EXAM 3 ATI QUESTIONS EDOCRINE SYSTEM

A nurse is reviewing the medical record of a client who has diabetes insipidus and has been taking oral desmopressin. Which of the following findings indicates the client is having a therapeutic response to the medication? a Decreased urine output b Weight gain c Serum glucose level within the expected reference range d Increase in heart rate

a Decreased urine output Diabetes insipidus causes a large output of dilute urine to be excreted due to a deficiency of antidiuretic hormone or its release by the hypothalamus. Urine output can range from 4-30 L/day, and manifestations of dehydration are present (hypotension, tachycardia, dry mucous membranes, increased thirst, low urine specific gravity)

A nurse is caring for a client who has a new prescription for levothyroxine to treat hypothyroidism. Which the following findings should the nurse identify as an indication that the client requires intervention? a heart rate106/min b dry skin c oral temp 98.2 F d lethargy

a heart rate106/min Tachycardia can be a manifestation of hyperthyroidism, possible due to excessive hormone replacement. The client might require a lower dosage of levothyroxine.

A nurse is collecting data from a client who has hypothyroidism and takes levothyroxine. Which of the following findings indicates that the client is experiencing acute levothyroxine overdose? a bradycardia b Cold intolerance c tremor d hypothermia

c tremor Tremor and anxiety are expected findings in acute levothyroxine overdose. These findings are similar to those seen in hyperthyroidism

A nurse is reinforcing teaching with a client who has type 2 diabetes mellitus about storing unopened vials of insulin. Which of the following pieces of information should the nurse include in the teaching? a store the vials in the freezer b store the vials at room temperature c store the vials by a window d store the vials in the refrigerator

d store the vials in the refrigerator The nurse should tell the client to store unopened vials of insulin in the refrigerator. The client can use the unopened vials of insulin up to the printed expiration date

A nurse is assisting with the care of a client who has been diagnosed with an Addisonian crisis and has a blood pressure of 74/42 mmHg. Which of the following medication prescriptions should the nurse anticipate? A Desmopressin B Hydrocortisone C Dopamine D Furosemide

B Hydrocortisone Hydrocortisone assists with replacing cortisol levels in patients experiencing Addisonian crisis. A client with Addison's disease has adrenal corticoid insufficiency due to the pituitary's inability to produce cortisol. Addisonian crisis can cause sudden destruction to the adrenal gland/pituitary and be life threatening.

A nurse is teaching a client about acarbose therapy to treat type 2 diabetes mellitus. Which of the following instructions should the nurse include? 1 eat more iron rich foods 2 avoid drinking grapefruit juice 3 increase fiber intake 4 avoid drinking green tea

1 eat more iron rich foods Acarbose can cause iron deficiency anemia. The nurse should instruct the client to increase their intake of iron rich foods such as: red meats, spinach, and grains. The nurse should also monitor the clients CBC.

A nurse is providing teaching to a client who is about to begin exenatide therapy to treat type 2 diabetes. Which of the following instructions should the nurse include? Select all: 1 inject the drug subcutaneaously 2 expect the peak effect in 2 hrs 3 use the drug as a supplement to an oral hypoglycemic 4 inject the drug 1 hr after a meal 5 discard used pens 10 days after the first use

1 inject the drug subcutaneaously The client should inject exenatide into the sub-q tissue of the thigh, upper arm, or abdomen 2 expect the peak effect in 2 hrs Levels of exenatide peak 2 hrs. after administration and then decrease gradually with a half life of 2.4 hrs. 3 use the drug as a supplement to an oral hypoglycemic Exenatide supplements the action of an oral hypoglycemic such as metformin or sulfonylurea

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? 1 lactic acidosis 2 anticholinergic effects 3 extrapyramidal effects 4 hypophosphatemia

1 lactic acidosis Metformin can cause lactic acidosis which is a life threatening complication that manifests as muscle aches, sleepiness, malaise, and hyperventilation. The client should stop taking the drug and seek medical care immediately.

A nurse is providing teaching to a client about fludrocortisone to treat adrenocortical insufficiency. Which of the following instructions should the nurse include? Select all: 1 obtain weight measurement daily 2 report weakness or palpitations 3 have blood pressure checked regularly 4 eat more iron rich foods 5 avoid drinking grapefruit juice

1 obtain weight measurement daily fludrocortisone can cause fluid and electrolyte imbalances such as hypernatremia. Tracking weight on a daily basis can help identify weight gain and edema; reporting it can expedite any essential interventions 2 report weakness or palpitations fludrocortisone can cause hypokalemia. The nurse should monitor the clients potassium levels and tell the client to report muscle weakness or palpitations 3 have blood pressure checked regularly fludrocortisone can cause fluid retention and hypertension. The nurse should monitor the clients fluid balance and blood pressure to expedite any essential interventions.

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: 1 sore throat 2 joint pain 3 insomnia 4 bradycardia 5 rash

1 sore throat propylthiouracil can cause agranulocytosis. The nurse should monitor clients CBC and instruct the client to report fever or sore throat 2 joint pain PTU can cuase arthralgia and myalgia. The nurse should instruct the client to report these effects and take OTC analgesics for pain relief 4 bradycardia PTU can cause hypothyroidism, which manifests as bradycardia, drowsiness, and weight gain. 5 rash PTU can cause urticaria or skin rash.

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? 1 we will use a different spot for injection each time we give the medication 2 we'll give the shot in the thigh muscle rather than in the fatty tissue to decrease injection pain 3 we'll watch our child for signs of low blood sugar while using somatropin 4 we should stop the medication if our child loses weight.

1 we will use a different spot for injection each time we give the medication To avoid atrophy of the tissue, administration of somatropin includes rotating the injection site each time.

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? 1 thyrotoxicosis 2 hypothyroidism 3 lactic acidosis 4 radiation sickness

2 hypothyroidism PTU can cause hypothyroidism, which manifests as drowsiness, depression, weight gain, edema, and bradycardia. The nurse should request that the provider prescribes a lower dosage of the drug.

A nurse is caring for a client who takes repaglinide 15-30 mins before each meal to treat type 2 diabetes. The clients asks, "If I skip a meal, what should I do?" Which of the following responses should the nurse make? 1 double the dose before the next meal 2 take half the dose 3 skip the dose 4 take the usual dose

3 skip the dose To avoid a sudden and serious drop in blood glucose level, the client should skip the dose of repaglinide whenever skipping a meal. The nurse should also instruct the client to try to avoid skipping meals.

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: 1 blood amylase 2 creatinine clearance 3 urine calcium 4 blood glucose 5 CBC

3 urine calcium Somatropin can cause hypercalciuria. The nurse should monitor he clients urine calcium and instruct the client to report flank pain, urinary frequency, or hematuria. 4 blood glucose Somatropin can cause hyperglycemia. The nurse should monitor the clients blood glucose levels and instruct the client to report polyphagia, polydipsia, and polyuria.

A nurse is reinforcing teaching with a client who has primary adrenal insufficiency (Addison's disease) and a prescription for hydrocortisone. Which of the following statements should the nurse include in the teaching about this medication? A You may need to take a lower dosage when you are ill or experiencing stress B Take this medication before going to bed because it will make you tired C Carry a supply of pills and a single-use injectable preparation with you at all times D You will need to stop this medication before routine procedures such as a colonoscopy

C Carry a supply of pills and a single-use injectable preparation with you at all times Clients need to carry an emergency supply of the medication to take during times of unexpected stress. This supply should be carried at all times in injectable preparation plus a supply equal to the regular oral dosage. Single injectable should be administered IM in emergency cases

A nurse is reinforcing teaching with a client who has systemic lupus erythematosus and a new prescription for oral glucocorticoid therapy. Which of the following client statements indicates an understanding of the teaching? a I should take a calcium supplement while on this medication b I have to complete regular liver function studies while I am taking this medication c I can take NSAIDs to treat mild pain while using this medication d I will be sure to eat 6 small meals a day to prevent hypoglycemia from this medication

a I should take a calcium supplement while on this medication Remember glucocorticoids adverse effect is osteoporosis. Increasing calcium rich foods in clients diet and adding calcium and vitamin D supplements should be encouraged to prevent osteoporosis and decrease fracture risks

A nurse is reinforcing teaching with a client who is about to start taking propylthiouracil to treat hyperthyroidism. Which of the following statements should the nurse identify as an indication that the teaching has been effective? a I will need a lab test to check my liver function b I should take this medication once daily c If I get a rash, I'm probably having an allergic reaction d If I have difficulty sleeping, it's probably because of this medication

a I will need a lab test to check my liver function PTU is hepatotoxic and can cause severe liver injury. Client should report dark urine and yellowing eyes which indicate liver injury.

A nurse is preparing to administer levothyroxine to a client who has hypothyroidism. The nurse should identify which of the following laboratory results as supporting the administration of this medication? a Thyroid stimulating hormone (TSH) 8 microunits/mL b Free triiodothyronine (T3) 300 mcg/dL c Free thyroxine (T4) 7 mcg/dL d Thyroxine-binding globulin 2.3 mg/dL

a Thyroid stimulating hormone (TSH) 8 microunits/mL The expected range for TSH is 0.3-5 microunits/mL. When a client has primary hypothyroidism, the TSH level becomes elevated in an attempt to normalize the thyroid gland's function. When the client has had a therapeutic response to treatment, the TSH level returns to the expected reference range

A nurse is teaching a client who has type 1 diabetes mellitus about a new subcutaneous insulin infusion pump. Which of the following pieces of information should the nurse reinforce in the teaching? a plan to use a type of short-duration insulin in the infusion pump b replace the infusion pump set every 4 days c turn off the infusion pump for at least 3 hours each day d move the infusion pump catheter 1.27 cm (0.5 in) away from the old site

a plan to use a type of short-duration insulin in the infusion pump The client should plan to use short-duration such as regular, lispro. aspart, or glulisine insulin in the infusion pump to deliver a baseline infusion of insulin. The client should also administer bolus doses of insulin before each meal. The client should replace the infusion set every 1-3 days to maintain asepsis. Must maintain a constant infusion of insulin w/exception of removing the device special occasions for 1-2 hours

A nurse is reinforcing teaching with a client who has type 2 diabetes mellitus about self-administration of a new prescription for acarbose. Which of the following pieces of information should the nurse include in the teaching? a tell the client to take the medication with food b show the client how to perform an intramuscular injection c advise the client to avoid taking this medication with insulin d warn the client against exercising while taking this medication

a tell the client to take the medication with food Acarbose should be taken with food. The nurse should advise the client that this medication should be taken with the first bite of a meal 3 times each day. Acarbose inhibits an enzyme in the intestines that slows the digestion of carbohydrates and results in a lower postprandial increase of blood glucose levels.

A nurse is administering insulin glulisine 10 units subcutaneously at 0730 to an adolescent client who has type 1 diabetes mellitus. The nurse should anticipate the insulin's onset of action at which of the following times? a 0800 b 0745 c 0900 d 1030

b 0745 Insulin gluisine has a very short onset of action of 15 minutes. The nurse should expect the onset of action around 0745 and ensure the client eats breakfast immediately following the administration of the insulin

A nurse is reviewing the medication administration record of a client who ha impaired swallowing. The nurse should crush the medication when administering which of the following prescriptions? a Aspirin EC 80mg PO daily b Levothyroxine 75 mcg PO qAM before breakfast c Metformin XR 500 mg PO daily d Nitroglycerin 0.3 SL PRN chest pain

b Levothyroxine 75 mcg PO qAM before breakfast Levothyroxine can be crushed because it is not extended release, sublingual, or enteric coated. It should be mixed with 5-10 mL of water when crushed.

A nurse is caring for a client who has been taking metformin for 6 months. Which of the following findings should the nurse identify as an expected therapeutic effect of the medication? a decreased vitamin B12 levels b decreased blood glucose level c abdominal bloating and diarrhea d decreased LDL level

b decreased blood glucose level Metformin is a non-insulin medication for clients who have type 2 diabetes mellitus

A nurse is caring for a client who is taking acarbose to treat type 2 diabetes mellitus. For which of the following adverse effects of this medication should the nurse monitor? a insomnia b diarrhea c joint pain d polycythemia

b diarrhea. The most common side effect of acarbose are gastrointestinal. Diarrhea, abdominal distention, cramping and flatulence

A nurse is caring for a client with type 1 diabetes mellitus who has a prescription to administer regular insulin subcutaneously. Which of the following insulin durations should the nurse identify for regular insulin? a intermediate duration b short duration, slow acting c long duration d short duration, rapid acting

b short duration, slow acting The nurse should identify that regular insulin has a short duration with a slower acting time. The nurse should plan to administer regular insulin 30 minutes before meals

A nurse is caring for a client who has been receiving gastrostomy tube feedings and insulin. The client is scheduled to receive a tube feeding at 0700. At which of the following times should the nurse plan to administer insulin lispro subcutaneously? a 0600 b 0630 c 0645 d 0730

c 0645 Lispro is a rapid acting insulin with an onset of 15 minutes. The nurse should administer the insulin dose 15 min prior to the feeding.

A nurse is collecting data from a client who has type 2 diabetes mellitus and is taking metformin. Which of the following findings should indicate to the nurse that the medication is having a therapeutic effect? a tachycardia b fasting blood glucose level of 118 mg/dL c Glycosylated hemoglobin (HbA1c) of 6.8% d increased appetite

c Glycosylated hemoglobin (HbA1c) of 6.8% The nurse should identify that an HbA1c level of 6.8% is within the expected reference range of less than 7%, indicating the medication is having a therapeutic effect.

A nurse is caring for a client who is taking fludrocortisone. Which of the following findings indicates to the nurse that the client is experiencing an adverse effect of the medication? a Hypotension b Weight loss c Hypokalemia d Anorexia

c Hypokalemia The nurse should identify that hypokalemia is an adverse effect of fludrocortisone due to excessive sodium and water retention, resulting in the loss of excessive amounts of potassium. Other adverse effects: Hypertension, Edema and Heart failure

A nurse in a provider's office is collecting data from a client who has hypothyroidism and has been taking levothyroxine for 3 months. Which of the following statements by the client indicates that a decrease in the dosage of levothyroxine might be needed? a I have to take a laxative for constipation b I don't feel cold all the time anymore c I am having trouble getting to sleep at night d I am dieting but still not losing any weight

c I am having trouble getting to sleep at night Difficulty sleeping is a manifestation of hyperthyroidism. This statement by the client can indicate the dosage of levothyroxine needs to be reduced.

A nurse is caring for a client who was recently diagnosed with Addison's disease and placed on long-term mineralocorticoid therapy with fludrocortisone. Which of the following pieces of information should the nurse provide when explaining the purpose of this therapy? a Mineralocorticoids help the body metabolize carbohydrates, fats, and proteins b Mineralocorticoids support secondary sexual development c Mineralocorticoids maintain electrolyte and fluid balance d Mineralocorticoids reduce the risk of cardiac dysrhythmias

c Mineralocorticoids maintain electrolyte and fluid balance Mineralocorticoids-specifically aldosterone- are necessary for the regulation of fluid and electrolyte balance, particularly of sdium, potassium, and water. Fludrocortisone is the ONLY mineralocorticoid available.

A nurse us reinforcing teaching about glucocorticoid therapy with the parent of a child who has severe reactive airway disease. The parent asks why her child has to inhale the medication instead of taking it orally. Which of the following pieces of information should the nurse provide the parent? a Inhaled glucocorticoids are less likely to cause thrush b Oral glucocorticoids are hazardous during times of stress c Oral glucocorticoids are more likely to slow linear growth in children d Inhaled glucocorticoids are more effective for acute bronchospasm

c Oral glucocorticoids are more likely to slow linear growth in children Chronic use of oral glucocorticoids in high doses by children can result in decreased linear growth. Inhaled glucocorticoids deliver the anti-inflammatory agent directly to the local target area (airways) decreasing the risk for adrenal suppression.

A nurse is reinforcing teaching with a client who has hypothyroidism and is taking levothyroxine. The nurse should instruct the client to report which of the following manifestations to the provider? a weight gain b constipation c chest pain d fatigue

c chest pain Chest pain can result is client takes too much levothyroxine. It's important to increase the dosage gradually to prevent rapid changes in cardiac output that can cause tachycardia and angina, especially for clients who have longstanding hypothyroidism or cardiovascular disorders.

A nurse is monitoring a client who has diabetes insipidus and was administered desmopressin. Which of the following findings should indicate to the nurse the client is experiencing an adverse effect of this medication? a thirst b nocturia c headache d heart palpitations

c headache Headaches are an indicator of the adverse effect of water intoxication, which can occur as a result of taking desmopressin. This medication causes fluid retention and places the client at risk of water intoxication.

A nurse is reinforcing teaching with a client who has type 2 diabetes mellitus about a prescription for insulin lispro. Which of the following statements should the nurse include in the teaching? a the effects of the insulin lispro can last for 8-12 hours b administer insulin lispro 30-60 minutes before eating c insulin lispro has an onset of about 15 minutes d this insulin can be given as a continuous intravenous bolus

c insulin lispro has an onset of about 15 minutes. Insulin lispro is a rapid acting insulin and has an onset of 15-30 minutes

A nurse is reinforcing teaching about self administration of NPH insulin with a client who has type 2 diabetes mellitus. Which of the following instructions should the nurse include? a alternate injections between the abdomen and the thigh b shake the vial before withdrawing the dosage c rotate injection sites within the same area d discard the vial if the insulin is cloudy

c rotate injection sites within the same area To prevent lipodystrophy, the client should rotate injection sites, making them about 2.5 cm (1inch) apart within the same anatomical area

A nurse is reinforcing teaching with a client who has diabetes mellitus about a new prescription for pioglitazone. Which of the following statements should the nurse include in the teaching? a monitor for hypoglycemia 6 hours after taking the medication b this medication cannot be taken if you have a sulfa allergy c this medication can be taken when using insulin d this medication is effective for people with type 1 diabetes mellitus

c this medication can be taken when using insulin The client can take pioglitazone when using insulin because pioglitazone increases the cellular response to insulin, and insulin is needed in order for the medication to be effective.

A nurse is caring for a client who is taking a prescription for glucocorticoid adrenal replacement medication for the long-term treatment of Addison's disease. Which of the following findings indicates that the client is experiencing an adverse effect of the medication? a weight loss b hypotension c lethargy d Osteoporosis

d Osteoporosis Glucocorticoids inhibits bone growth and results in osteoporosis with long term treatment

A nurse is reinforcing teaching with a client who is taking levothyroxine to treat hypothyroidism and has a new prescription for a calcium supplement. Which of the following pieces of information should the nurse include in the teaching? a The calcium supplement will enhance the effect of the levothyroxine b The calcium supplement will accelerate the metabolism of the levothyroxine c Take the medications together at 1700 for greatest effect d Take the calcium supplement 4 hours apart from taking the levothyroxine

d Take the calcium supplement 4 hours apart from taking the levothyroxine Food or supplements containing iron, magnesium, or zinc also bind to levothyroxine and prevent complete absorption of the medication. It should be taken first thin in the morning on an empty stomach.

A nurse is reinforcing teaching with the guardian of a school-aged child about growth hormone therapy. Which of the following statements should the nurse include in the teaching? a Your child will grow an extra 4-6 inches while receiving hormone therapy b Hormone injection therapy will occur for 2-3 yrs. c Your child will receive hormone injections no more often than 1-2 times each week d The hormone injections are administered subcutaneously

d The hormone injections are administered subcutaneously This is the preferred route since the injections are more painful subcutaneously

A nurse is collecting data from a client who is taking vasopressin for diabetes insipidus. Which of the following findings should the nurse identify as a manifestation of water intoxication associated with this medication? a anxiety b urinary frequency c weight loss d headache

d headache The nurse should identify that a headache is a manifestation of water intoxication, an adverse effect of vasopressin. The nurse should report manifestation to the clients HCP.

A nurse in a provider's office is reinforcing teaching for a client who has type 2 diabetes mellitus and a new prescription for dulaglutide. Which of the following instructions should the nurse include? a administer the medication once daily at any time b swallow the medication whole c use this medication instead of insulin d nausea is an adverse effect that decreases over time

d nausea is an adverse effect that decreases over time Most common side effects nausea which decreases over time, pancreatitis. Client should instruct to notify HCP if abdominal pain, nausea with vomiting.

A nurse is preparing to administer 10 units of insulin glargine and 4 units of NPH insulin subcutaneously to a client. Which of the following actions should the nurse plan to take? a verify giving insulin glargine at 1700 with the provider b ensure the insulin glargine is a cloudy suspension c request a prescription for insulin glargine twice daily d use separate syringes for administering insulin glargine and NPH insulin

d use separate syringes for administering insulin glargine and NPH insulin DO NOT mix insulin glargine and insulin detemir with any other insulin. Should be administered separately (NPH insulin and insulin glargine)

A nurse at a providers 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? 1 hypotension 2 hyperglycemia 3 weight gain 4 fat redistribution

1 hypotension Hypotension and fatigue are findings of adrenal insufficiency. During times of stress, the client might need a dosage increase to prevent adrenal insufficiency. The nurse should report the findings to the provider.

A nurse is caring for a client who is about to begin taking pioglitazone to treat type 2 diabetes. The nurse should explain to the client about the need to monitor which of the following laboratory values? Select all: 1 Thyroid stimulating hormone TSH 2 Alanine aminotransferase ALT 3 LDL 4 CBC 5 Creatinine clearance

2 Alanine aminotransferase ALT pioglitazone can cause liver injury. The nurse should monitor ALT at the start of therapy and then every 3-6 months thereafter. 3 LDL pioglitazone can cause elevations in both high-density lipoproteins, which is a beneficial effect, and LDL's which is a detrimental effect. The nurse should monitor the clients plasma lipid levels at baseline and periodically throughout drug therapy.

A nurse is teaching a client who has a prescription for pramlintide therapy to treat type 1 diabetes. Which of the following instructions should the nurse include? 1 mix pramlintide with insulin in the syringe 2 administer pramlintide before meals 3 take pramlintide once daily at bedtime 4 inject pramlintide into the upper arm

2 administer pramlintide before meals Clients should take pramlintide 3 times a day with meals. Metformin is an endocrine system drug that clients take orally once per day with their evening meal.

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? 1 somatropin 2 hydrocortisone 3 glucagon 4 desmopressin

2 hydrocortisone Hydrocortisone provides replacement therapy for acute and chronic adrenocortical insufficiency such as Addison's disease. Hydrocortisone is identical to cortisol, the primary glucocorticoid the adrenal cortex generates

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 1 hypokalemia 2 hyperglycemia 3 acute renal failure 4 acute pancreatitis

3 acute renal failure Metformin can interact with iodine containing contrast dye and cause renal failure and lactic acidosis. The nurse should withhold metformin for 48 hrs. prior to and following the procedure. The nurse should also monitor the client for indications of acute renal failure or lactic acidosis such as: reduced urine output, hyperventilation, and abdominal pain.

Which of the following drugs should a nurse have available for a client who is experiencing insulin toxicity? 1 naloxone 2 diphenhydramine 3 acetylcysteine 4 glucagon

4 glucagon Glucagon a hyperglycemic that can be given subcutaneously, IM or IV is used to treat severe hypoglycemia from insulin toxicity in clients who are unconscious and for whom IV glucose is not readily available. If the client does not respond to glucagon, the nurse should administer a glucose solution IV.

A nurse administers pramlintide at 0800 to a client who has type 1 diabetes. At which of the following times should the nurse expect the drug to exert its peak action? 1 0820 2 0900 3 1030 4 1100

1 0820 Pramlintide peaks 20 mins after administration. The nurse should monitor for indications of hypoglycemia such as diaphoresis and tremors.

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? 1 avoid drinking alcohol 2 sit or stand for 30 mins. after taking the drug 3 urinate every 4 hrs. 4 take the drug 2 hrs. after a meal

1 avoid drinking alcohol The nurse should instruct the client to avoid drinking alcohol because it can interact with glipizide causing nausea, palpitations, and flushing. Alcohol increases hypoglycemic effects.

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? 1 drink 16 oz of water 2 perform a fingerstick blood glucose check 3 take another glipizide tablet 4 lie down and rest

2 perform a fingerstick blood glucose check Glipizide can cause hypoglycemia which can manifest as diaphoresis, shakiness, hunger, and fatigue. The nurse should tell the client to check their blood glucose level and if it indicates hypoglycemia to consume a snack of 15-20g (o.5 to o.7 oz) of carbohydrates, retest in 15-20 min, and repeat if their blood glucose level is still low.

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? 1 peripheral pulses 2 urine output 3 skin integrity 4 blood glucose

2 urine output Desmopressin is unlikely to alter peripheral pulses. Vasopressin another antidiuretic can cause vasoconstriction and angina pectoris. Desmopressin does not alter hemodynamics.

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? 1 oral contraceptives 2 calcium supplements 3 beta blockers 4 iron supplements

3 beta blockers Clients who take both insulin and beta blockers are at risk for failing to promptly recognize the symptoms of hypoglycemia because beta blockers mask symptoms such as tachycardia and tremors. Beta blockers also 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? 1 take levothyroxine with food to increase absorption 2 take levothyroxine with an antacid to reduce gastrointestinal effects 3 expect life-long therapy with the drug 4 carry a carbohydrate snack at all times

3 expect life-long therapy with the drug Therapy with levothyroxine usually continues for life because there are no other therapies that can restore thyroid function.

A nurse is caring for a client who is taking pioglitazone to treat type 2 diabetes. The nurse should monitor for which of the following findings? 1 joint pain 2 constipation 3 weight gain 4 dilated pupils

3 weight gain Pioglitazone can cause fluid retention. The nurse should monitor the client for weight gain and other indications of fluid retention or heart failure including: dyspnea, crackles, and wheezing

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? 1 rapid absorption 2 intradermal injection 3 injection pain 4 lipohypertrophy

4 lipohypertrophy Lipohypertrophy is a proliferation of fat at the sites of repeated insulin injections. It affects skin sensitivity and appearance. To prevent it, the client should rotate injection sites, keeping them at least 2.5 cm (1inch) apart, and avoid using the same spot within the same month.

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? 1 bacterial skin infections 2 diabetes insipidus 3 immunosuppression 4 recent myocardial infarction

4 recent myocardial infarction Levothyroxine can cause tachycardia, palpitations, and hypertension, especially when the client requires a dosage adjustment. Therefore, it is contraindicated for clients who have recently had a myocardial infarction.

A nurse should recognize that a provider will prescribe a lower dose of sitagliptin for a client who has type 2 diabetes and who also has which of the following? 1 thyroid disease 2 bronchitis 3 heart failure 4 renal impairment

4 renal impairment Sitagliptin requires cautious use with clients who have renal dysfunction and low creatinine clearance because the kidneys eliminate the drug virtually intact. The provider should prescribe a lower dose for this client or prescribe a different hypoglycemic drug,.

A nurse is caring for a client who is at 6 weeks gestation and has received a diagnosis of hyperthyroidism. The nurse should anticipate a prescription from the provider for which of the following medications? a Propylthiouracil b Liothyronine c Methimazole d Iodine-131

a Propylthiouracil (PTU) Used for 1st trimester of pregnancy because it doesn't cross the placental barrier well, posing little risk to the fetus.