Chapter 57-60 EAQ
Which instruction should the nurse give when a patient receiving metformin [Glucophage] therapy will undergo angiography?
"Do not take your metformin on the day of the test."
Which statement indicates that the patient needs additional teaching on oral hypoglycemic agents?
"I will take the medication only when I need it."
The patient has been prescribed lispro [Humalog] for treatment of type 1 diabetes mellitus. The nurse should give the patient which instruction?
"Inject this insulin with meals because it is very fast acting."
Which lifestyle changes should the nurse instruct a patient to implement in order to successfully manage diabetes mellitus? Select all that apply.
"Reduce the amount of alcohol you consume." "Incorporate daily physical exercise into your life." "Decrease the amount of carbohydrates in your diet."
The nurse is teaching safe administration of medication to a patient who has been prescribed levothyroxine [Levoxyl]. Which statement should the nurse include in the teaching session?
"Take this medicine on an empty stomach in the morning, at least 30 to 60 minutes before eating."
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?
"You can take 16 mg in the morning and 8 mg in the afternoon."
The nurse should include which statement when teaching a patient about insulin glargine [Lantus]?
"You cannot mix this insulin with any other insulin in the same syringe."
Which patient instructions should the nurse provide for a pregnant woman with gestational diabetes?
"You must take insulin injections as prescribed."
What should the nurse instruct a patient who is prescribed repaglinide [Prandin] for type 2 diabetes?
"You need to eat a meal after each dose."
The healthcare provider orders octreotide [Sandostatin] 250 mcg SC for a patient with acromegaly. The available medication is octreotide [Sandostatin] 1000 mcg/mL. How many milliliters will the nurse inject into the patient? Record your answer using two decimal places. Use a leading zero if applicable. _____ mL
0.25
The healthcare provider orders hydrocortisone sodium succinate [Solu-Cortef] 500 mg IV. The available medication is hydrocortisone sodium succinate [Solu-Cortef] 1000 mg/mL. How many milliliters will the nurse administer? Record your answer using two decimal places. Use a leading zero if applicable. _____ mL
0.50
The healthcare provider orders 150 mcg of levothyroxine [Synthroid] PO every morning. The medication available is levothyroxine [Synthroid] 75 mcg tablets. How many tablets will the nurse administer?
2
The primary healthcare provider prescribes a thyroid replacement drug to a patient with hypothyroidism. How should the nurse monitor for return to a euthyroid state?
Analyze the patient's serum thyroid-stimulating hormone levels
A patient with a history of inflammatory bowel disease is prescribed insulin therapy and acarbose [Precose] for the treatment of high postprandial glucose levels. Which nursing action is a priority in this case?
Consult the primary healthcare provider before administering acarbose [Precose]
Before administering metformin [Glucophage], the nurse should notify the prescriber about which laboratory value?
Creatinine (Cr) level of 2.1 mg/dL
Which is the drug of choice to treat diabetes insipidus?
Desmopressin [DDAVP]
A nurse is developing a plan of care for a patient with Addison's disease who is taking hydrocortisone [Cortef]. Which outcome is of the highest priority for this patient's care plan?
During times of stress, the patient increases the glucocorticoid dose.
Which condition is seen in a patient with hyperosmolar nonketotic syndrome (HHNS)?
Extreme hyperglycemia
Which clinical findings may indicate diabetes mellitus in a patient? Select all that apply.
Hemoglobin A1C (A1C) level greater than 6.5% Fasting plasma glucose level of 126 mg/dL or higher
The nurse is caring for a patient who has Addison's disease. The primary healthcare provider prescribes fludrocortisone [Florinef]. Which adverse effect should the nurse monitor in this patient?
Hypokalemia
Which hormones play a role in the regulation of glucose homeostasis? Select all that apply.
Insulin Glucagon
The endocrinologist prescribes radioactive iodine to an adult patient who has thyroid cancer. What is the reason for prescribing this drug to the patient?
It destroys cancerous or overactive thyroid tissue
The nurse administering hydrocortisone to a patient recognizes which statement(s) as true regarding the medication? Select all that apply.
It is a synthetic steroid identical to cortisol. It has glucocorticoid and mineralocorticoid actions. It is a preferred drug for adrenocortical insufficiency
Which assessment findings in a patient with diabetes mellitus are indicative of diabetic ketoacidosis? Select all that apply.
Ketones in the urine Isotonic dehydration Electrolyte imbalances Extreme hyperglycemia
The patient newly diagnosed with hypothyroidism has been prescribed levothyroxine. The nurse should give the patient which instruction(s)? Select all that apply.
Levothyroxine brands should not be changed, if possible. Levothyroxine can affect the metabolism of other medications. Levothyroxine can be given intravenously but is usually taken orally
When assessing a patient who has Cushing's syndrome, the nurse recognizes which characteristics as clinical manifestations of this disorder? Select all that apply.
Moon face Glycosuria Mood swings Osteoporosis
A patient is taking fludrocortisone [Florinef]. 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?
Muscle weakness
After delivery, a patient develops uterine atony and increased bleeding. Which medication would the nurse expect to administer?
Oxytocin [Pitocin]
A patient who has type 2 diabetes is taking nateglinide [Starlix]. The nurse understands this medication helps to control blood glucose levels through which mechanism?
Promotion of insulin secretion
A patient has a serum glucose concentration of 375 mg/dL, urine output of 450 mL/hr, and an arterial pH of 7.1. The sliding scale requires intravenous insulin for a blood glucose concentration of more than 350 mg/dL. Which type of insulin is the nurse most likely to administer?
Regular insulin [Novolin R]
What should the nurse assess in a patient who is prescribed metformin [Glucophage] for treatment of type 2 diabetes?
Renal function
A patient with type 1 diabetes mellitus asks, "Why can't I take a sulfonylurea like my friend who has diabetes?" What is the nurse's best response?
Sulfonylurea increases beta-cell stimulation to secrete insulin, and your beta cells do not contain insulin."
The nurse observes that A1C levels are elevated in a patient who is taking metformin [Glucophage] for type 2 diabetes. Which class of drugs is likely to be prescribed to this patient?
Sulfonylureas
A patient diagnosed with thyroid cancer undergoes a thyroidectomy and is prescribed levothyroxine sodium [Synthroid]. What instructions should the nurse give the patient about taking this medication?
Take on an empty stomach.
The nurse is assessing an elderly patient who has been taking levothyroxine [Synthroid] for 6 months. The nurse finds that the patient has anxiety, tachycardia, and insomnia. What should the nurse interpret from these findings?
The patient is experiencing adverse effects of the thyroid drugs
A patient is scheduled to start taking insulin glargine [Lantus]. Which information should the nurse give the patient regarding this medication?
This medication provides blood glucose control for 24 hours
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?
Thyroid stimulating hormone (TSH)
Which early symptoms of hypoglycemia should the nurse instruct a patient's family to treat with a fast-acting carbohydrate source? Select all that apply.
Tremor Irritability Sweating Confusion
A patient goes into cardiac arrest. Which endocrine drug has a potential role in cardiopulmonary resuscitation (CPR)?
Vasopressin [Pitressin]
A patient is taking glipizide [Glucotrol] and a propranolol. A nurse is teaching hypoglycemia awareness and should warn the patient about the absence of which symptom caused by the propranolol?
tachycardia
