Endocrine Pharm

The nurse is caring for a client after insertion of an implanted insulin pump. Which statement by the client indicates a need for further instruction?

"I need to make sure I still give my insulin before I eat."

The nurse teaches the client, who is newly diagnosed with diabetes insipidus, about the prescribed intranasal desmopressin. Which statements by the client indicate understanding? Select all that apply.

"I should decrease my oral fluids when I start this medication." "I should report headache and drowsiness to my health care provider since these symptoms could be related to my desmopressin."

The nurse determines that the client needs further instruction about prescribed thyroid replacement medication if which statement is made?

"I should expect full therapeutic effect from the medication within 3 to 5 days."

The client with hyperparathyroidism is taking alendronate. Which statements by the client indicate understanding of the proper way to take this medication? Select all that apply.

"I should sit up for at least 30 minutes after taking this medication." 4. "I should take this medication first thing in the morning on an empty stomach.

A medication has been prescribed for a client with hypoparathyroidism for management of hypocalcemia. The client arrives at the clinic for follow-up evaluation and complains of chronic constipation since beginning the medication. The nurse provides information to the client regarding measures to alleviate the constipation and determines that the client needs additional information when the client makes which statement?

"I will add ½ ounce of mineral oil to my daily diet."

A client newly diagnosed with diabetes mellitus is instructed by the health care provider to obtain glucagon for emergency home use. The client asks a home care nurse about the purpose of the medication. What is the nurse's best response to the client's question?

"It is for the times when your blood glucose is too low from too much insulin."

The diabetes nurse specialist conducts a teaching session to a group of nursing students regarding sulfonylureas, oral hypoglycemic medications used for type 2 diabetes mellitus. Which statement, describing the primary action of these medications, should the nurse include in the teaching session?

"Sulfonylureas promote insulin secretion by the pancreas."

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

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

The nurse administers 20 units of insulin isophane recombinant to a hospitalized client with diabetes mellitus at 7:00 a.m. The nurse should monitor the client most closely for a hypoglycemic reaction at which time?

4:00 p.m.

Somatropin, a growth hormone, is prescribed for a client. The nurse reviews the assessment data in the client's health record, knowing that the medication would be contraindicated for which client?

A 20-year-old with growth failure

A nurse is providing teaching regarding acarbose. The nurse should tell the client that which expected side or adverse effect(s) may occur with this medication?

A nurse is providing teaching regarding acarbose. The nurse should tell the client that which expected side or adverse effect(s) may occur with this medication?

Octreotide acetate is prescribed for a client with acromegaly. The nurse monitors the client, knowing that which side or adverse effect is associated with the administration of this medication?

Abdominal pain

A client with diabetes mellitus taking daily NPH insulin has been started on therapy with dexamethasone. The nurse anticipates that which adjustments in medication dosage will be made?

An increased dose of NPH insulin

Glyburide is prescribed for a client with type 2 diabetes mellitus. What is the most important instruction the nurse should provide to the client?

Assess for signs of hypoglycemia.

Insulin glargine is prescribed for a client with diabetes mellitus. The nurse should tell the client that it is best to take the insulin at which time?

At bedtime every day

A nurse is providing teaching regarding nateglinide. A portion of the teaching involves time of administration, and the nurse should tell the client to take the medication at which time?

Before each meal

A nurse is caring for a client with a diagnosis of hyperthyroidism. Laboratory studies are performed and the serum calcium level is 12.0 mg/dL (3 mmol/L). Which medication should the nurse anticipate to be prescribed for the client?

Calcitonin

A client is started on tolbutamide once daily. The nurse should instruct the client to monitor for which intended effect of this medication?

Decreased blood glucose

The nurse is assigned to care for several male and female clients who take estrogen or progestins. For which complication should the nurse monitor these clients?

Deep vein thrombosis (DVT)

The nurse is preparing to administer an intravenous (IV) insulin injection. The vial of regular insulin has been refrigerated. On inspection of the vial, the nurse finds that the medication is frozen. Which should the nurse do?

Discard the insulin and obtain another vial.

The nurse is preparing the client's morning insulin isophane dose. The nurse notices a clumpy precipitate inside the insulin vial. What is the most appropriate nursing action related to this finding?

Draw the dose from a new vial.

The health care provider has prescribed regular insulin 6 units and NPH insulin 20 units subcutaneously to be administered every morning. How should the nurse prepare to administer insulin?

Draw up the regular insulin first and then the NPH insulin in the same syringe.

A daily dose of prednisone is prescribed for a client. The nurse provides instructions to the client regarding administration of the medication and should instruct the client that which time is best to take this medication?

Early morning

Propylthiouracil is prescribed for a client with hyperthyroidism. The nurse provides instructions to the client regarding the medication and informs the client to notify the health care provider (HCP) if which sign or symptom occurs?

Fever

The nurse is teaching a client with hyperthyroidism about the prescribed medication, propylthiouracil. The nurse determines that teaching has been successful if the client states to report which symptom to the health care provider (HCP)?

Fever

The nurse is caring for a client who is receiving growth hormone replacement therapy. The nurse monitors the client for which option as an adverse effect of this therapy?

Hyperglycemia

A client is being treated with spironolactone. The nurse should monitor the client for which fluid/electrolyte imbalance?

Hyperkalemia

A client newly diagnosed with diabetes mellitus is instructed by the health care provider to obtain glucagon for emergency home use. The client asks the home care nurse about the purpose of the medication. The nurse should instruct the client that the purpose of the medication is to treat which problem?

Hypoglycemia from insulin overdose

The nurse evaluates that the family of a client newly diagnosed with diabetes mellitus correctly understands the reason for having glucagon on hand for emergency home use if the family indicates that the purpose of the medication is to treat which complication?

Hypoglycemia from insulin overdose

A client is taking Humulin NPH insulin and regular insulin every morning. The nurse should provide which instructions to the client? Select all that apply.

Hypoglycemia may be experienced before dinnertime. The insulin should be administered at room temperature.

Insulin lispro is prescribed for the client, and the client is instructed to administer the insulin before meals. When should the nurse instruct the client to administer the insulin?

Immediately before eating

The nurse is instructing a client who is taking levothyroxine and tells the client that full therapeutic benefits will be seen when?

In 1 to 3 weeks

A client has been taking glucocorticoids to control rheumatoid arthritis. Which laboratory abnormality is the client at risk for as a result of taking this medication?

Increased serum glucose

The nurse is completing a health history for an insulin-dependent client who has been self-administering insulin for 40 years. The client reports experiencing periods of hypoglycemia followed by periods of hyperglycemia. What is the most likely cause for this pattern of blood glucose fluctuation?

Injecting insulin at a site of lipodystrophy

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

Insomnia 2. Weight loss Mild heat intolerance

The clinic nurse develops a plan of care for a client with emphysema who will be started on long-term corticosteroid therapy. Which specific instruction should the nurse include in the plan of care?

Instruct the client to return to the clinic for monitoring of blood glucose levels.

A client with a recent history of total thyroidectomy has developed iatrogenic hypoparathyroidism. Which observed findings does the nurse determine are associated with the hypoparathyroidism? Select all that apply.

Laryngospasm Positive Chvostek's sign 5. Positive Trousseau's sign

A nurse is administering a prescribed dose of dexamethasone to a client following cranial surgery. Which would the nurse implement to assess for a common side effect of this medication?

Perform blood glucose monitoring.

A client with diabetes mellitus visits a health care clinic. The client's diabetes mellitus previously had been well controlled with glyburide daily, but recently the fasting blood glucose level has been 180 to 200 mg/dL (10.2 to 11.4 mmol/L). Which medication, if added to the client's regimen, may have contributed to the hyperglycemia?

Prednisone

Glimepiride is prescribed for a client with diabetes mellitus. The nurse instructs the client that which food items are most acceptable to consume while taking this medication? Select all that apply.

Red meats 3. Whole-grain cereals Carbonated beverages

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 tell the client to take which action?

Refrigerate the insulin.

The emergency department nurse is caring for a client admitted with diabetic ketoacidosis. The health care provider prescribes intravenous (IV) insulin. The nurse plans to prepare which type of insulin for the client?

Regular insulin

Somatropin is administered to a client with growth failure. A nurse monitors the client, knowing that which is the expected therapeutic effect of this medication?

Stimulate linear growth.

A nurse is caring for a client recently diagnosed with type 2 diabetes mellitus who has been prescribed sustained-release glipizide. What is the most important point for the nurse to include in teaching this client about this medication?

Swallow the medication whole and never crush or chew it.

A nurse provides instructions to a client taking fludrocortisone acetate. The nurse instructs the client to notify the health care provider (HCP) if which manifestation occurs?

Swelling of the feet

Acarbose is prescribed to treat a client with type 2 diabetes mellitus. Which instruction should the nurse provide when teaching the client about this medication?

Take the medication with the first bite of each regular meal.

The nurse is preparing to discharge a client who has had a parathyroidectomy. The discharge instructions include medication administration of oral calcium supplements that the client will need daily. Which statement by the nurse would be most appropriate regarding the oral calcium supplement therapy?

Take the tablets following a meal.

The nurse is providing instructions to a client with a diagnosis of Addison's disease regarding the administration of prescribed glucocorticoids. The nurse should provide which instruction to the client?

That an increased dose of medication may be needed during times of stress

The nurse should tell the client, who is taking levothyroxine, to notify the health care provider (HCP) if which problem occurs?

Tremors

The health care provider (HCP) prescribes exenatide for a client with type 1 diabetes mellitus who takes insulin. The nurse should plan to take which most appropriate intervention?

Withhold the medication and call the HCP, questioning the prescription for the client.

The nurse teaches the client being discharged to home with a prescription for a daily dose of prednisone to take the medication at which best time?

`In the early morning

When teaching the client with adrenal insufficiency about cortisone, the nurse should include which items? Select all that apply.

Take the medication with food. 3. Increase intake of potassium-rich foods. 4. Stay away from people with active infections. Notify the health care provider if illness occurs or surgery is anticipated

Acarbose is prescribed for a client diagnosed with type 2 diabetes mellitus. What should the nurse include in the client's instructions?

Take the medication with the first bite of each meal.

An 8-year-old boy is being treated with desmopressin. Understanding the purpose of this medication, the nurse should set which client goal?

The boy will have 5 nights in sequence without enuresis.

A client is receiving somatropin. The nurse should monitor which most significant laboratory study during therapy with this medication?

Thyroid-stimulating hormone level

Potassium iodide is prescribed for a client with thyrotoxic crisis. The client calls a clinic nurse and complains of a brassy taste in the mouth. Which instruction should the nurse provide the client?

Withhold the medication and notify the health care provider (HCP).

A nurse caring for a 23-year-old client newly diagnosed with type 1 diabetes mellitus teaches the client insulin administration. Which statement by the client indicates a need for further teaching?

"I will rotate my insulin injection between my arms, thighs, and abdomen on a daily basis."

The nurse teaches a client newly diagnosed with type 1 diabetes about storing Humulin N insulin. Which statement indicates to the nurse that the client understood the discharge teaching?

"I can store the open insulin bottle in the kitchen cabinet for 1 month."

The nurse is teaching the client about his prescribed prednisone. Which statement, if made by the client, indicates that further teaching is necessary?

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

The nurse is providing discharge teaching for a client newly diagnosed with type 2 diabetes mellitus who has been prescribed metformin. Which client statement indicates the need for further teaching?

"I need to constantly watch for signs of low blood sugar."

A client who has been taking iodine solution is admitted to the emergency department, and an iodine overdose is suspected. Gastric lavage is initiated to remove the iodine from the stomach. In addition to treatment with gastric lavage, the nurse anticipates that which medication will be administered?

Sodium thiosulfate

A client arrives at the clinic complaining of fatigue, lack of energy, constipation, and depression. Hypothyroidism is diagnosed, and levothyroxine is prescribed. What is an expected outcome of the medication?

Achieve normal thyroid hormone levels

A client arrives at the clinic complaining of fatigue, lack of energy, constipation, and depression. Following diagnostic studies, hypothyroidism is diagnosed and levothyroxine is prescribed. The nurse informs the client that which is the expected outcome of the medication?

Achieve normal thyroid hormone levels.

A client with hyperthyroidism has been given methimazole. Which nursing considerations are associated with this medication? Select all that apply.

Administer methimazole with food. Assess the client for unexplained bruising or bleeding. 4. Instruct the client to report side and adverse effects such as sore throat, fever, or headaches.

A client with a history of coronary artery disease has developed diabetes insipidus as a result of cranial surgery. The client's medication therapy will include vasopressin. The nurse monitors this client most carefully for which sign or symptom that indicates a side or adverse effect of this medication?

Chest pain

The nurse in the health care clinic is reviewing the record of a client with diabetes mellitus who was just seen by the health care provider (HCP). The nurse notes that the HCP has prescribed metformin. What preexisting disorder, if noted in the client's record, would indicate a need to collaborate with the HCP before instructing the client to take the medication?

Emphysema

A sulfonamide is prescribed for a client with a urinary tract infection. The client has diabetes mellitus and is receiving tolbutamide. Because the client will be taking these 2 medications, which prescription should the nurse anticipate for this client?

Decreased dosage of tolbutamide

The client with a traumatic brain injury (TBI) has begun excreting copious amounts of dilute urine through the Foley catheter. The client's urine output for the previous shift was 3000 mL. The nurse expects that the health care provider will prescribe which medication?

Desmopressin

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

Diabetes mellitus

The nurse monitors the client taking octreotide acetate for acromegaly for which most common side or adverse effect of this medication?

Diarrhea

The home health care nurse is visiting a client who was recently diagnosed with type 2 diabetes mellitus. The client is prescribed repaglinide and metformin. The nurse should provide which instructions to the client? Select all that apply.

Diarrhea may occur secondary to the metformin. 2. The repaglinide is not taken if a meal is skipped. 3. The repaglinide is taken 30 minutes before eating. 4. A simple sugar food item is carried and used to treat mild hypoglycemia episodes.

The nurse is preparing a dose of 10 units of regular insulin and 35 units of NPH insulin for a client with type 1 diabetes mellitus. The nurse obtains an insulin syringe, gently rotates the insulin solutions, cleans the tops of the vials of insulin, and injects an amount of air equal to the dose prescribed into each vial. What is the next nursing action?

Draws up 10 units of regular insulin and checks the syringe contents with another nurse before drawing up the NPH insulin

The nurse provides instructions to a client who is taking levothyroxine. The nurse should tell the client to take the medication in which way?

On an empty stomach

The nurse is caring for a client with a history of heart failure just diagnosed with type 2 diabetes mellitus. The health care provider prescribes an oral hypoglycemic for the client. Which oral hypoglycemic medication prescribed for this client should the nurse question?

Pioglitazone

A client scheduled to undergo subtotal thyroidectomy is taking a potassium iodide solution. The client complains to the nurse that she is experiencing a brassy taste in her mouth when taking the medication. Which instruction should the nurse provide to the client?

Report the symptom to the health care provider (HCP).

Metformin is prescribed for a client with type 2 diabetes mellitus. What is the most common side effect that the nurse should include in the client's teaching plan?

Gastrointestinal disturbances

A client is started on tolbutamide once daily. When should the nurse tell the client to take the medication?

At breakfast

The nurse provides education to the client with hyperthyroidism about potassium iodide before medication administration. The client is scheduled for a subtotal thyroidectomy. Which response by the client indicates understanding?

"It suppresses thyroid hormone."

Cortisone acetate is prescribed for a client with adrenal insufficiency. The nurse provides instructions to the client regarding the medication. Which statement, if made by the client, indicates a need for further instruction?

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

The nurse is providing education to a client with type 2 diabetes about starting insulin glargine to help with improved glycemic control. Which statement made by the client indicates understanding?

"It has a decreased risk for hypoglycemia."

The nurse provides family teaching to the mother of a 13-year-old client with pituitary dwarfism who is on growth hormone therapy. Which statement by the mother indicates that teaching has been successful?

"My child will have an immediate increase in growth."

The nurse is providing instructions to the client newly diagnosed with diabetes mellitus who has been prescribed pramlintide. Which instruction should the nurse include in the discharge teaching?

"Take your prescribed pills 1 hour before or 2 hours after the injection."

A client with diabetes mellitus is self-administering NPH insulin from a vial that is kept at room temperature. The client asks the nurse about the length of time an unrefrigerated vial of insulin will maintain its potency. What is the most appropriate response to the client?

1 MONTH

The nurse monitors the blood glucose level of the client who received NPH insulin at 7 a.m. with an understanding that the client may experience a hypoglycemic reaction during which time frame?

11 a.m. to 7 p.m.

A client received 20 units of Humulin N insulin subcutaneously at 08:00. At what time should the nurse plan to assess the client for a hypoglycemic reaction?

17:00

A hospitalized client with diabetes mellitus receives NPH insulin in the morning. The nurse monitors the client for hypoglycemia, knowing that the peak action is expected to occur how soon after the medication administration?

4 to 12 hours after administration

The nurse is monitoring a client receiving glipizide. The nurse knows that which finding would indicate a therapeutic outcome for this client?

A decrease in polyuria

Levothyroxine is prescribed for a client diagnosed with hypothyroidism. Upon review of the client's record, the nurse notes that the client is taking warfarin. Which modification to the plan of care should the nurse review with the client's health care provider?

A decreased dosage of warfarin sodium

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

Administer the full dose as prescribed.

Vasopressin is prescribed for a client with diabetes insipidus. The nurse should be particularly cautious in monitoring a client receiving this medication if the client has which preexisting condition?

Coronary artery disease

A client with previously well-controlled diabetes mellitus has had fasting blood glucose levels ranging from 180 to 200 mg/dL. The client takes glyburide 5 mg orally daily. In reviewing the client's medication list, the home health care nurse suspects that which newly added medications could be contributing to the elevated blood glucose levels?

Prednisone

The nurse is educating a client about medroxyprogesterone. The nurse should provide the client with which information about the medication?

Should be administered intramuscularly every 3 months

Glyburide daily is prescribed for a client. What instruction should the nurse include in the client's teaching plan?

Take the medication in the morning before breakfast.

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

Withdraws the NPH insulin first

A client is seen in the clinic for complaints of thirst, frequent urination, and headaches. After diagnostic studies, diabetes insipidus is diagnosed. Desmopressin is prescribed. The client asks why this medication was prescribed. Which is a correct statement by the nurse?

"It increases water reabsorption."

A client with diabetes insipidus asks the nurse about the purpose of a new medication, vasopressin. The nurse provides teaching about the medication. Which statement by the client indicates successful teaching?

"It prevents me from 'peeing' so much."

A client diagnosed with hypothyroidism is taking levothyroxine. The client returns to the clinic 1 week after beginning the medication and tells the nurse that the medication has not helped. What is the appropriate nursing response to the client?

Full therapeutic effect may take 1 to 3 weeks.

Metformin is prescribed for a client with type 2 diabetes mellitus. The nurse should tell the client that which is the most common side or adverse effect of the medication?

Gastrointestinal (GI) disturbances