PathoPharm Quiz 3 review questions

A patient has been taking levothyroxine for several years and reports that for the past 2 weeks, the drug doesn't seem to work as well as before. What will the nurse do? a.Ask the patient when the prescription was last refilled. b.Expect the patient to have an elevated temperature and tachycardia. c.Suggest that the patient begin taking calcium supplements. d.Tell the patient to try taking the medication with food.

a.Ask the patient when the prescription was last refilled.

The nurse assesses a newly diagnosed patient for short-term complications of diabetes. What does this assessment include? a.Evaluation for hyperglycemia, hypoglycemia, and ketoacidosis b.Cranial nerve testing for peripheral neuropathy c.Pedal pulse palpation for arterial insufficiency d.Auscultation of the carotids for bruits associated with atherosclerosis

a.Evaluation for hyperglycemia, hypoglycemia, and ketoacidosis

Which statement is correct about the contrast between acarbose and miglitol? a.Miglitol has not been associated with hepatic dysfunction. b. With miglitol, sucrose can be used to treat hypoglycemia. c. Miglitol is less effective in African Americans. d. Miglitol has no gastrointestinal side effects.

a.Miglitol has not been associated with hepatic dysfunction.

A patient with type 1 diabetes reports mixing NPH and regular insulin to allow for 1 injection. What should the nurse tell the patient? a.This is an acceptable practice. b.These two forms of insulin are not compatible and cannot be mixed. c.Mixing these two forms of insulin may increase the overall potency of the products. d.NPH insulin should only be mixed with insulin glargine.

a.This is an acceptable practice.

A nurse caring for a patient notes that the patient has a temperature of 104°F and a heart rate of 110 beats/min. The patient's skin is warm and moist, and the patient complains that the room is too warm. The patient appears nervous and has protuberant eyes. The nurse will contact the provider to discuss: a.cretinism. b.Graves' disease. c.myxedema. d.Plummer's disease.

b.Graves' disease.

A nurse is teaching a patient who will begin taking methimazole [Tapazole] for Graves' disease about the medication. Which statement by the patient indicates understanding of the teaching? a.Because of the risk for liver toxicity, I will need frequent liver function tests. b.I should report a sore throat or fever to my provider if either occurs. c.I will need a complete blood count every few months. d.It is safe to get pregnant while taking this medication.

b.I should report a sore throat or fever to my provider if either occurs.

The nurse is caring for a pregnant patient recently diagnosed with hypothyroidism. The patient tells the nurse she does not want to take medications while she is pregnant. What will the nurse explain to this patient? a.Hypothyroidism is a normal effect of pregnancy and usually is of no consequence. b.Neuropsychologic deficits in the fetus can occur if the condition is not treated. c.No danger to the fetus exists until the third trimester. d.Treatment is required only if the patient is experiencing symptoms.

b.Neuropsychologic deficits in the fetus can occur if the condition is not treated.

The nurse prepares a patient with Graves' disease for radioactive iodine (131I) therapy. Which statement made by the patient best demonstrates understanding of 131I therapy? a.I will have to isolate myself from my family for 1 week so that I don't expose them to radiation. b.This drug will be taken up by the thyroid gland and will destroy the cells to reduce my hyperthyroidism. c.This drug will help reduce my cold intolerance and weight gain. d.I will need to take this drug on a daily basis for at least 1 year.

b.This drug will be taken up by the thyroid gland and will destroy the cells to reduce my hyperthyroidism. c.This drug will help reduce my cold intolerance and weight gain.

A patient is admitted to the hospital and will begin taking levothyroxine [Synthroid]. The nurse learns that the patient also takes warfarin [Coumadin]. The nurse will notify the provider to discuss ____ the ____ dose. a.reducing; levothyroxine b.reducing; warfarin c.increasing; levothyroxine d.increasing; warfarin

b.reducing; warfarin

A patient with type 1 diabetes recently became pregnant. The nurse plans a blood glucose testing schedule for her. What is the recommended monitoring schedule? a.Before each meal and before bed b.In the morning for a fasting level and at 4:00 PM for the peak level c.6 or 7 times a day d.3 times a day, along with urine glucose testing

c.6 or 7 times a day

A nurse obtaining an admission history on an adult patient notes that the patient has a heart rate of 62 beats/min, a blood pressure of 105/62 mm Hg, and a temperature of 96.2°F. The patient appears pale and complains of always feeling cold and tired. The nurse will contact the provider to discuss tests for which condition? a.Cretinism b.Graves' disease c.Hypothyroidism d.Plummer's disease

c.Hypothyroidism

A patient with hypothyroidism begins taking PO levothyroxine [Synthroid]. The nurse assesses the patient at the beginning of the shift and notes a heart rate of 62 beats/min and a temperature of 97.2°F. The patient is lethargic and difficult to arouse. The nurse will contact the provider to request an order for which drug? a.Beta blocker b.Increased dose of PO levothyroxine c.Intravenous levothyroxine d.Methimazole [Tapazole]

c.Intravenous levothyroxine

Insulin glargine is prescribed for a hospitalized patient who has diabetes. When will the nurse expect to administer this drug? a.Approximately 15 to 30 minutes before each meal b.In the morning and at 4:00 PM c.Once daily at bedtime d.After meals and at bedtime

c.Once daily at bedtime

A patient in her twenties with Graves' disease who takes methimazole [Tapazole] tells a nurse that she is trying to conceive and asks about disease management during pregnancy. What will the nurse tell her? a.Methimazole is safe to take throughout pregnancy. b.Propylthiouracil should be taken throughout her pregnancy. c.The patient should discuss changing to propylthiouracil from now until her second trimester with her provider. d.The patient should discuss therapy with iodine-131 instead of medications with her provider.

c.The patient should discuss changing to propylthiouracil from now until her second trimester with her provider.

What is the most reliable measure for assessing diabetes control over the preceding 3-month period? a.Self-monitoring blood glucose (SMBG) graph report b.Patient's report c.Fasting blood glucose level d.Glycosylated hemoglobin level

d.Glycosylated hemoglobin level

A nurse is teaching a patient who has been diagnosed with hypothyroidism about levothyroxine [Synthroid]. Which statement by the patient indicates a need for further teaching? a.I should not take heartburn medication without consulting my provider. b.I should report insomnia, tremors, and an increased heart rate to my provider. c.If I take a multivitamin with iron, I should take it 4 hours after the Synthroid. d.If I take calcium supplements, I may need to decrease my dose of Synthroid.

d.If I take calcium supplements, I may need to decrease my dose of Synthroid.

A patient with type 1 diabetes is eating breakfast at 7:30 AM. Blood sugars are on a sliding scale and are ordered before a meal and at bedtime. The patient's blood sugar level is 317 mg/dL. Which formulation of insulin should the nurse prepare to administer? a. No insulin should be administered. b.NPH c.70/30 mix d.Lispro [Humalog]

d.Lispro [Humalog]

A patient with type 1 diabetes who takes insulin reports taking propranolol for hypertension. Why is the nurse concerned? a.The beta blocker can cause insulin resistance. b.Using the two agents together increases the risk of ketoacidosis. c.Propranolol increases insulin requirements because of receptor blocking. d.The beta blocker can mask the symptoms

d.The beta blocker can mask the symptoms

A nurse provides dietary counseling for a patient newly diagnosed with type 1 diabetes. Which instruction should be included? a.You may eat any foods you want and cover the glucose increase with sliding scale, regular insulin. b. Most of the calories you eat should be in the form of protein to promote fat breakdown and preserve muscle mass. c.Your total caloric intake should not exceed 1800 calories in a 24-hour period. d.You should use a carbohydrate counting approach to maintain glycemic control.

d.You should use a carbohydrate counting approach to maintain glycemic control.

A patient arrives in the emergency department with a heart rate of 128 beats/min and a temperature of 105°F. The patient's skin feels hot and moist. The free T4 level is 4 ng/dL, the free T3 level is 685 pg/dL, and the TSH level is 0.1 microunits/mL. The nurse caring for this patient will expect to administer: a.intravenous levothyroxine. b.iodine-131 (131I). c.methimazole [Tapazole]. d.propylthiouracil (PTU).

d.propylthiouracil (PTU).