PHARM - Endocrine System ATI Questions

As you continue to talk with the client about managing her diabetes with regular insulin (Humulin R), you should include which of the following instructions? (SELECT ALL THAT APPLY) A. self-inject chilled insulin B. carry a carbohydrate snack C. rotate injection sites D. wear a medical alert bracelet E. expect to adjust the dosage during illness

B. carry a carbohydrate snack C. rotate injection sites D. wear a medical alert bracelet E. expect to adjust the dosage during illness

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? A. drink 16oz of water B. perform a fingerstick blood glucose check C. take another glipizide tablet D. lie down and rest

B. perform a fingerstick blood glucose check

What are the 3 laboratory tests used to diagnose thyroid problems?

- T3 - T4 - TSH

A client is about to start taking hydrocortisone (Cortef) to treat adrenocortical insufficiency. You should instruct the client to do which of the following to help reduce the risk for adverse effects of this drug? (SELECT ALL THAT APPLY) A. increase her calcium and vitamin D intake B. take the drug with food C. record weight regularly D. urinate every 4 hr E. report increased stress

A. increase her calcium and vitamin D intake B. take the drug with food C. record weight regularly E. report increased stress

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? A. lactic acidosis B. anticholinergic effects C. extrapyramidal effects D. hypophosphatemia

A. lactic acidosis

What are 3 symptoms of Cushingoid syndrome?

- moon face - buffalo hump - osteoporosis - HTN

What type of insulin can be administered IV?

- only Regular insulin

Spironolactone is what classification of medication?

- potassium-sparing diuretic

6 Rights of medication administration

- right drug - right time - right dose - right patient - right route - right documentation

What are symptoms of hypoglycemia?

- shakiness - anxiety - tingling sensation around the mouth - hunger

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

A. "We will use a different spot for injection each time we give the medication."

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

A. 0820

You give the client 5 units of lispro insulin (Humalog) and 10 units of insulin glargine subcutaneously at 1400. Based on your instructions, the client should expect her blood glucose level to be at the lowest at which of the following times? A. 1500 B. 1730 C. 1900 D. 2130

A. 1500

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? A. avoid drinking alcohol B. sit or stand for 30 min after taking the drug C. urinate every 4 hr D. take the drug 2 hr after a meal

A. avoid drinking alcohol

The client will self-inject 8 units of NPH insulin and 4 units of regular insulin each day before breakfast. As you show the client how to self-administer the insulin, you should include which of the following instructions? (SELECT ALL THAT APPLY) A. draw the regular insulin into the syringe first, then the NPH insulin B. inject the insulin mixture into a large muscle C. discard any unused premixed syringes within 5 days D. use a 5ml syringe when mixing the two types of insulin E. use one syringe to reduce the number of injections

A. draw the regular insulin into the syringe first, then the NPH insulin E. use one syringe to reduce the number of injections

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

B. administer pramlintide before meals

A nurse is caring for a client who is about to begin taking pioglitazone to treat type 2 diabetes mellitus. The nurse should explain to the client about the need to monitor which of the following laboratory values? (SELECT ALL THAT APPLY) A. thyroid-stimulating hormone (TSH) B. alanine aminotransferase (ALT) C. LDL D. CBC E. creatinine clearance

B. alanine aminotransferase (ALT) C. LDL

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? A. hypokalemia B. hyperglycemia C. acute renal failure D. acute pancreatitis

C. acute renal failure

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? A. oral contraceptives B. calcium supplements C. beta blockers D. iron supplements

C. beta blockers

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? A. take levothyroxine with food to increase absorption B. take levothyroxine with an antacid to reduce gastrointestinal effects C. expect life-long therapy with the drug D. carry a carbohydrate snack at all times

C. expect life-long therapy with the drug

Which of the following drugs should a nurse have available for a client who is experiencing insulin toxicity? A. naloxone B. diphenhydramine C. acetylcysteine D. glucagon

D. glucagon

What talking with a client about self-administering regular insulin (Humulin R), you should include which of the following instructions? A. shake the vial vigorously B. expect the solution to appear cloudy C. store unopened vials at room temperature D. inject the insulin subcutaneously

D. inject the insulin subcutaneously

What is the 15/15 rule for hypoglycemia?

- 15 grams of carbs - 15 mins until rechecking glucose level

Can long-acting insulins be mixed with other insulins?

- NO!!

What is the generic & brand name for intermediate-acting insulin?

- NPH (N)

What is the onset time for intermediate-acting insulin?

- NPH --> 1.5 hrs

What is the duration time for intermediate-acting insulin?

- NPH --> 24 hrs

What is the peak time for intermediate-acting insulin?

- NPH --> 4-12 hrs

Why are long-term corticosteroids gradually reduced in dosage prior to discontinuing?

- d/t adrenal gland atrophy

What are the generic & brand names for long-acting insulin?

- glargine (Lantus) - detemir (Levemir)

What is the onset time for each long-acting insulin?

- glargine --> 2-4 hrs - detemir --> 2-4 hrs

What is the duration time for long-acting insulin?

- glargine --> 24 hrs - detemir --> 24 hrs

What is the peak time for long-acting insulin?

- glargine --> none (NO PEAK = NO PLATE) - detemir --> 3-14 hrs

You instruct the client to watch for and report which of the following indications of an adverse reaction to insulin? A. palpitations B. weight gain C. low urine output D. constipation

A. palpitations

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? A. peripheral pulses B. urine output C. skin integrity D. blood glucose

B. urine output

You are caring for a client who is takin exenatide (Byetta) to treat type 2 diabetes mellitus. The client reports severe abdominal pain. You suspect which of the following adverse reactions to this drug? A. peptic ulcer disease B. hyperkalemia C. hyperglycemia D. pancreatitis

D. pancreatitis

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? A. bacterial skin infection B. diabetes insipidus C. immunosuppression D. recent myocardial infarction

D. recent myocardial infarction

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

D. renal impairment

MATCH DRUG WITH THERAPEUTIC EFFECT (#2) A. levothyroxine B. somatropin C. propylthiouracil D. hydrocortisone

MATCH THERAPEUTIC EFFECT WITH DRUG (#2) A. hypothyroidism B. Turner's syndrome C. thyrotoxic crisis D. Addison's disease

Can intermediate-acting insulin be mixed with other insulins?

- can be mixed with rapid- or short-acting insulins in the same syringe

A nurse is providing teaching to a client about taking fludrocortisone to treat adrenocortical insufficiency. Which of the following instructions should the nurse include? (SELECT ALL THAT APPLY) A. obtain weight measurement daily B. report weakness or palpitations C. have blood pressure checked regularly D. eat more iron-rich foods E. avoid drinking grapefruit juice

A. obtain weight measurement daily B. report weakness or palpitations C. have blood pressure checked regularly

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 THAT APPLY) A. sore throat B. joint pain C. insomnia D. bradycardia E. rash

A. sore throat B. joint pain D. bradycardia E. rash

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? A. somatropin B. hydrocortisone C. glucagon D. desmopressin

B. hydrocortisone

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

C. weight gain

You are caring for a client who takes acarbose (Precose) and a sulfonylurea to treat type 2 diabetes mellitus. Which of the following is an indication of an adverse reaction to this drug combination? A. polyuria B. tremors C. bradycardia D. thirst

B. tremors

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? A. thyrotoxicosis B. hypothyroidism C. lactic acidosis D. radiation sickness

B. hypothyroidism

A nurse is caring for a client who is about to begin taking somatropin. The nurse should explain the need to monitor for which of the following laboratory values? (SELECT ALL THAT APPLY) A. blood amylase B. creatinine clearance C. urine calcium D. blood glucose E. CBC

C. urine calcium D. blood glucose

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? A. rapid absorption B. intradermal injection C. injection pain D. lipohypertrophy

D. lipohypertrophy

MATCH DRUG WITH THERAPEUTIC EFFECT A. glipizide (Glucotrol) B. radioactive iodine-131 (Iodotope) C. glucagon (GlucaGen) D. desmopressin (DDVAP)

MATCH THERAPEUTIC EFFECT WITH DRUG A. type 2 diabetes mellitus B. thyroid cancer C. hypoglycemia D. diabetes insipidus

What is the onset time for each rapid-acting insulin?

- aspart --> 15 min - lispro --> 15 min - glulisine --> 15 min

A client is about to start taking somatropin (Genotropin). You plan to evaluate the effectiveness of this drug therapy with which of the following assessments? A. level of consciousness (LOC) B. ECG C. height and weight D. breath sounds and respiratory rate

C. height and weight

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

C. skip the dose

What are the generic & brand names of each rapid-acting insulin?

- aspart (Novolog) - MOVE YOUR ASS PARTS - lispro (Humalog) - LESS PRO - glulisine (Apidra)

What is the peak time for each rapid-acting insulin?

- aspart --> 1-3 hrs - lispro --> 30 min - 1.5 hrs - glulisine --> 30 min - 1.5 hrs

What is the duration time for each rapid-acting insulin?

- aspart --> 3-5 hrs - lispro --> 3-4 hrs - glulisine --> 5 hrs

Can rapid-acting insulin be mixed? If so, with what?

- can be mixed - ONLY with other longer-acting insulins - NEVER with glargine or detemir

What is the generic & brand name for short-acting insulin?

- humulin R (Regular)

What is the peak time for short-acting insulin?

- humulin R --> 2-4 hrs

What is the onset time for short-acting insulin?

- humulin R --> 30 min

What is the duration of short-acting insulin?

- humulin R --> 6-8 hrs

When is the dosing of corticoid (steroid) medication to occur?

- in the AM with food

What is a symptom of hyperglycemia?

- increased thirst - frequent urination

What is the name of the medication used to treat thyroid deficiency?

- synthroid (Levothyroxine)

What are potential causes for hypoglycemia symptoms?

- too much food - too much insulin - oral diabetic medications - excessive exercise

Two hours after self-administering regular insulin subcutaneously, the client contacts you at the provider's office to report that she is sweating, shaky, and has a rapid pulse. Which of the following actions should you advise her to take? (SELECT ALL THAT APPLY) A. drink 4oz of orange juice B. check her blood glucose level C. take an oral hypoglycemic D. measure her urine output E. self-administer a long-acting insulin

A. drink 4oz of orange juice B. check her blood glucose level

You are caring for a client who is taking levothyroxine (Synthroid) to treat hypothyroidism. The client reports palpitations, weight loss, and diarrhea. You suspect which of the following adverse effects of this drug? A. hyperthyroidism B. Addison's disease C. myxedema D. hyperglycemia

A. hyperthyroidism

A nurse at a provider's 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? A. hypotension B. hyperglycemia C. weight gain D. fat redistribution

A. hypotension

A nurse is providing teaching to a client who is about to begin exenatide therapy to treat type 2 diabetes mellitus. Which of the following instructions should the nurse include? (SELECT ALL THAT APPLY) A. inject the drug subcutaneously B. expect the peak effect in 2 hr C. use the drug as a supplement to an oral hypoglycemic D. inject the drug 1 hr after a meal E. discard used pens 10 days after the first use

A. inject the drug subcutaneously B. expect the peak effect in 2 hr C. use the drug as a supplement to an oral hypoglycemic

A client is about to start taking sustained release glipizide to treat type 2 diabetes mellitus. Which of the following instructions should you include when talking with the client about taking this drug? A. chew the tablet completely before swallowing it B. take it once a day, 30 min before breakfast C. take it in the evening before bedtime D. drink 16oz of water right after taking it

B. take it once a day, 30 min before breakfast

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

A. eat more iron-rich foods

When talking with a 30-year-old woman who will receive radioactive iodine-131 (Iodotope) to treat Grave's disease, you should include which of the following instructions? (SELECT ALL THAT APPLY) A. report weight gain and edema B. use effective contraception C. allow 2 to 3 months for full effects D. expect period blood sampling E. obtain regular eye examinations

A. report weight gain and edema B. use effective contraception C. allow 2 to 3 months for full effects D. expect period blood sampling