PN NCLEX 6th Edition- Pharmacology/Endocrine

Which statement indicates that a client with Addison's disease knows how to safely manage a medication regimen that consists of daily doses of glucocorticoids?

"I will need to call my doctor for an increase in medication dose when I'm experiencing a lot of stress."

A client informs the nurse that she has been taking acarbose (Precose) as prescribed. The nurse determines that a therapeutic effect of the medication has occurred if which laboratory value is noted?

A 2-hour postprandial serum glucose of 120 mg/dL

The nurse is asked to prefill syringes containing NPH and regular insulin for a diabetic client who lives at home alone and has difficulty with seeing and accurately preparing dosages. Considering the stability of insulin, which number of prefilled syringes should the nurse prepare for the client?

A 7-day supply

A client experiencing preterm labor at 29 weeks' gestation has been admitted to the hospital. The client has a prescription to receive betamethasone. The nurse explains to the client that the medication will produce which effect?

Promote maturation of the fetal lungs.

The nurse is assisting in reinforcing a teaching plan for a client given a prescription for pioglitazone (Actos). The nurse plans to reinforce instructions to the client about which information related to this medication?

Signs of hypoglycemia

A client is scheduled for subtotal thyroidectomy. Potassium iodide (Lugol solution) is prescribed. The nurse understands that which outcome is the therapeutic effect of this medication?

Suppress thyroid hormone production.

A licensed practical nurse (LPN) is assisting in the care of a client who is receiving oxytocin (Pitocin) to induce labor. The LPN plans to notify the registered nurse immediately if which is noted?

The uterus becomes hyperstimulated.

Somatrem (Protropin) is administered to a client with pituitary dwarfism. Which is the expected therapeutic effect of this medication?

To stimulate linear growth

The nurse is reinforcing teaching for a client regarding how to mix regular insulin and NPH insulin in the same syringe. Which action performed by the client indicates the need for further teaching?

Withdraws the NPH insulin first

Which instruction should the nurse reinforce to the client with diabetes mellitus receiving acarbose (Precose)? Select all that apply

"Take the medication with each meal." "Side effects include abdominal bloating and flatus." "Take some form of glucose if hypoglycemia occurs." "Report symptoms such as shortness of breath or tiredness."

A client received a dose of regular insulin (Humulin R) this morning at 7:00 am. At which time should the nurse likely anticipate the potential for a hypoglycemic reaction to occur?

10:00 am

A client has self-administered his first injection of regular insulin at 7:30 am, before breakfast. This client should be instructed to closely monitor for signs of hypoglycemia at which time?

11:00 am

The nurse is monitoring a client receiving glipizide (Glucotrol). Which outcome indicates an ineffective response from the medication?

A glycosylated hemoglobin level of 12%

A client with myasthenia gravis verbalizes complaints of feeling much weaker than normal. The health care provider plans to implement a diagnostic test to determine if the client is experiencing a myasthenic crisis and administers edrophonium (Enlon). Which data would indicate that the client is experiencing a myasthenic crisis?

A temporary improvement in the condition

When discussing the rationale for levothyroxine (Synthroid) with a client with hypothyroidism, the nurse should emphasize that the client can anticipate which primary expected outcome?

Achieving normal thyroid hormone levels

A client with diabetes mellitus calls the clinic and tells the nurse that she has been nauseated during the night. The client asks the nurse if the morning insulin should be administered. Which is the appropriate nursing response?

Administer the full dose as prescribed.

A hospitalized client with severe seborrheic dermatitis is receiving treatments of topical glucocorticoid applications followed by the application of an occlusive dressing. The nurse monitors the client for which systemic effect that can occur as a result of this treatment?

Adrenal suppression

The nurse is collecting data from a client receiving pioglitazone (Actos) 30 mg orally daily. Which finding indicates that the client is experiencing the expected result of the action of this medication?

Decreased fasting blood glucose and reduced hemoglobin A1C (HbA1c)

Desmopressin acetate (DDAVP) is prescribed for the treatment of diabetes insipidus. The nurse monitors the client after medication administration for which therapeutic response?

Decreased urinary output

The nurse is monitoring a client receiving desmopressin acetate (DDAVP) for adverse effects to the medication. Which sign/symptom indicates the presence of an adverse effect?

Drowsiness

The nurse performs an admission assessment on a client who visits a health care clinic for the first time. The client tells the nurse that propylthiouracil (PTU) is taken daily. The nurse continues to collect data from the client, suspecting that the client has a history of which disorder?

Graves' disease

A client has a fasting blood glucose of 268 mg/dL at 7:30 am. The sliding scale prescriptions are blood glucose 151 to 200 mg/dL, administer 3 units Humalog insulin; 201 to 250, administer 6 units Humalog insulin; 251 to 300 mg/dL, administer 9 units Humalog insulin; over 300 mg/dL contact the health care provider. Therefore, at 7:30 am, how many units of Humalog should be administered?

Humalog 9 units

The nurse is monitoring a client receiving levothyroxine sodium (Synthroid) for hypothyroidism. Which findings indicate the presence of a side effect associated with this medication? Select all that apply.

Insomnia Weight loss Mild heat intolerance

The nurse is reinforcing instructions to a client regarding the administration of lypressin. The nurse instructs the client that the medication will be taken by which routes?

Intranasal

A client diagnosed with diabetes insipidus is beginning medication therapy with lypressin. The nurse realizes the client understands instructions if the client comments the medicine will be taken in which manner?

Intranasally to promote water reabsorption

A client who exhibits fatigue, lack of energy, constipation, and depression is diagnosed with hypothyroidism. The health care provider prescribes levothyroxine (Synthroid). To increase the likelihood of medication compliance in the early course of treatment, the nurse plans to reinforce which information?

The full therapeutic effect may take 1 to 3 weeks.

Fludrocortisone (Florinef) is prescribed for a client with Addison's disease. Which is the primary action of this medication?

To enhance the reabsorption of sodium and chloride ions in the distal tubules of the kidney

Glimepiride (Amaryl) is prescribed for a client with diabetes mellitus. The nurse reinforces instructions for the client and tells the client to avoid which while taking this medication?

Alcohol

A client is suspected of having myasthenia gravis, and the health care provider administers edrophonium (Enlon) to determine the diagnosis. After administration of this medication, which sign/symptom would indicate the presence of myasthenia gravis?

An increase in muscle strength

Humalog insulin is prescribed for a child with type 1 diabetes mellitus. The nurse is reinforcing a teaching session with the child and mother about the onset, peak, and duration times of the insulin. The nurse provides which information about this type of insulin?

Onset of 15 to 30 minutes from injection time, peak of 2 to 4 hours later, and duration time of 4 to 8 hours

The nurse preparing a client for surgery reviews the client's medication record. The client is to receive nothing by mouth (NPO) after midnight. Which medication noted on the client's record should the nurse question?

Prednisone

The nurse assists in developing a plan of care for a client with hyperparathyroidism receiving calcitonin-human (Cibacalcin). Which outcome has the highest priority regarding this medication?

Reaching normal serum calcium levels

The nurse reinforces instructions to a client who is taking levothyroxine (Synthroid). Which instruction should the nurse give the client?

Take the medication on an empty stomach.

Lispro (Humalog) insulin is prescribed three times a day, with the amount based on blood glucose levels. The nurse determines that the client understands teaching regarding lispro insulin if which statement is made?

"I will take the lispro 10 to 15 minutes before I eat breakfast, lunch, and dinner."

The nurse is preparing to administer an injection of regular insulin. The vial of the regular insulin has been refrigerated. On inspection of the vial, the nurse finds that the medication is frozen. Which action should the nurse take?

Discard the insulin and obtain another vial.

A client with a partial right adrenalectomy is placed on corticosteroid replacement therapy. Which data would indicate that the client is experiencing an adverse effect related to the pharmacological treatment?

Tarry stools

A client who will undergo thyroidectomy at a later date has been started on medication therapy with potassium iodide (SSKI). As the licensed practical nurse (LPN) prepares to administer a scheduled dose, the client states that there is a burning sensation and a brassy taste in the mouth. Which action should the LPN take?

Withhold the medication and notify the RN.

Prednisone 10 mg orally daily has been prescribed for a client. The nurse provides instructions to the client regarding the medication. Which statement by the client indicates that further teaching is needed?

"I can take acetylsalicylic acid (aspirin) or my antihistamine if I need it."

The community health nurse visits a client at home who has been prescribed prednisone 5 mg orally daily. The nurse reinforces teaching for the client about the medication. Which statement made by the client indicates a need for further teaching?

"I can take aspirin or my antihistamine if I need it."

The nurse realizes that the client taking metformin (Glucophage) needs further teaching when the client makes which statement?

"I should treat hypoglycemic episodes due to metformin with glucose tablets only."

The nurse is reinforcing instructions to the client about insulin glargine (Lantus). The nurse determines that the client understands the action of the medication if the client makes which statement?

"I will give myself this medication subcutaneously once each night before bed."

The nurse reinforces instructions to a client with myxedema about the dosage, method of administration, and side effects of levothyroxine sodium (Synthroid). Which statement by the client indicates an understanding of the nurse's instructions?

"I will report any episodes of palpitations, chest pain, or dyspnea."

Cortisone acetate (Cortone) is prescribed for a client with adrenal insufficiency, and the nurse reinforces instructions to the client regarding the medication. Which statement by the client would indicate a need for further teaching?

"I will stop the medication when I feel better."

Thyroid replacement therapy is prescribed for a client diagnosed with hypothyroidism. The client asks the nurse when the medication will no longer be needed. Which response by the nurse would be accurate?

"The medication will need to be continued for life."

An adult client with hypothyroidism is admitted to the hospital. When reviewing the client's health record, the nurse notes that the client is taking a maintenance dose of levothyroxine (Synthroid). Which is the range of the normal adult maintenance dose of this medication?

0.1 to 0.2 mg daily

The client plans to give their lispro (Humalog) insulin injection at 0800 right before eating breakfast. The nurse knows that the client understood the education provided when the client states which time presents the greatest risk for hypoglycemia?

0930

A client with an exacerbation of chronic obstructive pulmonary disease (COPD) has been on oral glucocorticoids and is being weaned to triamcinolone (Azmacort) by inhalation. The nurse determines that the client understands the potential adverse effects to watch for during this medication change when the client states to monitor for which?

Anorexia, nausea, weakness, and fatigue

A client is taking Humulin NPH insulin daily every morning. The nurse reinforces instructions to the client and should tell the client that which is the most likely time for a hypoglycemic reaction to occur?

4 to 12 hours after administration

A client received 20 units of NPH insulin subcutaneously at 8:00 am. The nurse should check the client for a potential hypoglycemic reaction at which time?

5:00 pm

A client has been prescribed acarbose (Precose) for treatment of diabetes mellitus. Client teaching regarding this medication should include which instructions? Select all that apply.

Abdominal cramping is common. Side effects include excessive flatulence. The medication should be taken with each meal.

A client receiving desmopressin (DDAVP) begins to complain of a headache. The nurse notes that the client is listless and falls asleep easily. The nurse interprets that the client is most likely experiencing which reaction?

Adverse medication effects

Prednisone is prescribed for a client with diabetes mellitus who is taking Humulin neutral protamine Hagedorn (NPH) insulin daily. Which prescription change does the nurse anticipate during therapy with the prednisone?

An increased amount of daily Humulin NPH insulin

Prednisone is prescribed for a client with diabetes mellitus who is taking NPH insulin daily. Which prescription should the nurse anticipate during therapy with the prednisone?

An increased amount of daily NPH insulin

The nurse is caring for a client with Paget's disease who has an elevated serum calcium level of 12.3 mEq/L. The nurse checks to see that which medication is available in the stock medication supply area for possible use to reverse this elevation?

Calcitonin (Calcimar)

Potassium iodide (Lugol's solution) is prescribed for a client. The client calls the nurse at the clinic and complains of a brassy taste and burning sensations in the mouth. How should the nurse respond?

Contact the health care provider.

A client is admitted with chest pain related to atrial fibrillation. Based on her blood glucose reading, metformin (Glucophage) is prescribed for the client. As the nurse reviews the client's chart and prescriptions, which finding would require the nurse to verify the metformin prescription? Refer to chart.

Creatinine result

A client is diagnosed with hypothyroidism, and levothyroxine (Synthroid) is prescribed. The nurse notes that the client is presently taking warfarin sodium (Coumadin) and anticipates that the health care provider will alter which medication dosage?

Decrease the dosage of warfarin sodium.

The nurse is collecting data from a client seen in the health care clinic for the first time. When the nurse asks the client about current prescribed medications, the client tells the nurse that metformin (Glucophage) is taken daily. Based on this finding, the nurse elicits data from the client regarding the presence of which condition?

Diabetes Mellitus

A client who has sustained an eye injury has been prescribed corticosteroid eye drops. The nurse should most carefully monitor for side effects of this medication if the client has which health problem listed on the medical record?

Diabetes mellitus

The home care nurse is visiting a client who was recently diagnosed with type 2 diabetes mellitus. The client is prescribed repaglinide (Prandin) and metformin (Glucophage) and asks the nurse to explain these medications. The nurse should reinforce which instructions to the client? Select all that apply.

Diarrhea can occur secondary to the metformin. The repaglinide is not taken if a meal is skipped. The repaglinide is taken 30 minutes before eating. Candy or another simple sugar is carried and used to treat mild hypoglycemia episodes.

A glucocorticoid is prescribed for a client with adrenal insufficiency, and the nurse reinforces medication instructions to the client. The nurse determines that the client needs further teaching if the client states which action is necessary?

Discontinue the medication when symptoms subside.

A daily dose of prednisone is prescribed for a client. The nurse reinforces instructions to the client regarding administration of the medication and instructs the client to take this medication at which time?

Early morning

A client diagnosed with hypothyroidism is taking levothyroxine (Synthroid). The client returns to the clinic 1 week after beginning the medication and tells the nurse that the medication has not helped. The appropriate nursing response to the client is based on which information?

Full therapeutic effect may take 1 to 3 weeks.

Metformin (Glucophage) is prescribed for a client with type 2 diabetes mellitus. Which should the nurse tell the client is a common side effect of the medication?

Gastrointestinal (GI) disturbances

A client newly diagnosed with diabetes mellitus is instructed by the health care provider to obtain glucagon hydrochloride (Glucagon) for emergency home use. The client asks the nurse about the purpose of the medication. The nurse tells the client that the purpose of the medication is to treat which aspect of diabetes?

Hypoglycemia from insulin overdose

Levothyroxine sodium (Synthroid) is prescribed for a client with hypothyroidism. When should the nurse encourage the client to take the medication?

In the morning

The nurse needs to mix Regular insulin (clear) and NPH insulin (cloudy) in the same syringe. Arrange the actions in the order that they should be performed. All options must be used.

Inject air into the NPH insulin vial. Inject air into the Regular insulin vial. Draw up the Regular insulin into the syringe. Draw up the NPH insulin into the syringe.

Insulin glargine (Lantus) is prescribed for a client with diabetes mellitus. The nurse tells the client that which is the best time to take the insulin?

Once daily, at the same time each day

A client with diabetes mellitus visits a health care clinic. The client's diabetes mellitus previously had been well controlled with glyburide (DiaBeta) daily, but recently the fasting blood glucose level has been 180 to 200 mg/dL. Which medication, added to the client's regimen, may have contributed to the hyperglycemia?

Prednisone

The home care nurse visits a client recently diagnosed with diabetes mellitus who is taking Humulin NPH insulin daily. The client asks the nurse how to store the unopened vials of insulin. The nurse should provide which information?

Refrigerate the insulin.

The nurse is reinforcing instructions to a client regarding intranasal desmopressin acetate (DDAVP). The nurse should tell the client that the medication has which side effect?

Runny nose

A client diagnosed with hyperthyroidism will be taking propylthiouracil (PTU). The nurse reinforces medication instructions and determines that the client understands the information if the client states that it is most important to report which symptoms to the health care provider?

Sore throat

Potassium iodide (Lugol solution) is prescribed for a client. The client calls the nurse in the health care provider's office and reports symptoms of a brassy taste in the mouth when taking the medication. Which instruction does the nurse reinforce to the client?

The health care provider will need to be notified for further medication instructions.

The health care provider (HCP) prescribes exenatide (Byetta) for a client with type 1 diabetes mellitus who takes insulin. The nurse knows that which is the most appropriate intervention?

The medication is withheld and the HCP is called to question the prescription for the client.

A client is seen in the clinic for complaints of thirst, frequent urination, and headaches. Following diagnostic studies, diabetes insipidus is diagnosed. Desmopressin acetate (DDAVP) is prescribed for the client. What would the nurse explain to the client as the purpose of the medication?

To increase water reabsorption

An oral hypoglycemic medication, a sulfonylurea, is prescribed for a client with type 2 diabetes mellitus. The nurse plans to administer the medication, knowing that what is the primary action of this medication?

To promote insulin secretion by the pancreas

The nurse is caring for a client after a thyroidectomy and notes that calcium gluconate is prescribed for the client. The nurse determines that this medication has been prescribed for which reason?

Treat hypocalcemic tetany.

The nurse reinforces medication instructions to a client who is taking levothyroxine (Synthroid). The nurse instructs the client to notify the health care provider (HCP) if which sign/symptom occurs?

Tremors

The nurse is teaching a client, newly diagnosed with diabetes mellitus, to mix 24 units NPH and 12 units regular insulin in the same syringe. What is the procedure for mixing the insulin? Arrange the actions in the order that they should be performed. All options must be used.

Wipe off both vials with an alcohol pad. Inject 24 units of air into the NPH insulin vial. Inject 12 units of air into the regular insulin vial. Draw up 12 units regular insulin into the syringe. Draw up 24 units of NPH insulin into the syringe.