subcutaneously
A nurse is caring for a client who is taking metformin to treat type 2 diabetes mellitus and reports muscle pain. Which of the following adverse reactions should the nurse suspect?
Lactic acidosis ( life threatening complication manifests as muscle aches sleepiness malaise and hyperventilation if symptoms appear stop drug and seek medical care)
A nurse is teaching a client about self-administering regular insulin. The nurse should instruct the client to rotate injection sites to prevent which of the following?
Liphohypertrophy (affects skin sensitivity and appearance. to prevent it rate injection sites keeping them 1 inch apart and avoid using the same spot in the same month)
A nurse is speaking with a client who is taking glipizide to treat type 2 diabetes mellitus and has called to report feeling shaky, hungry, and fatigued. Which of the following actions should the nurse instruct the client to take?
Perform a fingerstick blood glucose check (if hypoglycemia is indicated have the patient consume a snack of 15-20g of carbs and retest in 15-20 minutes repeat steps if still low)
A nurse is assessing a client who has a new prescription for levothyroxine. The nurse should identify which of the following findings as a contraindication for this drug?
Recent myocardial infarction (can cause tachycardia palpitations and hypertension ESPECIALLY when patient requires a dose adjustment therefore contraindication for recent MI)
A nurse should recognize that a provider will prescribe a lower dose of sitagliptin for a client who has type 2 diabetes mellitus and who also has which of the following?
Renal impairment (low creatinine clearance caution due to needing the kidneys for proper drug elimination)
A nurse is caring for a client who is about to begin taking propylthiouracil (PTU) to treat hyperthyroidism. The nurse should instruct the client to report which of the following adverse effects? (Select all that apply.)
Sore throat (can cause agranulocytosis so the nurse should monitor CBC and have the patient report sore throat or fever) Joint pain (can cause arthralgia and myalgia take over the counter analgesics) Bradycardia (can cause hypothyroidism which manifest as bradycardia drowsiness and weight gain) Rash (can cause urticaria or rash clients report these effects)
A client is about to start taking sustained release glipizide to treat type 2 diabetes mellitus. Which of the following instructions should you include when talking with the client about this drug?
Take it once a day 30 minutes before breakfast
You are caring for a client who takes acarbose and a sulfonylurea to treat type 2 diabetes mellitus. Which of the following is an indication of an adverse drug reaction to this combination?
Tremors (this combo can cause hypoglycemic reaction also including hunger tachycardia, shakiness, and diaphoresis.)
A nurse is caring for a client who is about to begin taking somatropin. The nurse should explain the need to monitor which of the following laboratory values? (Select all that apply.)
Urine calcium (can cause hypercalciuria and need to monitor this and for flank pain urinary frequency and hematuria) Blood glucose (drug can cause hyperglycemia and instruct patient to report polyphagia polydipsia and polyuria)
A nurse is caring for a client who is taking desmopressin. The nurse should make which of the following assessments to evaluate the drug's effectiveness?
Urine output (antidiuertic hormone treats diabetes insipidus RN monitor fluid intake and output with osmolality and blood pressure)
A nurse is caring for a client who is taking metformin and is scheduled to undergo angiography using iodine-containing contrast dye. The nurse should identify that an interaction between metformin and the IV contrast dye increases the client's risk for which of the following conditions?
acute renal failure (metformin can interact with contrast dye and cause acute renal failures and lactic acidosis the nurse should withhold metformin for 48h prior to and following the procedure) (indications of renal failure or lactic acidosis decrease urine output hyperventilation and abdominal pain)
