Endocrine

The patient is having an overnight dexamethasone suppression test performed to diagnose Cushing's syndrome. A nurse administers dexamthasone 1 mg at 11 pm. During shift change report, the nurse instructs the oncoming nurse to draw blood for which test at 8 Am? A. Cortisol B. Sodium C. Glucose D. Potassium

A. Cortisol Dexamthasone suppresses the release of adrenocorticotropic hormone and therefore suppresses cortisol

A 6 year old child with short stature homeobox (SHOX) deficiency who weighs 20 kg is prescribed somatotropin to promote normal growth. Which dosage of the drug should be administered to the child? A. 8 mg/ hr IM B. 10 mg once subQ C. 7 mg/ week IM D. 2 mg/day subQ

C. 7 mg/week IM The fixed dose for somatotropin is 0.35 mg/kg/week for children.

Follicle stimulating hormone (FSH) and letenizing hormone (LH) are produced by which structure? A. Ovaries B. Hypothalamus C. Anterior pituitary gland D. Posterior pituitary gland

C. Anterior pituitary gland FSH and Lh are secreted by the anterior pituitary gland and they act on the ovaries

Which drug is used to diagnose adrenocortical insufficiency? A. Octreotide B. Somatotropin C. Cosyntropin D. Desmopressin

C. Cosyntropin

Which laboratory value would the nurse monitor in a patient with diabetes insipidus who is being treated with vasopressin? A. Blood glucose B. Liver Enzymes C. Creatinine Clearance D. Thyroid stimulating Hormone

C. Creatinine clearance A creatinine clearance of less than 50 mL/min may indicate renal impairment, a potential adverse effect of vasopressin that can result in water intoxication.

The primary healthcare provider is administering somatropin to a patient. Which assessment is necessary? Select all A. glucose levels B. Platelet counts C. Thyroid function D. Potassium levels E. Growth hormone levels

A. Glucose levels C. Thyroid function E. Growth Hormone levels Somatropin is a growth hormone given to children to manage inadequate growth.

The nurse is caring for a patient who has Addison's disease. The primary healthcare provider provides fludrocortisone. Which adverse effect should the nurse monitor in this patient? A. Hypokalemia B. Hyponatremia C. Hypocalcemia D. Hypoglycemia

A. Hypokalemia

The healthcare provider orders hydrocortisone sodium succinate 500 mg IV. the available medication is hydrocortisone sodium succinate 1000 mg/ml. How many mL will the nurse administer? Record to the nearest decimal place.

0.5 ml

Which clinical findings are associated with acute levothyroxine toxicity? A. Angina B. headache C. tachycardia D. Hyperthermia E. Atrial fibrilation

A. Angina C. Tachycardia D. Hyperthermia

Which hormone inhibits the release of growth hormone? A. Somatropin B. Somatolactin C. Somatostatin D. choriomammotropin

C. Somatostatin is otherwise known as growth hormone inhibitor

A nurse should consider which diagnostic test a priority to obtain before a patient receives iodine 131? A. Creatinine level B. Electrocargiogram C. White blood cell count D. Beta human chorionic gonadotropin test (hCG) test.

D. Beta hCG test. this test is diagnostic of pregnancy and iodine 131 is contraindicated in pregnancy.

Which finding in a patient taking levothyroxine and warfarin would require follow up by a nurse? A. Excessive bruising B. Weight loss of 5 kg C. Shortness of breath D. Cardiac dysrhythmias

A. Excessive bruising. levothyroxine increases the effects of warfarin, so there would be an increased chance of bruising. All of the other choices are not associated side effects of the interaction between levothyroxine and warfarin.

The endocrinologist prescribed radioactive iodine to an adult patient who has thyroid cancer. What is the reason for prescribing this drug to the patient? A. It destroys cancerous or overactive thyroid tissue B. It acts as a prophylactic agent against radiation exposure. C. It inhibits the conversion of t4 to t3 D. It increases the cellular metabolic rate and oxygen consumption.

A. It destroys cancerous or overactive thyroid tissue.

The nurse administers hydrocortisone to a patient recognizes which statements as true regarding the medication? Select all. A. It is a synthetic steroid identical to cortisol B. It should not be given during times of stress. C. It has glucocoritocoid and mineralocorticoid actions D> It is a preferred drug for adrenocorticoid insufficiency. E. It is given intravenously for chronic replacement therapy

A. It is a synthetic steroid identical to cortisol C. It has glucocorticoid and mineralocorticoid actions D. It is a preffered frug for adrenocortical insufficiency

The nurse administers hydrocortisone to a patient recognizes which statements as true regarding the medication? Select all A. It is a synthetic steroid identical to coritisol B. it should not be given during times of stress C. It has glucocorticoid and mineralcorticoid actions D. It is a preferred drug for adrenocortical insufficiency E. It is given intravenously for chronic replacement therapy

A. It is a synthetic steroid identical to cortisol C. It has glucocorticoid and mineralocrticoid actions D. It is a preferred drug for adrenocortical insufficiency

An adult patient who has a growth hormone deficiency is receiving somatropin. An increase in which characteristic would indicate to the nurse that the patient is experiencing the desired effect of the medication? A. Lean body mass B. Physical strength C. Height (3 inches) D. Joint range of motion

A. Lean body mass Height does not occur in adults as the epiphyses close

The nurse is caring for a patient who has a large pituitary tumor. Which drug would the nurse expect to administer to this patient? A. Octreotidde B. Cosyntropin C> Somatostatin D. Desmopressin

A. Octreotide this is uses in the treatment of large pituitary tumors

After delivery, a patient develops uterine atony and increased bleeding. Which medication would the nurse expect to administer? A. Oxytocin B. Octreotide C. Cosyntropin D. Somatropin

A. Oxytocin Oxytocin is used to strengthen the urterus' contractions postpartum. The other drugs have no effect on the uterus.

Which clinical findings are associated with cushings syndrome? select all A. Striae B hirsutism C. Hypotension D. Hyperglycemia E. Abdominal pain

A. Striae B. hirsutism D. Hypoglycemia these are hallmark signs of cushings syndrome while the others show addison's disease

A patient with the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) is prescribed tolvaptan. Which are common adverse effects of this drug? Select all A. Thirst B. Diarrhea C. Polyuria D. Dry mouth E. Hypoglycemia

A. Thirst C. Polyuria D. Dry mouth These are adverse effects of Tolvaptan

During an assessment, a patient asks the nurse, "what should I do if I miss too or three doses of thyroid replacement drug in a row?" Which is the nurse's best response? A. You should consult your primary healthcare provider B. You can take the dose immediately when you remember it C. Skip the missed dose and resume your usual schedule D. If it is almost the time for your next does, then take a double dose of the drug

A. You should consult your primary healthcare provider Missing your doses should warrant a healthcare provider visit

Which prescribed treatment would the nurse anticipate for a patient wit a thyroid stimulating hormone (TSH) level of 7 microunits/mL? A. An order for methimozole B. An order for levothyroxine C. treatment with radioactive iodine D. Surgical removal of the thyroid tissue.

B an order for Levothyroxine A level of 7 mcg/mL is an indicator of hypothyroidism, and Levothyroxine (T4) is the primary treatment for hypothyroidism Normal TSH is 0.3-6,0 mcg/mL

The patient newly diagnosed with hypothyroidism has been prescribed levothyroxine. The nurse should give the patient which instructors? Select All A. Levothyroxine should be taken with food B. Levothyroxine brands should not be changed, if possible C. Levothyroxine can affect the metabolism of other medications D. Levothyroxine should be taken at night E. Levothyroxine can be given IV but is usally orally

B,C,E

The healthcare provider orders 150 mcg of levothyroxine by mouth every morning. The medication is available in 75 mcg tablets. How many tablets will the nurse administer? A. 1 B. 2 C. 4 D. 0.5

B. 2

A patient in cardiac arrest receives vasopressin during cardiopulmonary resuscitation (CPR). An increase in which finding would indicate a desired effect of the medication? A. Blood pH B. Blood pressure C. Respiratory rate D. Body temp

B. Blood pressure

The nurse is planning care for a patient with signs of acute adrenal insufficiency. What is the priority patient problem? A. Pain and discomfort B. Deficient fluid volume C. Excessive caloric intake D. Shortness of breath upon exertion

B. Deficient fluid volume Adrenal insufficiency is characterized by hypotension, dehydration, weakness, lethargy, and GI symptoms.

A nurse is developing a plan of care for a patient with Addison's disease who is taking hydrocortisone. Which intervention is of the highest priority for this patient's care plan? A. The patient wears a medical ID bracelet at all times B. During times of stress, the patient increases the glucocoritocoid dose C. The patient carries an injectable form and an oral form of glucocorticoid. D. The patient divides the daily dose taking two thirds of it in the morning and one third in the afternoon.

B. During times of stress, the patient increases the glucocorticoid dose Failure to increase the dosage in times of stress and illness can be life threatening

A pediatric patient has gigantism caused by excess growth hormone (GH). Which finding would indicate to the nurse that the patient has developed an additional complicated related to this condition? A. atrophy of sweat glands b. Enlarged heart on chest xray C. Blood glucose below 70 mg/dL D. Elevated of liver function test results

B. Enlarged heart on chest X-ray

A patient is receiving vasopressin. Which symptoms warrant immediate notification of the healthcare provider? A. Pale skin. B. Headache C. Drowsiness D. Listlessness E. Blood Shot eyes

B. Headache C. Drowsiness D. Listlessness The adverse effects of vasopressin are headaches, drowsiness, and listlessness

A nurse is caring for a patient with decreased T3 and T4 and elevated TSh levels. The nurse is likely suffering from which condition? A. Thyrotixicosis B. Hypothyroidism C. Graves disease D. Hyperthyroidism

B. Hypothyroidism. when tsh is elevated and T3 and T4 are lowered, the patient is suffering from hypothyroidism.

A patient with graves disease is treated with iodine 131 therapy. Which statement by the patient indicates an understanding of this treatment's effects? A. Ill need to take this drug on a daily basis for at least 1 year. B. Ill tell my doctor if I have fatigue, hair loss or cold intolerance C. Im looking forward to feeling better and immediately after this treatment D. Ill have to isolate myself from my family so i dont expose them to radiation.

B. Ill tell my doctor if I have fatigue, hair loss or cold intolerance. Hypothyroidism is a complication of the treatment, and fatigue, hairloss, and cold intolerance are signs of this

Which is an effect of octreotide? A. It stimulates the body's metabolism B. It antagonizes the effect of growth hormone C. It stimulate the protein synthesis in the muscles. D. It regulates the fat metabolism in adipose tissues.

B. It antagonizes the effect of growth hormone

When assessing a patient who has cushings syndrome, the nurse recognizes which characteristics of clinical manifestations of this disorder? Select All A. Ketonuria B. Moon face C. Glycosuria D. Moon Swings E. Osteoporosis

B. Moon Face. C. Glycosuria D. Mood Swings E. Osteoporosis All of these are manifestations of excess secretion of adronocorticotropic hormone

Which outcome should a nurse establish for a patient who has acromegaly and is receiving octreotide? A. Normal urine volume B. Softening of facial features C. Increase in long bone length D. Stimulation of the milk reflex

B. Softening of facial features octreotide suppresses growth hormone, which is acromegaly

Thyroxine has been recently added to the reoutine medications for a patient who also uses insulin, warfarin, cholestyramine, and antacids daily. Which statement by the nurse should be included in medication education? A. The dosage of insulin that you take may need to be decreased B. Take your cholestyramine atleast 4 hours apart from levothyroxine C. You will need to void aluminum containing antacids such as Maalox and Mylanta D. Your dose of warfarin will have to be increased while you are taking this.

B. Take your cholestyramine atleast 4 hours aprart from the levothyroxine

While reviewing the history and the lab reports of an adult patient, the nurse finds that the patient has decreased metabolic rate, weight gain, and hair loss. What can the nurse interpret from these findings? A. The patient may have cretinism B. The patient may have myxedema C. The patient may have Grave's disease D. The patient may have Plummer's disease

B. The patient may have myxedema. Hyposecretion of thyroid hormone as an adult may lead to myxedema.

The clinical instructor asks the nursing student about various drug interactions of thyroid drugs. which statement by the nursing student indicates effective learning? A. Thyroid drugs may increase serum digitalis levels B. Thyroid drugs should not be taken to treat obesity C. Thyroid drug absorption is increased by cholestyramine D. Thyroid drugs may decrease the activity of oral anticoagulants

B. Thyroid drugs should not be taken to treat obesity All of the other choices are false

The nurse is teaching the patient about oral steroid therpay for chronic adrenal insufficiency. Which statement by the patient indicates a need for further teaching? A. I can take my full dose in the morning B. When I am traveling for work I will take lower doses C. I understand that I shouldnt experience many adverse effects D. I can break up my dose and take some in the afternoon if I get tired.

B. When I am traveling for work, i will take lower doses patients should always take the full dose in the morning

The nurse is teaching the patient about oral steroid therapy for chronic adrenal insufficiency. Which statement by the patient indicates a need for further teaching? A. I can take my full dose in the morning B. When i am travelling for work I will take lower doses C. I understand that I shouldnt experience many adverse effects D. I can break up my dose and take some in the afternoon if I get tired

B. When I am travelling for work I will take lower doses

A patient diagnosed with thyroid cancer undergoes a thyroidectomy and is prescribed levothyroxine sodium. What instructions should the nurse give the patient about taking this medication? A. Take on a full stomach B. Take on an empty stomach C. Take immediately after arising D. Take immediately before bedtime

B.. Take on an empty stomach levothyroxine needs to be taken on an empty stomach to make sure absorption is maintained

A patient who has hypothalamic diabetes insipidus is receiving desmopressin. Which laboratory test should a nurse obtain to evaluate the effectiveness of the medication? A. Creatinine B. Urine ketones C. Urine osmolality D. Blood Urea Nitrogen (BUN)

C urine osmolality diabetes insipidus is characterized by a decrease in the urine osmolality

A patient who has Cushing's syndrome is taking ketoconazole as an adjunct treatment to brain radiation. A nurse should expect the patient to have which therapeutic response? A. Increase cortisol synthesis B. Increased resistance to infection C. Enhances radiation effect to the brain D. Increases adrenocorticotropic hormone (ACTH) production

C. Enhances radiation effect to the brain. Ketoconazole is an antifungal drug that is used in patients with Cushings Syndrome to enhance radiation to the brain

The nurse is creating a care plan for a patient receiving desmopressin. Interventions for which patient problem will be most important to implement? A. Pain and discomfort B. Knowledge deficiency C. Fluid and electrolyte imbalance D. Shortness of breath while walking

C. Fluid and electrolyte imbalance. Desmopressin is a form of antidiuretic hormone that increases sodium and water retention that would lead to an alteration in fluid volume

The nurse is teaching a patient with polyuria, polydipsia, and dehydration who has been prescribed desmopressin. Which statement by the patient indicates the need for additional teaching? A. I will take this medication with my breakfast B. I will avoid consuming alcohol along with this drug C. I will increase intake of juices and water in my diet D. I will notify my prescriber if I develop excessive drowsiness or headaches

C. I will increase intake of juices and water in my diet Those taking desmopressin must reduce intake of all fluids

Which statement is accurate regarding the mechanism of action of somatropin in the treatment of growth hormone deficiency in children? A. It decreases sugar levels B. It increases protein levels C. It stimulates skeletal growth D. It increases endogenous growth

C. It stimulates skeletal growth

A patient is taking fludrocortisone. A nurse should recognize that which symptom, if reported by the patient, indicates the patient is experiencing a life threatening electrolyte imbalance caused by fludrocortisone therapy? A. Syncope B. Weight loss C. Muscle weakness D. Numbness and tingling

C. Muscle weakness This is a sign of hypokalemia, which is potentially life threatening

A patient with hemophilia A is prescribed desmopressin. What is the mechanism of action of desmopressin in this case? A. Constricts the blood vessels B. Increases water reabsorption C. Promotes release of clotting factor VIII D. Stimulates the release of Von Willebrand factor

C. Promotes release of clotting factor VIII

The patient reports that she had to switch pharmacies to save money. She noted that her thyroid pill looked different. The nurse anticipates that the healthcare provider will order which test? A. Creatinine level B. ECG C.TSH D. Beta hCG test.

C. TSH

The patient states that when he takes hydrocortisone 24 mg in the morning, he is very tired by mid afternoon. Which statement by the nurse is correct? A. You can take 24 mg at night instead B. You can take 12 mg in the morning and 12 mg at night C. You can take 16 mg in the morning and 8 mg in the afternoon D. This is an adverse effect and you should stop taking the medication

C. You can take 16 mg in the morning and 8 mg in the afternoon If afternoon or evening fatigue occurs after taking the full hydrocortisone dose in the morning, the dosing should be split into 2/3 in the morning and 1/3 in the evening.

The primary healthcare provider prescribed a thyroid replacement drug to a patient with hypothyroidism. How should the nurse monitor for return to a euthyroid state? A. Assess for anxiety and palpitations B. Verify the medication history of patient and family C. Evaluate the patient's knowledge of thyroid therapy D. Analyze the patient's serum thyroid stimulating hormone levels

D. Analyze the patient's serum thyroid stimulating hormone levels The efficiency of the thyroid replacement drug would have to be monitored by the levels of thyroid hormone in the blood.

The primary healthcare provider prescribes vasopressin to a patient. Which side effect would the nurse expect in the patient? A. Confusion B. Drowsiness C. Frequent thirst D. Decreased urination

D. Decreased urination Vasopressin mimics the actions of antidiuretic hormones, which results in a decrease in urine output.

Which is the drug of choice to treat diabetes insipidus? A. Tolvaptan B. Conivaptan C. Pegvisomant D. Desmopressin

D. Desmopressin Diabetes insipidus can be treated with desmopressin or vasopressin

A patient has been given instructions about levothyroxine. Which statement by the patient indicates understanding of these instructions? A. Ill plan to do double my dose if I gain more than 1 pound per day B. Ill be glad when I don't have to take this medication in a few months C. It is best to take the medication with food so I don't have any nausea. D. Ill take this medication in the morning so as not to interfere with sleep.

D. Ill take this medication in the morning so as not to interfere with sleep.

A patient is receiving desmopressin for the treament of diabetes insipidus. Which instructions the priority for a nurse to give the patient? A. weigh yourself several times each week B. Rotate the nostril you use daily to prevent irritation C. You'll quickly see results of a lower urine amount D> reduce your water intake to precent water intoxication

D. Reduce your water intake to prevent water intoxication This needs to happen so that seizures and comas do not occur

A patient is receiving desmopressin for the treatment of diabetes insidious. Which instruction is the priority for a nurse to give the patient? A. Weigh yourself several times each week B. Rotate the nostril you use to prevent irritation C. You'll quickly see the results of a lower urine amount D. Reduce your water intake to prevent water intoxication

D. Reduce your water intake to prevent water intoxication. Increased water intake while taking desmopressin can result in seizures and coma

The nurse is assessing an elderly patient who has been taking levothyroxine for 6 months. The nurse finds that the patient has anxiety, tachycardia, and insomnia. What should the nurse interpret from these findings? A. The patient is hypersensitive to thyroid drugs B. The patient has common age related symptoms C. The patient is not responding to the thyroid drugs D. The patient is experiencing adverse effects of the thyroid drugs

D. The patient is experiencing adverse effects of the thyroid drugs These are the hallmark side effects of levothyroxine

A patient goes into cardiac arrest. Which endocrine drug has a potential role in cardiopulmonary resuscitation (CPR)? A. Oxytocin B. Octreotide C. Cosyntropin D. Vasopressin

D. Vasopressin Vasopressin acts a potential vasoconstrictor that may be used in CPR

Which statement is the most important for a nurse to make to a patient who is taking methimazole? A. Headache and dizziness may occur but not very frequently B. Another medication can be given if you experience any nausea C. You may experience some muscle soreness with this muscle D. You need to notify your doctor if you have a sore throat and fever

D. You need to notify your doctor if you have a sore throat and fever. Agranulocytosis is the most serious side effect of methimazole

The endocrineologist orders lanreotide for a patient with acromegaly. Which should identify as the reason for prescribing this drug? A. Relief of bone pain B. Prevention of osteopenia C. Promotion of epiphyseal closure D. Suppression of growth hormone release

D. suppression of growth hormone release Lanreotide is a somatostatin analog, so it is also a growth hormone inhibitor