PrepUs 44, 43, 42
A nurse should recognize that a client taking antithyroid medication may be developing thyrotoxicosis if the client exhibits which of the following symptoms?
Extreme tachycardia
The endocrine system consists of several organs and glands that secrete hormones. What gland is responsible for coordination between the endocrine system and the nervous system?
Hypothalamus
The pharmacology instructor is diagramming the nervous and endocrine systems. What organ would the instructor diagram as the connector between the nervous and endocrine systems?
Hypothalamus
The physiology instructor is talking with the class of nursing students. What would the instructor explain to the students is the connecting link between the nervous system and the endocrine system?
Hypothalamus
The pharmacology instructor is providing education regarding propylthiouracil to the nursing students. What would the instructor identify as the primary mode of action for this medication?
Inhibition of production of thyroid hormone
A client is experiencing an increase in blood glucose levels. The nurse understands that which hormone would be important in lowering the client's blood glucose level?
Insulin
A client is to receive nafarelin. The nurse would instruct the client in administering this drug by which route?
Intranasal
A client diagnosed with hyperthyroidism is unsure about the need for the prescribed propranolol, stating, "I looked this up online and it's for high blood pressure, not thyroid problems." What statement concerning beta-adrenergic blockers should the nurse use as a basis for the response?
It will block stimulation of the sympathetic nervous system.
A client is diagnosed with liver disease. How would this affect the metabolism of the drugs used to treat the client's hypothyroidism?
It would be prolonged.
The nurse knows that phosphates should be given only when hypercalcemia is accompanied by hypophosphatemia. Hypophosphatemia is assumed when the serum phosphorus is less than what level?
Less than 3 mg/dL
An older adult has been prescribed a thyroid hormone replacement medication. The nurse should first clarify which prescription?
Levothyroxine (Synthroid) 150 mcg orally once per day
The nurse should teach clients who are taking thyroid hormones to take the medication:
on an empty stomach
A client diagnosed with excessive parathyroid production is prone to develop:
osteopenia.
Symptoms such as severe tachycardia, fever, dehydration, heart failure, and coma are consistent with what thyroid-associated health condition?
thyroid storm
Bisphosphonates are drugs that bind to bone and inhibit calcium resorption from bone. These drugs are used to treat hypercalcemia. Which of the following are bisphosphontes? Choose all that apply.
• risedronate (Actonel) • ibandronate (Boniva) • alendronate (Fosamax)
The main drugs approved for prevention and treatment of osteoporosis are the bisphosphonates (e.g., Fosamax, Actonel). Which of the following characteristics describe bisphosphonates? Choose all that apply.
Prevent the loss of calcium Should be taken with 6 to 8 ounces of water at least 30 minutes before eating any food
What is the duration of action of water-soluble, protein-derived hormones compared to that of lipid-soluble steroid and thyroid hormones?
The water-soluble hormones have a shorter duration of action.
A nurse is caring for a patient undergoing thyroid hormone replacement therapy. What should the nurse inform this patient regarding administration of the drug?
Take the drug before breakfast.
During a general health assessment, a client indicates taking thyroid medication to increase weight loss. What statement should be the basis of the nurse's response?
Taking excessive or unnecessary thyroid medication may produce serious or life-threatening manifestations of toxicity.
How are lipid-soluble steroid and thyroid hormones typically inactivated?
They are typically conjugated in the liver to inactive forms and then excreted in bile or urine.
Hormones are chemicals produced in the body to perform specific functions. What is a characteristic of a hormone?
They travel through the blood to specific receptor sites throughout the body
The nurse is assessing a child who is receiving growth hormone therapy. What would the nurse identify as suggesting glucose intolerance?
Thirst
When describing desmopressin to a group of students, the instructor explains that it is a synthetic form of:
antidiuretic hormone
Deficiency of which hormone causes polyuria and polydipsia?
antidiuretic hormone (ADH)
Which hormone is released in the presence of low blood volume?
antidiuretic hormone (ADH)
A female client is diagnosed with a pituitary hormone deficiency. She reports that her drug dosages are modified frequently. The nurse explains that the dosage of all pituitary hormones must be individualized. The nurse knows that what factor determines the dosage?
The responsiveness of affected tissues, which varies
A client presents at the clinic with weight loss despite an increased appetite. The nurse knows this client should be assessed for:
hyperthyroidism
A client relates feeling run down, sleeping poorly, feeling more irritable than usual, and having problems remembering things. Based upon these data, what hormonal problem is the client likely experiencing?
hypoparathyroidism
A nurse is caring for a client with subacute lymphocytic thyroiditis. The health care provider prescribes thyroid hormones to the client. From which sign during ongoing assessment should the nurse conclude that the client is responding to the therapy?
increased appetite
When describing thyroid function, the nurse would emphasize the need for intake of:
iodine.
A female client presents to the emergency department with symptoms and laboratory values indicative of hypercalcemia. What IV solutions would the health care provider order to treat the hypercalcemia?
Sodium chloride (0.9%)
`Which of the following statements accurately describes the the release of steroid hormones?
Steroid hormones are released as they are synthesized.
A patient is to receive pegvisomant. The nurse would expect to administer this agent by which route?
Subcutaneous
Growth hormones cause all of the following EXCEPT:
Suppression of triglyceride synthesis.
A client is receiving a thyroid hormone to treat hypothyroidism. Which would indicate to the nurse that the client needs a reduced dosage of the drug?
Tachycardia
The nurse is educating a client who has received a prescription for ibandronate for osteoporosis. What prescription instruction is correct for this drug?
Take 150 mg once a month on the same day of the month
Levothyroxine (Synthroid) 88 mcg is prescribed for a client. How many mg of Synthroid will the nurse administer? Do NOT round the answer.
0.088
Alendronate (Fosamax) is prescribed for a patient. Which statement made by the patient will indicate to the nurse that further instruction is needed?
"I can go back to bed as soon as I take this drug."
The nurse educates a client recently diagnosed with hypothyroidism about using the prescribed levothyroxine. The client has a history of diabetes. Which client statement establishes the need for further clarification?
"It does not matter which brand of the drug I take, they are all the same."
The nurse is providing client teaching regarding the administration of levothyroxine (Synthroid). What is the nurse's priority teaching point?
"Take the medication with a full glass of water."
A pregnant client asks about the safety of taking thyroid hormone replacement drugs during her pregnancy. What is the nurse's best response?
"Thyroid hormones are pregnancy category A drugs and should be taken during pregnancy."
The nurse is caring for a client with osteoporosis who has been prescribed zoledronic acid. What should the nurse teach the client about the administration of this medication?
"You'll be given this drug as a one-time intravenous dose."
A nurse is discussing nutrition with a group of older adults at a community senior center. The nurse informs the group that the recommended daily calcium intake is:
1000-1500 mg
The nurse is caring for a client who is being monitored for hypercalcemia. The nurse understands that what calcium level is considered a medical emergency?
12mg/dL
The nurse receives an order to administer leuprolide 5 mcg/kg subcutaneously to a child with precocious puberty. The child weighs 66 lbs. What is the correct dosage for this child?
150
Some hormones are secreted in cyclic patterns. How long is the time pattern related to secretion of estrogen and progesterone?
28 days
A child weighing 14.5 kg has von Willebrand's disease. The patient requires an intravenous injection of 0.3 g/kg of desmopressin (DDAVP) in 10 mL of sterile saline. How much DDAVP should be administered?
4.4 g
A child weighing 14.5 kg has von Willebrand's disease and has been prescribed desmopressin 0.3 mcg/kg IV. How much desmopressin (DDAVP) should the nurse administer?
4.4 mcg
A child with von Willebrand's disease requires an intravenous injection of 0.3 mcg/kg of desmopressin in 50 mL of sterile saline. The child weighs 15 kg. How much desmopressin should be administered?
4.5 mcg
The nurse educates a client newly diagnosed with hypothyroidism that replacement therapy usually continues until the client is euthyroid for how long?
6 to 12 months
A 43-year-old male client takes prednisone 7.5 mg daily to treat his temporal arteritis. His dose varies from 7.5 to 10 mg based on symptoms and laboratory test analysis. His disease process has been managed successfully with this drug regimen for 7 years. To prevent osteoporosis, what would his health care provider order? (Select all that apply.)
A calcium supplement A bisphosphonate drug Regular weight-bearing exercise
Which of the following are secreted in 24-hour (circadian) cycles?
ACTH, cortisol, and growth hormone
A client is diagnosed with diabetes insipidus. The health care provider orders desmopressin, which the nurse knows is the synthetic equivalent of what hormone?
ADH
What hormone does the posterior pituitary gland store and release?
ADH
Deficiency of which hormone causes excessive and frequent urination and excessive thirst?
ADH deficiency
An 8-year-old male is being treated for asthma, a chronic inflammatory disease of the airways. What hormone might the health care provider order to treat this client?
Adrenal cortex hormones
A nurse is caring for a patient suffering from a severe form of hyperthyroidism called thyrotoxicosis or thyroid storm. Which of the following should the nurse observe in the patient as a characteristic of thyroid storm?
Altered mental status
A health care provider has prescribed thyroid drugs to a client with euthyroid goiter. Which should the nurse include in the nursing diagnosis checklist?
Anxiety related to symptoms, adverse reactions, and treatment regimen
The health care provider has prescribed growth hormone for a 12-year-old boy with growth impairment. The boy's parents should be instructed to contact the provider if they notice which signs in their son?
Any of the above
The home care nurse may be involved in a wide range of activities when caring for the client with hyperthyroidism or hypothyroidism. What would be included in the client's plan of care? (Select all that apply.)
Assessing the client's response to therapy Teaching about the disease process Preventing and managing adverse drug effects
When growth in a child is impaired by a deficiency of endogenous growth hormone, somatropin may be prescribed. When in the period of growth and development must somatropin (Humatrope) be administered to children?
Before epiphyses closure
What medications when prescribed would treat a serum calcium level of 13.8 mg/dl? Select all that apply.
Bisphosphonates such as alendronate Calcitonin-salmon such as miacalcin Glucocorticoids such as hydrocortisone
The nurse is providing discharge instructions to a client who will be self-administering octreotide for treatment of acromegaly. The nurse instructs the client to schedule which follow-up/diagnostic tests while on octreotide? (Select all that apply.)
Blood glucose Ultrasound of the gallbladder for gallbladder stones
The following are examples of calcium and vitamin D preparations. Which of them are oral preparations for calcium supplementation? Choose all that apply.
Calcium acetate (PhosLo) Calcium carbonate (Os-Cal, Tums) Calcium citrate (Citracal)
Clients prescribed both calcium and tetracycline should receive what medication instructions?
Calcium should be taken more than 2 to 3 hours before or after taking tetracycline
Insulin is a hormone that affects the human cell by reacting with membrane receptor sites. What does this reaction cause to happen?
Changes the cell permeability to glucose
The pharmacology instructor is discussing hormones with the nursing students. What hormone, important in the digestive process, is secreted by the gastrointestinal mucosa?
Cholecystokinin
A client is to undergo fertility treatment and is to receive an agent that induces ovulation because her ovaries are functioning. Which agent would this most likely be?
Chorionic gonadotropin
An 11-year-old client with growth failure due to lack of growth hormone has somatropin (Saizen) administered. What outcome would indicate that the drug should be stopped?
Closure of the epiphyses in long bones
The primary function of the thyroid gland includes:
Control of cellular metabolic activity
The adrenal cortex influences glucose levels through the production of which hormone?
Cortisol
A nurse is caring for a patient with hypothyroidism. The nurse would know that the effects of hypothyroidism include:
Decreased cardiac output
The nurse is caring for a client with severe hypothyroidism and knows to contact the health care provider if which symptoms of myxedema coma occur? (Select all that apply.)
Decreased level of consciousness Decreased respirations Decreased blood pressure
After administering desmopressin to a client with diabetes insipidus, which would the nurse identify as indicating drug effectiveness?
Decreased reports of thirst
A client diagnosed with diabetes insipidus is taking vasopressin (Desmopressin). What outcome would indicate to the nurse that the desmopressin is producing a therapeutic effect?
Decreased urine output
A client diagnosed with TSH suppression has been prescribed levothyroxine sodium (T4). The nurse caring for the client should monitor for which adverse reaction to levothyroxine sodium (T4)?
Diarrhea, vomiting
A patient is diagnosed with hypocalcemia. The nurse knows that which statement regarding hypocalcemia is correct?
Hypocalcemia can be accompanied by hyperphosphatemia.
A 4-year-old is tested and found to have deficient GH. What does this condition cause in children?
Dwarfism
The kidneys produce a hormone that stimulates the bone marrow to produce red blood cells. What is the name of this hormone?
Erythropoietin
The most common cause of subclinical hyperthyroidism is:
Excess thyroid hormone therapy.
The nurse would contact the health care provider prior to administering desmopressin to a client with a history of what condition?
Heart attack
The nurse is preparing to administer levothyroxine to a client. Which assessment finding would cause the nurse to hold the medication?
Heart rate of 110 beats per minute
What is the best position for the client after the administration of a bisphosphonate medication?
High Fowler's
Predisposing factors for myxedema coma include all of the following EXCEPT:
History of Lupus.
A female client presents to the health care provider's office for a routine physical examination. The nurse assesses her current over-the-counter drug history and discovers that she takes vitamin D 600 international units daily. The nurse recognizes that the client is at risk for what condition?
Hypercalcemia
A patient is diagnosed with hypercalcemia. The nurse knows that which statement regarding hypercalcemia is correct?
Hypercalcemia can lead to calcium deposits that damage the kidneys.
A client presents at the clinic reporting weight loss despite an increased appetite. For which condition should this client be assessed?
Hyperthyroidism
The nurse is caring for a 77-year-old client and understands that calcium deficiency commonly occurs in the elderly because of what factors? (Select all that apply.)
Impaired liver or kidney metabolism of vitamin D Lack of exposure to sunlight Impaired absorption of calcium from the intestine
Thyroid hormones are principally concerned with the increase in metabolic rate of tissues that can result in certain effects? What are some of these effects? (Select all that apply.)
Increased heart rate Increased body temperature Increased cardiac output
What is the most likely goal for oxytocin therapy?
Induce uterine contractions.
Which of the following drug types is most likely to cause respiratory depression and myxedema coma in clients with thyroid disorders?
Methimazole
The nurse is caring for a client with a possible calcium deficiency and reads the client's history to see if the client has experienced which common reasons for calcium deficiency? (Select all that apply.)
Long-term dietary deficiencies of calcium and vitamin D Impaired absorption of calcium from the intestine Lack of exposure to sunlight
A nurse is performing patient education for a woman who has just been prescribed a bisphosphonate. Which diagnostic and history findings would have prompted the woman's care provider to prescribe a bisphosphonate?
Low bone density and a family history of osteoporosis
The nurse cares for a client who was admitted for multiple bone fractures resulting from a fall. The client has a comorbidity of hypothyroidism. Which diet is the most appropriate for this client?
Low calorie, high fiber
In addition to calcium, what electrolyte affects parathyroid hormone (PTH) secretion?
Magnesium
A patient asks the nurse to explain the physiological actions of phosphorous. The nurse knows which of these statements regarding phosphorous is correct?
Milk is the best source of phosphorus
A client is brought to the emergency department after taking an overdose of levothyroxine. When assessing this client, what adverse effects would the nurse expect to find?
Nervousness and tachycardia
A client who has taken an overdose of levothyroxine (Synthroid) is brought to the Emergency Department. In assessing this client, what side effect would the nurse expect to find?
Nervousness, tachycardia, tremors
A client admitted to the hospital with hyperthyroidism treated with propylthiouracil suddenly develops a skin rash. Which action would the nurse implement first?
Notify the primary health care provider.
A 48-year-old client with acromegaly is not a candidate for other therapy. What medication, administered sub-q, would the nurse caring for the client expect to be ordered?
Octreotide (Sandostatin)
A patient with hypothyroidism is at increased risk for respiratory depression and myxedema coma if given what category of drugs?
Opioid analgesics
Calcium preparations can be given by two different routes. Which of the following are those routes?
Oral and IV
The nurse is discussing the use of corticosteroids with a group of nursing students and tells that students that both men and women who take corticosteroids are at risk for what side effect?
Osteoporosis
An instructor is preparing a teaching plan for a class on the various pituitary hormones. Which hormone would the instructor include as being released by the posterior pituitary gland?
Oxytocin
The nurse would administer what to a client in labor to improve her uterine contractions?
Oxytocin
The pituitary gland is further specialized into three functional areas. What is a hormone that is stored in the posterior lobe?
Oxytocin
When studying for a test in pharmacology, a student asks a peer group what the most important regulator of serum calcium levels in the body are. What would be the peer group's best reply?
PTH
A nurse educating a client and their family about levothyroxine (Synthroid) for the treatment of hypothyroidism should advise the client to contact the health care provider if which occur? (Select all that apply.)
Palpitation Excessive diaphoresis Significant weight changes Chest pain
Which are the three hormones/vitamins that regulate calcium and bone metabolism?
Parathyroid hormone (PTH) Calcitonin Vitamin D
The nursing class is studying family nursing. What hormone would the instructor tell the students plays a part in milk production?
Proactin
After teaching a group of students about the negative feedback system, the instructor determines that the students have understood the information when they identify which hormone as not being regulated by this mechanism?
Prolactin
Thioamide antithyroid drugs treat hyperthyroidism by inhibiting the synthesis of thyroid hormone. What is the prototype of the thioamide anti-thyroid drugs?
Propylthiouracil
What does release of antidiuretic hormone (ADH) cause?
Reabsorption of water
A 25-year-old female client is diagnosed with hypothyroidism. She is admitted to the hospital for acute gallbladder disease and subsequent surgical intervention. When planning postoperative opioid pain management, the nurse must take into account the fact that the client is at greater risk for what condition, secondary to the client's hypothyroidism diagnosis?
Respiratory depression
The nurse is caring for a client who takes alendronate. What laboratory result best demonstrates successful treatment?
Serum calcium 2.45 mmol/L (9.8 mg/dL)
The nurse is caring for a client receiving tolvaptan and digoxin. When assessing for drug-drug interactions, the nurse should prioritize what laboratory result?
Serum potassium level
Following an assessment by her primary care provider, a 70-year-old resident of an assisted living facility has begun taking daily oral doses of levothyroxine. Which assessment finding should prompt the nurse to withhold a scheduled dose of levothyroxine?
The resident's apical heart rate is 112 beats/minute with a regular rhythm.
What criteria must be met for treatment with somatropin to be considered for a child?
The child must not have begun puberty.
The nurse is caring for four clients. Which client is at the highest risk for osteoporosis?
The female client aged 76
What is the body's physiological response when blood levels of calcium are excessive?
The parathyroid glands stop making parathyroid hormone.
Which of the following are appropriate goals to set with your patient who is suffering from an alteration in calcium levels? Choose all that apply.
The patient will achieve and maintain normal serum levels of calcium. The patient will comply with instructions for safe drug use. The patient will be monitored closely for therapeutic and adverse effects of drugs used to treat hypercalcemia.
The functioning of which gland should be evaluated when a client is exhibiting signs and symptoms of a low basal metabolic rate?
Thyroid
A group of nursing students are doing a presentation on hormones. What hormone would the students' presentation show regulates the metabolic rate and influences the growth and development of the body?
Thyroid hormone
Which of the following hypothalamic hormones causes the release of TSH in response to stress, such as exposure to cold?
Thyrotropin-releasing hormone (TRH)
The pharmacology instructor is talking about the drug propylthiouracil (PTU). What would the instructor cite as the primary mode of action for propylthiouracil (PTU)?
To inhibit production of thyroid hormone
What medication is used to treat diabetes insipidus caused by hypofunction of the posterior pituitary gland?
Vasopressin (Pitressin)
The nurse and patient are discussing the importance of various vitamins. The nurse knows which of the following vitamins is essential for proper intestinal absorption of calcium?
Vitamin D
Knowing that thyroid hormones are principally concerned with the increase in metabolic rate of tissues, which symptom would a nurse observe in a client with uncontrolled hyperthyroidism? (Select all that apply.)
Weight loss Tachycardia
Which statement reflects the relationship between calcium and phosphate?
When there is an increase in calcium, the phosphate is decreased.
What is the rationale for a nurse to suggest avoiding whole grains to a client being treated for osteopenia?
Whole grains are known to interfere with calcium absorption.
The process in which hormone secretion is stimulated when hormones are needed and inhibited when they are not needed is known as:
a negative feedback system.
A nurse's assessment of a client has revealed signs and symptoms of Paget's disease. Which of the following is one of the signs the nurse may have observed?
bone deformity
A home care nurse is caring for a 70-year-old female client who has been diagnosed with osteoporosis. When developing a plan of care for this client, the nurse should include measures to prevent what complication of the disease?
bone fracture
The home care nurse is caring for an elderly female patient who has been diagnosed with osteoporosis. When explaining the disease and its treatment to the patient, what should the nurse identify as a potentially serious complication?
bone fracture
The nurse should review which lab result before advising a client about taking the first dose of ibandronate (Boniva)?
calcium
A patient with osteoporosis has bones that become progressively porous, brittle, and especially prone to fracture. This increased susceptibility to fracture manifests most commonly as:
compression fracture of the vertebrae
A patient with osteoporosis has bones that become progressively porous, brittle, and especially prone to fracture. This increased susceptibility to fracture manifests most commonly as:
compression fracture of the vertebrae.
Which hormone stimulates the adrenal cortex to produce and secrete adrenocortical hormones?
corticotropin
Which would be used to diagnose adrenal function?
corticotropin
A nurse is organizing the care of a child who takes somatotropin. The desired outcome the nurse should prioritize in the planning of this child's care is that the client will:
demonstrate in increase in linear growth.
A head injury has resulted in the hospitalization of a client. Nursing assessments confirm that the client is producing substantial amounts of dilute urine and is consuming large amounts of liquids. Considering the history and assessment findings support the possibility of what metabolic disorder?
diabetes insipidus
While the nurse is talking with a client, the client informs the nurse that the client has been under treatment for weight loss management. The client indicates taking antithyroid medication to increase weight loss. Included in client education about antithyroid medication is that taking:
excessive or unnecessary antithyroid medication may produce serious or life-threatening manifestations of toxicity.
A clinic nurse is following a 9-year-old boy who is taking somatropin. What will the nurse monitor periodically?
height
The hypothalamus is the gland that helps regulate the CNS and ANS and the endocrine system. By regulating these systems, the hypothalamus works to maintain the:
homeostasis.
A nurse is preparing to administer a scheduled dose of levothyroxine to an elderly client who is being treated in the hospital for a respiratory infection. Prior to administering the drug, the nurse should perform what assessment?
measurement of blood pressure
A 34-year-old teacher is being seen at the primary care group. The client is undergoing diagnostics for an alteration in thyroid function. What physiologic function is affected by the altered thyroid function?
metabolic rate
Based on the nurse's knowledge about thyroid hormone supplements, the nurse administers levothyroxine cautiously to a client who has recently had which condition or disorder?
myocardial infarction
The hypothalamus fine-tunes and regulates the release of hormones through:
negative feedback systems
What organ provides the controlver the amount of calcium in the blood?
parathyroid
A hospital client's current medication administration record specifies oral administration of propylthiouracil (PTU) every 8 hours. What sign or symptom may have originally prompted the care provider to prescribe this drug?
persistent tachycardia
What are the functions of the antidiuretic hormone (ADH)? Select all that apply.
reabsorption of water raising blood volume dilution of extracellular fluids increasing arterial blood pressure
Which hormones are responsible for the growth of the body during childhood, especially the growth of muscles and bones?
somatotropin
Which agent would the nurse identify as a growth hormone agonist?
somatropin
Which needs to be used in a child prior to the closure of the bone epiphyses in order to exert its effects?
somatropin
Alendronate (Fosamax) is prescribed for a 67-year-old postmenopausal woman. In order to help prevent gastrointestinal distress, the nurse will advise the patient to:
stand or sit upright for at least 30 minutes after taking alendronate.
Which of the following drugs are used to treat osteoporosis and can actually increase bone formation? Choose all that apply.
teriparatide (Forteo)
The control mechanisms for most metabolic functions of the body, as well as the maintenance of homeostasis, is the function of:
the hypothalamus and the pituitary gland.
Calcium participates in many metabolic processes, including the regulation of which of the following? Choose all that apply.
• Cell membrane permeability and function • Nerve-cell excitability and transmission of impulses • Contraction of cardiac, skeletal, and smooth muscl
The main drugs approved for prevention and treatment of osteoporosis are the bisphosphonates (e.g., Fosamax, Actonel). Which of the following characteristics describe bisphosphonates? Choose all that apply.
• Prevent the loss of calcium • Should be taken with 6 to 8 ounces of water at least 30 minutes before eating any food