Pharmocology practice question chapter 41,42,44,45 Endocrine
1.A client with a diagnosis of diabetes is prescribed pramlintide. How will this drug assist in controlling the client's blood sugar? A) It slows gastric emptying. B) It blocks the absorption of food. C) It is absorbed by insulin. D) It increases the release of insulin.
A
11. A client's morning blood work reveals a serum calcium level of 3.1 mg/dL (normal 8.5-10.5 mg/dL). The nurse should consequently assess this client for which function? A) muscle tone B) level of consciousness C) respiratory rhythm D) respiratory rate
A
11. Heavy intake of which herb should be avoided by a client who is prescribed an antidiabetic medication? A) garlic B) anise C) basil D) oregano
A
15. A 55-year-old client was successfully treated for thyroid storm earlier in the year. In subsequent health education, the nurse should caution the client against excessive intake of what foods? A) seafood and kelp B) leafy green vegetables and beef C) purine-rich foods D) red wine and aged cheeses
A
15. A middle-aged client is proactive with personal health maintenance and reports taking 2400 International Units of vitamin D daily, stating, "More is better when it comes to vitamins." The nurse should provide health teaching to the client associated with a risk for which disorder? A) hypercalcemia B) hyperphosphatemia C) hypocalcemia D) tetany
A
16. Laboratory testing reveals that a client is in a severely hyperthyroid state, and propylthiouracil has been prescribed. When providing health education related to this drug, what information should the nurse stress to the client? A) "You'll need to take these pills every 8 hours." B) "I'm going to show you how to perform your daily injection." C) "At first, you'll come to the outclient clinic for your IV infusion once per day." D) "It's best to inject propylthiouracil into your abdomen rather than your arm."
A
18. An older adult client has been diagnosed with osteoporosis, and the nurse is reviewing the risks and benefits of the prescribed alendronate. The client should be instructed to seek prompt medical attention if which symptom develops? A) esophageal bleeding B) fever C) sudden fatigue D) musculoskeletal pain
A
19. Which condition must be met in order for glyburide treatment to be effective? A) The client must have functioning pancreatic beta cells. B) The client must have hemoglobin A1C of ≤7%. C) The client must not have hyperglycemia. D) The client must be able to self-administer the medication.
A
2. A client has been diagnosed with hyperplasia of the parathyroid gland. Which alteration in blood values will the nurse expect to observe? A) hypercalcemia B) hypoparathyroidism C) hyperthyroidism D) hypocalcemia
A
2. A client is diagnosed with hyponatremia and hypoglycemia and is currently experiencing lactic acidosis. What condition is most consistent with this clinical presentation? A) myxedema coma B) psychotic depression C) cretinism D) congenital hypothyroidism
A
20. An older adult client has been using levothyroxine for several years on an outclient basis. Which client statement should the nurse attribute to the decreased effect of levothyroxine? A) "I've been using a lot of antacids lately because of my indigestion." B) "My daughter and I have started the Atkin's diet to try to lose some weight." C) "Overall, I'd say that I'm under a lot of stress lately." D) "I've stopped taking aspirin for my arthritis and started using Tylenol."
A
3. A 38-year-old client has been living with Addison's disease for many years and has achieved adequate symptom control through lifestyle modifications and drug therapy. However, the client has now been admitted to the hospital in addisonian crisis. Which of the nurse's assessment question is most appropriate? A) "Have you been under an unusual amount of stress lately?" B) "How would you describe your diet over the last few days?" C) "When was the last time that you drank any alcohol?" D) "Has your urine output been typical for the past few days?"
A
4. A client has a decreased calcium level. Which vitamin will participate in raising the client's calcium level? A) vitamin D B) vitamin C C) ferrous sulfate D) vitamin B12
A
4. A client's recent symptoms of unexplained fatigue and listlessness have prompted a referral to the endocrinology department. A plasma corticotropin (ACTH) stimulation test for adrenal insufficiency is being performed. Following the administration of ACTH, what finding would confirm the suspected diagnosis? A) low cortisol levels B) stupor C) increased levels of corticotropin-releasing hormone (CRH) D) signs of Cushing's disease
A
5. A client with suspected adrenal insufficiency has been administered 1 mcg of cosyntropin as an IV bolus. Serum testing 30 minutes later reveals a markedly elevated level of cortisol. What conclusion should the nurse infer from this finding? A) The client has normal adrenocortical function. B) The client has primary adrenal insufficiency. C) The client has Cushing's disease. D) The client has Addison's disease.
A
5. A newborn is diagnosed with hypothyroidism. What will the client likely develop if the condition is left untreated? A) mental retardation B) renal dysfunction C) an immune disorder D) paralytic ileus
A
5. Which statement by the nurse represents the most appropriate response to the question why a quick-acting sugar given by mouth is better in the regulation of insulin than the use of intravenous glucose for a low blood sugar? A) "The ingestion of food allows the digestive tract to stimulate vagal activity and the release of incretins." B) "The combination of insulin and food will yield a higher blood sugar than intravenous glucose." C) "Both food and intravenous glucose will produce changes similarly in the gastrointestinal tract to increase blood sugar." D) "You are mistaken. The intravenous glucose yields a higher blood glucose through the release of incretins."
A
6. A client, diagnosed with hypothyroidism, is currently taking an opioid for knee pain. This client is at increased risk for developing which adverse reaction? A) myxedema coma B) pulmonary congestion C) tachycardia D) hyperventilation
A
8. 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? A) "In order to manage this condition, you'll need to take these for the rest of your life." B) "You'll have to take these until you can pass the corticotropin stimulation test without them." C) "You'll have to take these until your kidneys regain their normal level of function." D) "You'll need to take these until your symptoms have been stable for at least 6 months."
A
9. A client who regularly takes metformin has developed a severe infection. How will the infection change the established diabetic regimen? A) Metformin is contraindicated in the presence of an infection. B) Metformin will be given more frequently to decrease blood sugar. C) Metformin will result in better regulation of blood sugar. D) Metformin will allow the client to decrease the absorption of glucose.
A
9. An older adult client has been prescribed oral corticosteroids to decrease the symptoms of chronic obstructive pulmonary disease. What is the client at risk for developing? A) osteoporosis B) osteoarthritis C) oat cell carcinoma D) Paget's disease
A
16. The nurse prepares to administer hydrocortisone 250 mg IV bolus every 4 hours and fludrocortisone 0.1 mg PO daily for an adult client newly diagnosed with Addison's disease. Which measures would the nurse provide for safe and effective drug administration? Select all that apply. A) Dilute hydrocortisone to 50 mg/mL and administer 5 mL IV bolus over 30 seconds. B) Instruct to limit intake of foods rich in potassium because drugs increase potassium. C) Assess vital signs for improved cardiac function and NA+, K+, and BUN. D) Increase sodium intake in diet to maintain normal blood pressure. E) Monitor for adverse effects: hypertension, heart failure, hyperglycemia, immunosuppression.
A,C,E
1. A child is born with cretinism. What element was lacking in the mother's diet during pregnancy? A) potassium B) iodine C) sodium D) magnesium
B
10. What is the expected action of sitagliptin on type 2 diabetes? A) It blocks the S phase of the cell cycle. B) It slows the rate of inactivation of the incretin hormones. C) It is a synthetically prepared monosodium salt. D) It inhibits hydrogen, potassium, and ATPase.
B
11. A client will soon begin long-term treatment with hydrocortisone after being diagnosed with Addison's disease. In order to mitigate the potentially adverse effect of this treatment regimen, the nurse should encourage the client to increase the intake of what nutrient? A) water B) calcium C) sodium D) potassium
B
12. A client, being treated for hypothyroidism, has developed symptoms of adrenal insufficiency. What medication will be added to the client's medication regimen? A) anti-infective agent B) corticosteroid agent C) nonsteroidal anti-inflammatory agent D) antiadrenergic agent
B
13. A client with a diagnosis of Addison's disease has had fludrocortisone acetate added to the medication regimen. What is the most plausible rationale for this change in treatment? A) The client's anterior pituitary gland is overstimulated. B) The client requires increased mineralocorticoid supplementation. C) The client's adrenal cortex has become resistant to hydrocortisone. D) The client's GI tract is unable to tolerate hydrocortisone.
B
14. A client's low ionized calcium levels have necessitated an infusion of an IV calcium preparation. During the administration of this medication, the nurse should prioritize what assessment? A) oxygen saturation levels B) cardiac monitoring C) assessment of cognition D) assessment for visual changes
B
14. A client, who is 42 years old and newly diagnosed with type 2 diabetes, has attended educational sessions to provide insight into the diagnosis. Which of the client's statements should prompt the nurse to provide further teaching? A) "I don't like getting this diagnosis, but I know that treatment now can prevent future health consequences." B) "I'm disappointed, but I take some solace in the fact that I won't ever have to have insulin injections." C) "People always tried to encourage me to lose weight, and I suppose they might have been right." D) "From what I've learned, I know that the basic problem is that my pancreas can't keep up with my insulin needs."
B
15. A nurse educator, explaining the pathophysiology of diabetes to a newly diagnosed client, should provide what explanation for the client's "constant, insatiable thirst"? A) "The excess glucose in your blood accumulates in your blood vessels and neurons, including the neurons that control thirst." B) "Excess glucose pulled more water through your kidneys and the increased urination caused thirst." C) "Increased thirst is your body's attempt to dilute your blood because it contains too much glucose." D) "When your body cells are starved for useful glucose, they signal your body to increase food and fluid intake."
B
17. An older adult client has experienced recent declines in bone density and has consequently been deemed a candidate for treatment with alendronate. During health education, what teaching point should the nurse emphasize? A) "Your alendronate will be most effective if you couple it with an increase in your consumption of dairy products." B) "It's important that you not lie down for half an hour after taking your alendronate." C) "Make sure to let your care provider know promptly if you experience bone pain." D) "You'll have less stomach upset if you take your alendronate with some bland food."
B
17. Prior to administering propylthiouracil, the nurse has reviewed the relevant black box warning and should teach the client about the need for what form of follow-up? A) serial complete blood counts B) routine liver function testing C) daily nonfasting blood glucose testing D) chest radiographs every 3 months
B
17. The nurse is educating an adult client diagnosed with Addison's disease about the prescribed hydrocortisone PO and fludrocortisone PO. Which statement made by the client establishes the need for further clarification? A) "I will take hydrocortisone at 9 AM every day and other doses will be spaced evenly." B) "I will go to my local clinic and receive my mumps, measles, rubella (MMR) vaccine." C) "The antacids will help decrease gastric irritation, and I will take them in between doses of hydrocortisone." D) "Additional vitamins B6, C, folate, zinc, and phosphorous supplements need to be taken daily."
B
19. A client has been admitted in acute hypercalcemia and has been determined to have a serum calcium level of 12.9 mg/dL. What is the emergency department nurse's priority intervention? A) administration of IV calcitonin B) administration of IV normal saline C) oxygen supplementation D) subcutaneous administration of exogenous parathyroid hormone (PTH)
B
19. The nurse is educating an adult client diagnosed with adrenocortical carcinoma about the prescribed mitotane 6 g PO in divided doses. Which statement made by the client establishes the need for further clarification? A) "I should not drive or operate machinery while taking the drug." B) "The drug will eradicate my tumor and cure my cancer." C) "If I have a trauma or go into shock, the drug is temporarily stopped." D) "I should not drink alcoholic beverages while taking the drug."
B
19. What assessment findings would suggest to the nurse that a client may be experiencing an adverse effect to levothyroxine? A) constipation and abdominal distention B) hyperactivity and insomnia C) bradycardia and hypotension D) joint pain and decreased mobility
B
2. A client who has been taking oral prednisone for several months abruptly ceased treatment several days ago on the advice of a family member. The client has now been admitted to the emergency department with signs and symptoms that are characteristic of addisonian crisis. When assessing this client, the nurse should prioritize what assessment? A) assessment of urine for ketones B) assessment of serum potassium levels C) assessment for adventitious lung sounds D) assessment for venous thromboembolism
B
2. What distinguishing characteristic is associated with type 1 diabetes? A) Blood glucose levels can be controlled by diet. B) Exogenous insulin is required for life. C) Oral agents can control blood sugar. D) The disease always starts in childhood.
B
20. An older adult client has been prescribed metformin for the treatment of type 2 diabetes for several years. Which change in the client's laboratory values may demonstrate a need to discontinue the medication? A) a decrease in hemoglobin and hematocrit B) an increase in serum lactate C) a decrease in potassium accompanied by an increase in sodium D) an increase in white blood cells
B
3. What information should the nurse provide a client newly prescribed propylthiouracil about its primary mode of action? A) destroys part of the thyroid gland B) inhibits production of thyroid hormone C) suppresses the anterior pituitary hormones D) stimulates the thyroid cells
B
6. A 26-year-olds gradual development of a "moon face," coupled with protracted weight gain, has caused the nurse practitioner to suspect the possibility of Cushing's disease. When explaining this health problem to the client, how should the nurse describe it? A) "Cushing's disease happens when your pituitary gland doesn't stimulate your other glands enough." B) "Cushing's disease is a result of an overproduction of steroid hormones by your kidneys." C) "Cushing's disease most often happens when people are taking corticosteroid medications and stop them abruptly." D) "Cushing's disease often results from a growth on your kidney that causes inadequate production of steroids."
B
6. A 58-year-old client, diagnosed with diabetes at age 14, reports having pain in both feet and hands. What is this pain most likely a result of? A) a diabetes-related infectious process B) peripheral neuropathy C) an autoimmune disorder D) hypertension resulting from diabetes
B
6. The nurse is providing health education to an 80-year-old woman who has just been diagnosed with osteoporosis. Which is an accurate statement when teaching the client about this diagnosis? A) "Osteoporosis is usually a result of a bone injury." B) "Osteoporosis causes a risk for fractures." C) "Osteoporosis results from nonmodifiable risk factors." D) "Osteoporosis occurs only in women."
B
7. A client with a diagnosis of Cushing's disease has an increased risks of injury associated with what related disease process? A) hemorrhage and impaired hemostasis B) fractures and impaired wound healing C) neurovascular complications and rhabdomyolysis D) bruising and hematoma
B
18. The nurse prepares to administer ketoconazole 200 mg PO BID for an adult client diagnosed with Cushing's disease. Which measures would the nurse provide for safe and effective drug administration? Select all that apply. A) Administer the medication with 8 ounces of milk to increase absorption. B) Report yellow sclera, clay-colored stools, and elevated liver enzymes to prescriber. C) Instruct that the drug will lower serum cortisol to normal within 10 hours. D) Assess for increased muscle strength, improved cardiac status, normal glucose. E) Monitor for adverse effects: skin irritation with itching and nausea and vomiting.
B,D,E
12. A community health nurse is leading a health promotion workshop during a community health fair. A participant has asked the nurse for advice on the necessity of calcium supplements. The nurse should respond in the knowledge that which demographic group frequently has low calcium levels? Select all that apply. A) elementary-aged children B) young women C) middle-aged men D) middle-aged women E) older women
B,E
8. What expectorant is sometimes prescribed for the treatment of hyperthyroidism? A) propylthiouracil B) methimazole C) saturated solution of potassium iodide D) sodium iodide131
C
10. A client has been prescribed alendronate. Which instruction should the client be given regarding the administration of this medication? A) Take the medication with whole milk. B) Take the medication and lie down for 30 minutes. C) Take the medication on an empty stomach. D) Take the medication to increase bone resorption.
C
10. Hydrocortisone has been prescribed to a client for the treatment of Addison's disease. What action should the nurse should encourage the client to take regarding the self-administration of this medication? A) Should be taken at least 30 minutes before or 2 hours after meals. B) The best administration time is at bedtime. C) Should be taken before 09:00 each morning. D) Best is taken with an antacid.
C
11. A client is started on levothyroxine for treatment of hypothyroidism. During client teaching, how frequently can the dosage be increased until symptoms are relieved? A) every 3 to 5 days B) weekly C) every 2 weeks D) monthly
C
13. A client has been diagnosed with hypothyroidism and admits to the nurse that she has heard of her thyroid gland but does not know the function of thyroid hormone. The nurse should explain the fact that thyroid hormone is responsible for which action? A) regulating the levels of most other hormones in the body B) stimulating the brain and sex organs C) controlling the rate of cell metabolism throughout the body D) regulating levels of glucose in the blood and body tissuesC
C
13. 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? A) hydrochlorothiazide B) ibuprofen C) prednisone D) diltiazem
C
14. A client diagnosed with Cushing's disease will soon begin treatment with ketoconazole. The nurse should be cognizant of the black box warning for this drug and consequently monitor what laboratory values? A) white blood cell differential B) blood urea nitrogen and creatinine C) AST, ALT, and GGT D) hemoglobin, hematocrit, and red blood cell count
C
15. When assessing for therapeutic effects of mitotane in a client diagnosed with adrenocortical carcinoma, the nurse should expect to identify which outcome? A) decrease in agitation B) an audible S3 C) decrease in blood pressure D) decrease in urine output
C
16. A hospital client with a diagnosis of type 1 diabetes is prescribed Humulin R on a sliding scale. Based on the client's blood glucose reading, the nurse administered 8 units of insulin at 07:45. The nurse should consequently check the client's blood glucose level at what time to monitor peak effectiveness of the medication? A) 08:15 B) between 08:45 and 09:45 C) between 09:45 and 10:45 D) between 11:15 and 11:45
C
16. An older adult client has been diagnosed with osteoporosis and has begun taking alendronate. The nurse should be aware that this drug can increase bone density by which mean? A) decreasing renal excretion of calcium B) increasing the binding of vitamin D to calcium ions C) suppressing the function of osteoclasts D) enhancing the function of osteoblasts
C
18. The nurse knows that the lunch trays are usually distributed at approximately 12:15. The nurse should plan to administer the client's prescribed 4 units of regular insulin at what time? A) 12:15 B) 12:10 C) 11:45 D) 11:15
C
18. What assessment should the nurse perform prior to administration of a scheduled dose of levothyroxine? A) level of consciousness and orientation B) oxygen saturation level C) heart rate D) respiratory rate
C
20. An elderly adult woman has been diagnosed with postmenopausal osteoporosis and has been prescribed calcitonin. The nurse should anticipate administration by what route? A) oral B) topical C) intranasal D) intravenous
C
4. A client diagnosed with hypothyroidism is started on levothyroxine. What should the client be taught regarding medication administration in the home setting? A) Take medication with milk or food. B) Do not exercise with the medication. C) Take the medication on an empty stomach. D) Levothyroxine has a short half-life.
C
4. During a teaching session on the care of the diabetic client, the nurse should make which statement to explain the differences in insulin? A) "Insulin is prescribed based on the insurer's criteria for reimbursement." B) "Insulin is prescribed based on the client's age." C) "Insulins have different onsets and durations of action." D) "Insulin type is matched with the appropriate oral hypoglycemic agent."
C
5. A 55-year-old woman is diagnosed with a vitamin D deficit. What disorder results from this deficit? A) chondromalacia B) chondritis C) osteomalacia D) osteopenia
C
7. What is the medication of choice administered preoperatively to a client scheduled for a thyroidectomy to treat thyroid cancer? A) sodium iodide131 B) methimazole C) propylthiouracil D) propranolol
C
7. Which factor would contraindicate the administration of glipizide? A) a diagnosis of hypertension B) the ingestion of carbohydrates C) allergy to sulfonamides D) increase in alkaline phosphatase
C
8. A 60-year-old client with overall good health is to begin taking vitamin D supplements. What is the recommended supplement for this age group? A) 100 International Units daily B) 200 International Units daily C) 600 International Units daily D) 800 International Units daily
C
8. A client has been prescribed acarbose. What is the advantage of acarbose over alternative drugs? A) It can replace the use of insulin. B) The client does not have to limit food intake. C) It delays the digestion of complex carbohydrates. D) It prevents alkalosis.
C
9. A child has received a diagnosis of Addison's disease, and the nurse is providing health education to the child's family around hormone replacement therapy. When planning this child's care, the nurse should know that hormone replacement therapy constitutes a risk for what nursing diagnosis? A) latex allergic response B) deficient fluid volume C) delayed growth and development D) impaired gas exchange
C
1. An older adult client has been diagnosed with Paget's disease. Which serum electrolyte is altered in this disease process? A) sodium B) potassium C) chloride D) calcium
D
10. Which condition will warrant the tapering or possible discontinuation of propranolol? A) hyperthyroidism B) hypertension C) angina pectoris D) euthyroid state
D
1. An adult client has been experiencing severe lethargy and fatigue over the past several days, as well as feeling "shaky." Random blood glucose testing reveals a glucose level of 38 mg/dL, in spite of no significant change in the client's diet. The care team should suspect the possibility of what health problem? A) chronic renal failure B) acute renal failure C) Cushing's disease D) adrenal insufficiency
D
12. A client, who experienced hypoglycemia twice in the past week, states that he/she eats one meal per day and snacks the rest of the day. What client education will the nurse provide for a client who reports regularly experiencing hypoglycemic symptoms? A) A alcohol should be limited and taken only with meals. B) Daily caloric intake should be increase by 200 calories. C) Daily snacks should increase protein intake. D) Meals should be eaten at regular times.
D
12. In recent weeks, the client diagnosed with Addison's disease has experienced profound stress resulting from the collapse of his small business and subsequent conflict with his business partner. How might the presence of these stressors affect the client's long-term hydrocortisone medication regimen? A) The client should take the scheduled hydrocortisone later in the day. B) The ratio of mineralocorticoids to glucocorticoids should be adjusted. C) The client's hydrocortisone should be temporarily withheld. D) The client may temporarily require a higher dose of hydrocortisone.
D
13. An 8-month-old infant admitted with a new diagnosis of diabetes is to receive 1 unit of regular insulin. How will that 1 unit be administered? A) orally B) intravenously C) with a TB syringe D) dilution strength of U-10
D
14. Following the completion of diagnostic testing, an adult client has received a diagnosis of hyperthyroidism. What nursing diagnosis should the nurse prioritize in this client's care? A) risk for hypothermia related to hyperthyroidism B) constipation related to hyperthyroidism C) risk for imbalanced nutrition: less than body requirements related to hyperthyroidism D) anxiety related to hyperthyroidism
D
17. Before administering a prescribed 20 units of NPH insulin to a client, the nurse should implement which intervention? A) Massage the chosen injection site. B) Assess the client's understanding of diabetes. C) Assess the client's urine for the presence of glucose. D) Have a colleague confirm the dosage.
D
3. What type of insulin will most likely be administered intravenously to a client with a blood glucose level is over 600 mg/dL? A) NPH insulin B) Lente insulin C) Ultralente insulin D) regular insulin
D
3. When a client has an increased serum level of ionized calcium, which hormone will be released? A) insulin B) estrogen C) parathyroid hormone (PTH) D) calcitonin
D
7. A client reports numbness and tingling around the mouth and has a positive Trousseau's sign after a thyroidectomy. Which medication will be administered? A) parenteral normal saline B) parenteral potassium chloride C) parenteral digoxin D) parenteral calcium gluconate
D
9. A client, diagnosed with hyperthyroidism is scheduled to receive a medication to destroy the thyroid gland. Which medication will be administered? A) propylthiouracil B) methimazole C) saturated solution of potassium iodide D) sodium iodide131
D
