Pharm Exam 4 - Diabetic, Thyroid, Pituitary, Adrenal & Respiratory

The nurse is caring for a patient who is taking a first-generation antihistamine. What is the most important information for the nurse to teach the patient? "Do not drive after taking this medication." "Make sure you drink a lot of liquids while on this medication." "Take this medication on an empty stomach." "Do not take this medication for more than 2 days."

"Do not drive after taking this medication." First-generation antihistamines cause drowsiness. There is no evidence to indicate that the patient should force fluids, take the medication on an empty stomach, or place the medication on hold for any period of time.

The nurse is teaching the patient how to administer insulin. What information is essential to include in the plan? "For the most consistent absorption, inject the insulin into the abdomen." "Avoid administering the insulin into your arm." "Inject the insulin at a 30-degree angle between the fat and muscle." "Do not mix any insulins in the same syringe."

"For the most consistent absorption, inject the insulin into the abdomen." The abdomen has the most consistent absorption because the blood flow to the subcutaneous tissue typically is not as affected by muscular movements as it could be in the arm or thigh. Insulin can be administered in the arm. The patient should be instructed to inject insulin at a 45- to 90-degree angle, not a 30-degree angle. Most insulins can be mixed.

Which instruction will the nurse include when teaching a patient about the proper use of metered-dose inhalers? "After you inhale the medication once, repeat until you obtain relief." "Make sure that you puff out air repeatedly after you inhale the medication." "Hold your breath for 10 seconds if you can after you inhale the medication." "Hold the inhaler in your mouth, take a deep breath, and then compress the inhaler."

"Hold your breath for 10 seconds if you can after you inhale the medication." Holding the breath for 10 seconds allows the medication to be absorbed in the bronchial tree rather than be immediately exhaled.

Which statement indicates to the nurse that the patient needs additional teaching on oral hypoglycemic agents? "I will limit my alcohol consumption." "I will report symptoms of fatigue and loss of appetite." "I will take the medication only when I need it." "I will monitor my blood sugar daily."

"I will take the medication only when I need it." Oral hypoglycemic agents must be taken on a daily scheduled basis to maintain euglycemia and prevent long-term complications of diabetes. When alcohol is ingested with certain oral hypoglycemic drugs, the hypoglycemic effect can be intensified. The patient may experience fatigue and loss of appetite as side effects of the medication, and these should be reported to the health care provider. The patient needs to closely monitor blood sugar.

The nurse is teaching a patient about the use of an expectorant. What is the most important instruction for the nurse to include in the patient teaching? "Restrict your fluids in order to decrease mucus production." "Take the medication once a day only, at bedtime." "Increase your fluid intake in order to decrease viscosity of secretions." "Increase your fiber and fluid intake to prevent constipation."

"Increase your fluid intake in order to decrease viscosity of secretions." Expectorant drugs are used to decrease viscosity of secretions and allow them to be more easily expectorated. Increasing fluid intake helps this action.

A patient complains of worsening nasal congestion despite the use of oxymetazoline (Afrin) nasal spray every 2 hours. What is the nurse's most appropriate response? "Oxymetazoline is not an effective nasal decongestant." "Overuse of nasal decongestants results in rebound congestion." "Oxymetazoline should be administered every hour for severe congestion." "You are probably displaying an unexpected reaction to oxymetazoline."

"Overuse of nasal decongestants results in rebound congestion." Oxymetazoline (Afrin) is an effective nasal decongestant, but overuse results in worsening or "rebound" congestion. It should not be used more than every 4 hours. To avoid future rebound congestion with nasal sprays, it is recommended that they be used for no more than 3 to 5 days.

The 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 with your type of diabetes, the beta cells do not contain insulin. This medication will not work for you." "You must be mistaken. If your friend has diabetes mellitus, she is taking insulin." "Sulfonylurea will lower your blood sugar too much, and you will be hypoglycemic." "You are unable to store glucose, because you do not have insulin, and sulfonylurea helps with glucose storage."

"Sulfonylurea increases beta-cell stimulation to secrete insulin, and with your type of diabetes, the beta cells do not contain insulin. This medication will not work for you." Sulfonylurea agents reduce serum glucose levels by increasing beta-cell stimulation for insulin release, decreasing hepatic glucose production, and increasing insulin sensitivity. It is administered for type 2 diabetes mellitus but will not be effective in type 1.

A patient is prescribed ipratropium (Atrovent) and cromolyn sodium (Intal). What will the nurse teach the patient? "Do not take these medications within 4 hours of each other." "Take the ipratropium (Atrovent) at least 5 minutes before the cromolyn (Intal)." "Administer both medications together in a metered-dose inhaler." "Take the ipratropium (Atrovent) only in the mornings."

"Take the ipratropium (Atrovent) at least 5 minutes before the cromolyn (Intal)." When using an anticholinergic in conjunction with an inhaled glucocorticoid or cromolyn, the ipratropium should be used 5 minutes before the steroid. This causes the bronchioles to dilate so the steroid or cromolyn can get deeper into the lungs.

The patient newly diagnosed with type 2 diabetes mellitus has been ordered insulin glargine (Lantus). What information is essential for the nurse to teach this patient? "This medication should be mixed with the regular insulin each morning." "This medication is very short-acting. You must be sure you eat after injecting it." "This medication is very expensive, but you will be receiving it only a short time." "This medication has a duration of action of 24 hours."

"This medication has a duration of action of 24 hours." Insulin glargine (Lantus) has a duration of action of 24 hours with no peaks, mimicking the natural, basal insulin secretion of the pancreas. This medication cannot be mixed with other insulins and is not a short-acting insulin. The patient may need to receive this medication for a long time.

A patient is prescribed an antitussive medication. What is the most important instruction for the nurse to include in the patient teaching? "This medication may cause drowsiness and dizziness." "Watch for diarrhea and abdominal cramping." "This medication may cause tremors and anxiety." "Headache and hypertension are common side effects."

"This medication may cause drowsiness and dizziness." Antitussive medications also affect the central nervous system, thus causing drowsiness and dizziness. There is no reason to anticipate that the medication will cause diarrhea, abdominal cramping, tremors and anxiety, or headache and hypertension.

What information will the nurse teach the patient who has been prescribed an alpha glucosidase inhibitor? "This medication will stimulate pancreatic insulin release." "This medication will increase the sensitivity of insulin receptor sites." "This medication will delay the absorption of carbohydrates from the intestines." "This medication cannot be used in combination with other antidiabetic agents."

"This medication will delay the absorption of carbohydrates from the intestines." Alpha glucosidase is an enzyme necessary for the absorption of glucose from the GI tract. Inhibiting this enzyme inhibits glucose absorption, delaying rises in postprandial serum glucose levels.

The nurse is teaching the patient on the use of beclomethasone diproprionate (Beconase). Which statement by the patient indicates an understanding of the teaching? "I will need to taper off the medication to prevent acute adrenal crisis." "This medication will help prevent the inflammatory response of my allergies." "I will need to monitor my blood sugar more closely because it may increase." "I need to take this medication only when my symptoms get bad."

"This medication will help prevent the inflammatory response of my allergies." Beclomethasone diproprionate (Beconase) is a steroid spray administered nasally. It is used to prevent allergy symptoms. Its effect is localized, and therefore the patient does not have systemic side effects with normal use and does not have to worry about weaning off the medication as with oral corticosteroids. Because the medication has a localized effect, it will not produce the changes in blood sugar that would be generated by systemic steroids.

The nurse will include which information regarding the use of antileukotriene agents such as zafirlukast (Accolate) in the patient teaching? "Take the medication as soon as you begin wheezing." "It will take about 3 weeks before you notice a therapeutic effect." "This medication will prevent the inflammation that causes your asthma attack." "Increase fiber and fluid in your diet to prevent the side effect of constipation."

"This medication will prevent the inflammation that causes your asthma attack." Antileukotriene agents block the inflammatory response of leukotrienes and thus the trigger for asthma attacks. Response to these drugs is usually noticed within 1 week. They are not used to treat an acute asthma attack.

The nurse would include which statement when teaching a patient about insulin glargine (Lantus)? "You should inject this insulin just before meals because it is very fast-acting." "The duration of action for this insulin is approximately 8 to 10 hours, so you will need to take it twice a day." "You can mix this insulin with Lente insulin to enhance its effects." "You cannot mix this insulin with any other insulin in the same syringe."

"You cannot mix this insulin with any other insulin in the same syringe." Insulin glargine (Lantus) is a long-acting insulin with a duration of action up to 24 hours. It should not be mixed with any other insulins. The insulin is not fast-acting.

The nurse is caring for a patient in the clinic who states that he is afraid of taking antihistamines because he is a truck driver. What is the best information for the nurse to give this patient? "Take the medication only when you are not driving." "Take a lower dose than normal when you have to drive." "You are correct; you should not take antihistamines." "You may be able to safely take a second-generation antihistamine."

"You may be able to safely take a second-generation antihistamine." Second-generation antihistamines are often called non-sedating antihistamines. These may be safer for the patient to take, but the patient should still monitor for signs of excessive sedation.

The nurse is teaching a patient who has been prescribed repaglinide (Prandin). Which information will the nurse include in the teaching plan? "You will need to be sure you eat as soon as you take this medication." "This medication is compatible with all of your cardiac medications." "This medication will not cause hypoglycemia." "This medication has no side effects."

"You will need to be sure you eat as soon as you take this medication." Repaglinide (Prandin) is short-acting. The drug's very fast onset of action allows patients to take the drug with meals and skip a dose when they skip a meal. Prandin interacts with beta-adrenergic blockers as well as other medications. Hypoglycemia is a side effect of this medication, and there are many other possible side effects of this medication.

The recommended dosage for Afrin is _____ to _____ puffs, _____ to ______ times a day for _______ to ______ days.

1-2 puffs 4-6 times 5-7 days

The theraputic level for Theophyline (Amniophyiline) is between _______ and _______.

10-20

A blood glucose level around ______ is ideal. Typically between ______ and _______.

100 60-100

A patient should not take antitussives if they have taken an MAOI with in the last _____ days.

14

It typically takes _____ to ____ minutes for Glucagon to work.

15-20 minutes

Metformin cannot be given with in ______ hours of IV contrast.

24

You should instruct a patient taking neo-synephrine to not take it for more than ____ days because it causes __________ congestion.

3 rebound

A patient with hypothyroidism should take their medications either _______ to _______ minutes before they eat.

30-60

You should give glucagon if your patients blood glucose is less than _____.

70

As a nurse you know that prednisone can be given by: (select all the apply) A. Oral B. IV C.Sublingual D.Buccal E. Injected

A,B,E

As a nurse you know that your patient may have Cushing's because they have which of the following S&S: (select all the apply) A. Moon face B. Weight loss C. Puffy skin D.Buffalo Hump E. Decrease in edema F. Stretch marks in the trunk.

A,C,D,F

As a nurse you know your patient may have Addison's because they show the following symptoms: A.Orangish-bronzy skin B. Excess Fluid Volume C. Loss of weight D. Loss of fluids E. Weight gain F.Dehydration G. Electrolyte imbalnces.

A,C,D,F,G

Which instruction should the nurse provide when teaching a patient to mix regular insulin and NPH insulin in the same syringe? A. "Draw up the clear regular insulin first, followed by the cloudy NPH insulin." B. "It is not necessary to rotate the NPH insulin vial when it is mixed with regular insulin." C. "The order of drawing up insulin does not matter as long as the insulin is refrigerated." D. "Rotate subcutaneous injection sites each day among the arm, thigh, and abdomen."

A. "Draw up the clear regular insulin first, followed by the cloudy NPH insulin." To ensure a consistent response, only NPH insulin is appropriate for mixing with a short-acting insulin. Unopened vials of insulin should be refrigerated; current vials can be kept at room temperature for up to 1 month. Drawing up the regular insulin into the syringe first prevents accidental mixture of NPH insulin into the vial of regular insulin, which could alter the pharmacokinetics of subsequent doses taken out of the regular insulin vial. NPH insulin is a cloudy solution, and it should always be rotated gently to disperse the particles evenly before loading the syringe. Subcutaneous injections should be made using one region of the body (eg, the abdomen or thigh) and rotated within that region for 1 month.

The patient is prescribed 30 units regular insulin and 70 units NPH insulin subcutaneously every morning. The nurse will provide which instruction to the patient? A. "Draw up the regular insulin into the syringe first, followed by the cloudy NPH insulin." B. "Mixing insulins will help increase insulin production." C. "Rotate sites at least once weekly." D. "Use a 23- to 25-gauge syringe with a 1-inch needle for maximum absorption."

A. "Draw up the regular insulin into the syringe first, followed by the cloudy NPH insulin." Drawing up the regular insulin into the syringe first prevents accidental mixture of NPH insulin into the vial of regular insulin, which could cause an alteration in the onset of action of the regular insulin.

Which statement by the patient demonstrates an understanding of discharge instructions on the use of levothyroxine (Synthroid)? A. "I will take this medication in the morning so as not to interfere with sleep." B. "I will double my dose if I gain more than 1 pound per day." C. "I will stop the medication immediately if I lose more than 2 pounds in a week." D. "I can expect to see relief of my symptoms within 1 week."

A. "I will take this medication in the morning so as not to interfere with sleep." Levothyroxine increases basal metabolism and thus wakefulness. Patients should not double the dose or stop taking the medication abruptly. It may take up to 4 weeks for a therapeutic response to occur.

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

A. "I'll take this medication in the morning so as not to interfere with sleep." Levothyroxine is used to treat hypothyroidism by increasing the basal metabolism and thus wakefulness. It is administered as a once-daily dose and is a lifelong therapy. It is best taken on an empty stomach to enhance absorption.

A teaching plan for a patient who is taking lispro [Humalog] should include which instruction by the nurse? A. "Inject this insulin with your first bite of food, because it is very fast acting." B. "The duration of action for this insulin is about 8 to 10 hours, so you'll need a snack." C. "This insulin needs to be mixed with regular insulin to enhance the effects." D. "To achieve tight glycemic control, this is the only type of insulin you'll need."

A. "Inject this insulin with your first bite of food, because it is very fast acting." Lispro is a rapid-acting insulin and has an onset of action of 15 to 30 minutes with a peak action of about 2 hours, not 8 to 10 hours. Because of its rapid onset, it is administered immediately before a meal or with meals to control the blood glucose rise after meals. Lispro insulin must be combined with an intermediate- or a long-acting insulin, not regular insulin (which also is a short-duration insulin), for glucose control between meals and at night. To achieve tight glycemic control, patients must combine different types of insulin based on their duration of action.

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

A. "Reduce your water intake to prevent water intoxication." Failure to reduce the fluid intake while using desmopressin results in water intoxication, leading to seizures and coma. DDAVP is administered intranasally; therefore, rotating the nostril used is important to prevent irritation. Monitoring weekly weights for volume status and understanding that a rapid treatment response occurs also are important; however, they are not as important as reducing the fluid intake to prevent water intoxication.

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

A. "You need to notify your doctor if you have a sore throat and fever." Agranulocytosis (the absence of granulocytes to fight infection) is the most serious toxicity associated with methimazole. Sore throat and fever may be the earliest signs. Nausea, muscle soreness, and headache and dizziness are other adverse effects of methimazole that are not as serious as agranulocytosis.

The healthcare provider orders octreotide [Sandostatin LAR] 250 mcg IM now. The available medication is octreotide [Sandostatin LAR] 1000 mcg/mL. The nurse plans to administer how much? A. 0.25 mL B. 0.5 mL C. 1.25 mL D. 4 mL

A. 0.25 mL The ordered dose is 250 mcg, and the available medication is 1000 mcg/mL. Divide 250 mcg by 1000 mcg/mL, which equals 0.25 mL. The nurse will give 1/4 or 25% of 1 mL.

A patient is scheduled to start taking insulin glargine [Lantus]. On the care plan, a nurse should include which of these outcomes related to the therapeutic effects of the medication? A. Blood glucose control for 24 hours B. Mealtime coverage of blood glucose C. Less frequent blood glucose monitoring D. Peak effect achieved in 2 to 4 hours

A. Blood glucose control for 24 hours Insulin glargine is administered as a once-daily subcutaneous injection for patients with type 1 diabetes. It is used for basal insulin coverage, not mealtime coverage. It has a prolonged duration, up to 24 hours, with no peaks. Blood glucose monitoring is still an essential component to achieve tight glycemic control.

When assessing for potential toxicity to PTU, the nurse will monitor the patient for changes in which laboratory test? A. CBC B. BNP C. Serum electrolytes D. Renal function tests

A. CBC With antithyroid medications, the nurse should monitor for possible toxic reactions such as agranulocytosis, pancytopenia, and life-threatening hepatitis. An abnormal CBC would indicate bone marrow dysfunction.

Before administering metformin [Glucophage], the nurse should notify the prescriber about which laboratory value? A. Creatinine (Cr) level of 2.1 mg/dL B. Hemoglobin (Hgb) level of 9.5 gm/dL C. Sodium (Na) level of 131 mEq/dL D. Platelet count of 120,000/mm3

A. Creatinine (Cr) level of 2.1 mg/dL Metformin can reach toxic levels in individuals with renal impairment, which is indicated by a rise in the serum creatinine level. The prescriber may have to be notified of the hemoglobin, sodium, and platelet values, but they would not affect the administration of metformin.

What would the nurse assess when monitoring for the therapeutic effectiveness of vasopressin? A. Fluid balance B. Patient's pain scale C. Serum albumin levels D. Adrenocorticotropic hormone (ACTH) levels

A. Fluid balance Vasopressin causes decreased water excretion in the renal tubule, thus decreasing urine output. It is used to treat diabetes insipidus, which presents with polyuria and dehydration.

When teaching a patient regarding desmopressin (DDAVP), the nurse will inform the patient to monitor for which potential side effects? (Select all that apply.) A. Headache B. Weight gain C. Nasal irritation D. Hyperglycemia E. Hypotension

A. Headache B. Weight gain C. Nasal irritation Desmopressin works to decrease urine output; thus the patient would retain fluid and gain weight. Headache may also occur as a sequela of fluid retention. Because it is administered intranasally, it can be irritating; thus nostrils should be rotated. Desmopressin does not affect serum glucose levels.

The nurse is reviewing adverse effects of antithyroid medications with a patient who has been taking PTU. What adverse effects does the nurse include in the teaching? (Select all that apply.) A. Liver toxicity B. Polyuria C. Kidney damage D. Bone marrow toxicity E. Joint pain

A. Liver toxicity D. Bone marrow toxicity E. Joint pain The most damaging or serious adverse effects of the antithyroid medications are liver and bone marrow toxicity. Myalgias and arthralgias (joint pain) may also occur with PTU.

Pramlintide (Symlin) is added to the treatment plan for a patient with type 1 diabetes. What information about the action of this medication does the nurse include in the patient teaching? A. Pramlintide slows gastric emptying. B. Pramlintide increases glucagon excretion. C. Pramlintide works to prevent side effects of insulin. D. Pramlintide is an oral drug administered 15 minutes before meals.

A. Pramlintide slows gastric emptying. Pramlintide is a synthetic form of the naturally occurring hormone amylin. It works by slowing gastric emptying, suppressing glucagon secretion, and centrally modulating appetite and satiety. It is only administered subcutaneously.

A patient who has type 2 diabetes has a glycated hemoglobin A1c (HbA1c) of 10%. The nurse should make which change to the nursing care plan? A.Refer the patient to a diabetes educator because the result reflects poor glycemic control. B. Glycemic control is adequate; no changes are needed. C. Hypoglycemia is a risk; teach the patient the symptoms. D. Instruct the patient to limit activity and weekly exercise.

A. Refer the patient to a diabetes educator because the result reflects poor glycemic control. Glycated hemoglobin (HbA1c) is a measure of plasma glucose levels on average over the previous 2- to 3-month period. The target value is 6.5% or lower. If it is greater than 6.5%, a diabetes educator is an additional resource who can facilitate lifestyle, exercise, and medication changes. Hypoglycemia is not a concern, because elevated HbA1c levels indicate poor glycemic control. Exercise should be part of an overall management program, because it counteracts insulin resistance.

To prevent oral candidiasis, it is most important for the nurse to teach a patient using a steroid inhaler to perform which action? A. Rinse the mouth after each use. B. Minimize use of an inhaler to every other day. C. Swish and swallow with mycostatin after each use. D. Report any gingival irritation to the health care provider.

A. Rinse the mouth after each use. It is most important to teach patients to rinse their mouth after each use of a steroid inhaler to prevent the occurrence of oral candidiasis, a fungal infection. Mycostatin is not routinely used to prevent this infection unless the patient is immunocompromised. Reporting irritation once it has occurred does not prevent the infection. Minimizing the use of the inhaler to every other day negates its therapeutic effect.

When discussing glucocorticoids, what statement is accurate in relation to the action of these medications? A. They influence carbohydrate, fat, and protein metabolism. B. They are produced in decreased amounts during times of stress. C. They decrease serum sodium and glucose levels. D. They stimulate defense mechanisms to produce immunity.

A. They influence carbohydrate, fat, and protein metabolism. Glucocorticoids play a major role in carbohydrate, lipid, and protein metabolism within the body. They are produced in increasing amounts during stress, increase sodium and glucose levels, and suppress the immune system.

The patient reports that she had to switch pharmacies to save money. She noticed that her "thyroid pill" looks different. The nurse anticipates that the healthcare provider will order what? A. Thyroid stimulating hormone (TSH) B. Electrocardiogram (ECG) C. Beta human chorionic gonadotropin (hCG) test D. Creatinine level

A. Thyroid stimulating hormone (TSH) If a switch is made (from one branded product to another, from a branded product to a generic product, or from one generic product to another), retest serum TSH in 6 weeks, and adjust the levothyroxine dosage as indicated.

The nurse would question an order for steroids in a patient with which condition? A. Uncontrolled diabetes mellitus B. Rheumatoid arthritis C. Septic shock D. Exacerbation of chronic obstructive pulmonary disease (COPD)

A. Uncontrolled diabetes mellitus A common side effect of steroid therapy is hyperglycemia; therefore uncontrolled diabetes mellitus is a contraindication to steroid therapy.

The nurse is providing care to a patient following a non-accidental traumatic brain injury. The patient has developed diabetes insipidus due to the injury. What medication is most often used in the management of diabetes insipidus? A. desmopressin (DDAVP) B. corticotrophin (Acthar) C. octreotide (Sandostatin) D. somatropin (Humatrope)

A. desmopressin (DDAVP) asopressin (Pitressin) and desmopressin (DDAVP) are used to prevent or control polydipsia (excessive thirst), polyuria, and dehydration in patients with diabetes insipidus caused by a deficiency of endogenous antidiuretic hormone.

Which long-acting insulin mimics natural, basal insulin with no peak action and a duration of 24 hours? A. insulin glargine (Lantus) B. insulin glulisine (Apidra) C. regular insulin (Humulin R) D. NPH insulin

A. insulin glargine (Lantus) Insulin glargine has a duration of action of 24 hours with no peaks, mimicking the natural, basal insulin secretion of the pancreas.

Which manifestations should a nurse investigate first when monitoring a patient who is taking levothyroxine [Synthroid]? A.Tachycardia B. Tremors C. Insomnia D. Irritability

A.Tachycardia High doses of levothyroxine may cause thyrotoxicosis, a condition of profound excessive thyroid activity. Tachycardia is the priority assessment, because it can lead to severe cardiac dysfunction. Tremors, insomnia, and irritability are other symptoms of thyrotoxicosis and should be assessed after tachycardia.

Which information should be included in a teaching plan for patients taking oral hypoglycemic drugs? (Select all that apply.) A. Limit your alcohol consumption. B. Report symptoms of anorexia and fatigue. C. Take your medication only as needed. D. Notify your physician if blood glucose levels rise above the level set for you.

ABD A. Limit your alcohol consumption. B. Report symptoms of anorexia and fatigue. D. Notify your physician if blood glucose levels rise above the level set for you. Oral hypoglycemic drugs must be taken on a daily scheduled basis to maintain euglycemia and prevent long-term complications of diabetes. All other options are correct.

Which conditions is aminoglutethimide used to treat? (Select all that apply.) A. Cushings syndrome B. Testicular cancer C. Adrenal cancer D. Metastatic breast cancer E. Thyroid cancer

ACD A. Cushings syndrome C. Adrenal cancer D. Metastatic breast cancer Aminoglutethimide is an adrenal steroid inhibitor. Aminoglutethimide obstructs the normal actions of the adrenal cortex by inhibiting the conversion of cholesterol into adrenal corticosteroids. Aminoglutethimide is used in the treatment of Cushing's syndrome, metastatic breast cancer, and adrenal cancer.

Which actions describe the beneficial effects produced by sulfonylurea oral hypoglycemics? (Select all that apply.) A. Stimulate insulin secretion from beta cells B. Increase hepatic glucose production C. Enhance action of insulin in various tissues D. Inhibit breakdown of insulin by liver

ACD A. Stimulate insulin secretion from beta cells C. Enhance action of insulin in various tissues D. Inhibit breakdown of insulin by liver The sulfonylureas stimulate insulin secretion from the beta cells of the pancreas; enhance the actions of insulin in muscle, liver, and adipose tissue; and prevent the liver from breaking insulin down as fast as it ordinarily would (reduced hepatic clearance). Increased hepatic glucose production would serve to increase serum glucose levels, the opposite effect of oral hypoglycemic drugs.

Vasopressin can be given by IV, SubQ and nasally in order to replace ______.

ADH

If a patient with Addison's suddenly stops taking their medication it can cause Addison's ________ in which the adrenal glands stop working.

Addison's crisis

What is the nurse's best action when finding a patient with type 1 diabetes mellitus unresponsive, cold, and clammy? Administer subcutaneous regular insulin immediately. Administer glucagon. Start an insulin drip. Draw blood glucose level and send to the laboratory.

Administer glucagon. Glucagon stimulates glycogenolysis, raising serum glucose levels. The patient is showing signs of hypoglycemia.

The patient tells the nurse that she has a cold, is coughing, and feels like she has fluid in her lungs. What action will the nurse anticipate performing next? Administer dextromethorphan. Administer guaifenesin. Encourage the patient to drink fluids hourly. Administer fluticasone (Flonase).

Administer guaifenesin. The patient needs an expectorant. This medication will help the patient cough the fluid out of her lungs. Dextromethorphan and fluticasone will not help the patient expectorate. There is no information about the patient's fluid intake, so hourly fluids may be too much.

The health care provider orders ipratropium bromide (Atrovent), albuterol (Proventil), and beclomethasone (Vanceril) inhalers for a patient. What is the nurse's best action? Question the order; three inhalers should not be given at one time. Administer the albuterol, wait 5 minutes, administer ipratropium bromide, then beclomethasone several minutes later. Administer each inhaler at 30-minute intervals. Administer beclomethasone, wait 2 minutes, administer ipratropium bromide, then albuterol several minutes later.

Administer the albuterol, wait 5 minutes, administer ipratropium bromide, then beclomethasone several minutes later. Administering the bronchodilator albuterol (Proventil) first allows the other drugs to reach deeper into the lungs as the bronchioles dilate. Anticholinergics such as ipratropium bromide (Atrovent) also help bronchodilate, but to a lesser extent. Corticosteroids such as beclomethasone (Vanceril) do not dilate and are therefore given last.

A patient with a history of asthma is short of breath and says, "I feel like I'm having an asthma attack." What is the nurse's highest priority action? Calling a code Asking the patient to describe the symptoms Administering a beta2 adrenergic agonist Administering a long-acting glucocorticoid

Administering a beta2 adrenergic agonist In an acute asthmatic attack, the short-acting sympathomimetics are the first line of defense. A beta2-adrenergic agonist will provide immediate relief, while a glucocorticoid will not; there is no need to call a code.

Corticosteriods such as glucocorticoids and mineralocorticoids come from the ________ gland.

Adrenal

Typically, when a person has cushing's disease they will have to have their ___________ gland removed. After this gland is removed, the patient will typically return back to ____________.

Adrenal Normal

When a person is on ______________ you should asses their resp. rate and breath sounds.

Albuterol

____________ can cause hypertension, tachycardia, nervousness and may cause the patient to feel jittery

Albuterol.

Epinephrine can be used for ___________ reactions and _________. In these cases epinephrine should be administered ________.

Allergic Asthma Sub Q

Benadryl is typically given for ___________ reactions in which they can be given __________, _________ and __________.

Allergic Orally, IM, Nasally

Growth hormone comes from the ____________ ______________ gland.

Anterior pituitary

Tiotropium (spiriva) is an example of an _________________ med.

Anticholinergic

Cromolyn (Intal) is typically used for __________.

Asthma

Albuterol can be given for _________ as well as ________.

Asthma COPD

A patient receiving propylthiouracil (PTU) asks the nurse how this medication will help relieve his symptoms. What is the nurse's best response? A. "Propylthiouracil inactivates any circulating thyroid hormone, thus decreasing signs and symptoms of hyperthyroidism." B. "Propylthiouracil inhibits the formation of new thyroid hormone, thus gradually returning your metabolism to normal." C. "Propylthiouracil helps your thyroid gland use iodine and synthesize hormones better." D. "Propylthiouracil stimulates the pituitary gland to secrete thyroid-stimulating hormone (TSH), which inhibits the production of hormones by the thyroid gland."

B. "Propylthiouracil inhibits the formation of new thyroid hormone, thus gradually returning your metabolism to normal." Propylthiouracil is an antithyroid medication used to treat hyperthyroidism. It works by inhibiting the synthesis of new thyroid hormone. It does not inactivate present hormone.

Which patient statement demonstrates understanding of radioactive iodine (I-131) therapy? A. "I will have to isolate myself from my family for 1 week so as not to expose them to radiation." B. "This drug will be taken up by the thyroid gland and destroy the cells to reduce my hyperthyroidism." C. "This drug will help decrease my cold intolerance and weight gain." D. "I will need to take this drug on a daily basis for at least 1 year."

B. "This drug will be taken up by the thyroid gland and destroy the cells to reduce my hyperthyroidism." Radioactive iodine is an antithyroid medication that is administered orally for one or two doses only. It concentrates in the thyroid gland, enabling the radiation to destroy the hyperplastic cells.

The nurse is providing education to a patient about the time to take glipizide (Glucotrol). For maximum benefit, the nurse will tell the patient to administer glipizide at which time? A. In the morning B. 30 minutes before a meal C. 15 minutes postprandial D. At bedtime

B. 30 minutes before a meal Glipizide works best if given 30 minutes before meals. This allows the timing of the insulin secretion induced by the glipizide to correspond to the elevation in the blood glucose level induced by the meal.

The nurse has an order for a patient to receive prednisone for contact dermatitis. What condition in the patient would alert the nurse to question the order? A. Asthma B. AIDS C. COPD D. Multiple sclerosis

B. AIDS Because of their immunosuppressant properties, glucocorticoids are often avoided in the presence of any serious infection, including septicemia, systemic fungal infections, and varicella. These drugs would be contraindicated in patients with active AIDS infection as it could potentially decrease the immune system further. One exception is tuberculous meningitis, for which glucocorticoids may be used to prevent inflammatory central nervous system damage.

The nurse would question an order for somatrem (Protropin) in a patient with which condition? A. Dwarfism B. Acromegaly C. Growth failure D. Hypopituitarism

B. Acromegaly Somatrem is a synthetic form of growth hormone. Acromegaly is caused by excessive growth hormone, and thus this drug would be contraindicated.

Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) are products of which structure? A. Hypothalamus B. Anterior pituitary gland C. Posterior pituitary gland D. Ovaries

B. Anterior pituitary gland FSH and LH are secreted by the anterior pituitary gland. They both act on the ovaries to promote either follicular growth and development or ovulation and the development of the corpus luteum. They act in a negative feedback loop with the anterior pituitary gland and hypothalamus to affect the ovaries.

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

B. Excessive bruising Levothyroxine intensifies the effect of warfarin, an anticoagulant that increases the patient's risk for bleeding. The warfarin dose may need to be reduced. Bruising, weight loss, and shortness of breath are not effects associated with interactions of levothyroxine and warfarin.

A nurse is caring for a patient with decreased triiodothyronine (T3) and thyroxine (T4) and elevated thyroid-stimulating hormone (TSH) levels. The nurse knows the patient is likely suffering from what? A. Thyrotoxicosis B. Hypothyroidism C. Hyperthyroidism D. Graves' disease

B. Hypothyroidism The anterior pituitary increases production of TSH when thyroid hormone levels of T3 and T4, are reduced, reflecting primary hypothyroidism. Patients may experience fatigue caused by a lowered basal metabolic rate. Thyrotoxicosis, hyperthyroidism, and Graves' disease are medical conditions indicative of excessive thyroid activity.

Patients taking levothyroxine (Synthroid) and warfarin (Coumadin) concurrently would be monitored for which adverse effect? A. Cardiac arrhythmias B. Increased risk of bleeding C. Excessive weight loss D. Increased risk of deep vein thrombosis

B. Increased risk of bleeding Levothyroxine can compete with protein-binding sites of warfarin, allowing more warfarin to be unbound or free, thus increasing effects of warfarin and risk of bleeding.

An adult patient who has GH deficiency is receiving somatropin [Nutropin]. An increase in which finding would indicate to the nurse that the patient is improving? A. Height (by 3 inches) B. Lean body mass C. Physical strength D. Joint range of motion

B. Lean body mass Nutropin is a form of GH. In adults with GH deficiency, replacement therapy does not cause long bone growth or an increase in height, because the epiphyses are already closed. It does increase lean body mass and reduces adipose tissue. Although it increases muscle mass, Nutropin does not increase strength. Joint range of motion is not affected.

A patient who has type 2 diabetes is taking nateglinide [Starlix]. Which response should a nurse expect the patient to have if the medication is achieving the desired therapeutic effect? A. Inhibition of carbohydrate digestion B. Promotion of insulin secretion C. Decreased insulin resistance D. Inhibition of ketone formation

B. Promotion of insulin secretion Nateglinide is a meglitinide medication that acts to increase pancreatic insulin release. It is used as an adjunct to calorie restriction and exercise to maintain glycemic control in patients with type 2 diabetes. It does not act to reduce insulin resistance or inhibit carbohydrate digestion. It should not be used to manage diabetic ketone formation, because its glucose-lowering effects are too slow to be of benefit.

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

B. Softening of facial features Octreotide suppresses GH, which is excessive in acromegaly. This results in coarse facial features, splayed teeth, and large hands and feet. Treatment with octreotide reduces the continued development of these effects. The epiphyses have closed in adults, so height is not affected. Urine volume is affected by antidiuretic hormone. Prolactin stimulates the milk reflex.

A nurse assesses a patient who is taking pramlintide [Symlin] with mealtime insulin. Which finding requires immediate follow-up by the nurse? A. Skin rash B. Sweating C. Itching D. Pedal edema

B. Sweating Pramlintide is a new type of antidiabetic medication used as a supplement to mealtime insulin in patients with type 1 and 2 diabetes. Hypoglycemia, which is manifested by sweating, tremors, and tachycardia, is the adverse reaction of most concern. Skin rash, itching, and edema are not adverse effects of pramlintide.

Which manifestation would the nurse most clearly associate with a tumor of the hypothalamus? A. Mood swings B. Unstable body temperature C. Irregular respirations D. Increased heart rate

B. Unstable body temperature One function of the hypothalamus is the regulation of body temperature, and a tumor that compresses the hypothalamus would impair this function. Regulation of mood swings, respiratory rate, and heart rate are not functions of the hypothalamus.

Discharge teaching for a patient receiving glucocorticoids would include the preferred use of which medication for pain management? A. aspirin B. acetaminophen C. ibuprofen D. naproxen

B. acetaminophen Acetaminophen does not cause gastrointestinal distress as does aspirin, ibuprofen, naproxen, and glucocorticoids.

When caring for a patient newly diagnosed with gestational diabetes, the nurse would question an order for which drug? A. insulin glargine (Lantus) B. glipizide (Glucotrol) C. insulin glulisine (Apidra) D. NPH insulin

B. glipizide (Glucotrol) Oral antidiabetic drugs are generally not recommended for pregnant patients.

The nurse will advise the patient to treat hypoglycemia with which drug? A. propranolol (Inderal) B. glucagon C. acarbose (Precose) D. bumetanide (Bumex)

B. glucagon Glucagon stimulates glycogenolysis, raising serum glucose levels.

Which is a rapid-acting insulin with an onset of action of less than 15 minutes? A. insulin glargine (Lantus) B. insulin aspart (NovoLog) C. regular insulin (Humulin R) D. insulin detemir (Levemir)

B. insulin aspart (NovoLog) Insulin aspart is a rapid-acting insulin. Insulin glargine and insulin detemir are long-acting insulins. Regular insulin is short acting.

The nurse is caring for a patient scheduled to undergo a cardiac catheterization procedure utilizing iodine-based contrast material. The nurse would question an order for which medication to be given to this patient the day before the scheduled procedure? A. acarbose (Precose) B. metformin (Glucophage) C. repaglinide (Prandin) D. pioglitazone (Actos)

B. metformin (Glucophage) The concurrent use of metformin and iodinated (iodine-containing) radiologic contrast media has been associated with both acute renal failure and lactic acidosis. Therefore metformin should be discontinued at least 48 hours prior to any radiologic study requiring such contrast media and should be held for at least 48 hours after the procedure.

Which statements about levothyroxine [Synthroid] are correct? (Select all that apply.) A. Levothyroxine should be taken with food. B. Levothyroxine can be given by IV but is usually taken orally. C.Levothyroxine brands should not be changed if possible. D. Levothyroxine should be taken at night to avoid adverse effects. E. Levothyroxine can affect the metabolism of other medications.

BCE B. Levothyroxine can be given by IV but is usually taken orally. C.Levothyroxine brands should not be changed if possible. E. Levothyroxine can affect the metabolism of other medications. Levothyroxine is almost always administered by mouth. Oral doses should be taken once daily on an empty stomach (to enhance absorption). Dosing is usually done in the morning, at least 30 to 60 minutes before breakfast. Maintain patients on the same brand-name levothyroxine product. Intravenous administration is used for myxedema coma and for patients who cannot take levothyroxine orally. Levothyroxine affects the metabolism of other medications, including warfarin.

A nurse caring for a patient who has diabetic ketoacidosis recognizes which characteristics in the patient? (Select all that apply.) A. Type 2 diabetes B. Altered fat metabolism leading to ketones C. Arterial blood pH of 7.35 to 7.45 D. Sudden onset, triggered by acute illness E. Plasma osmolality of 300 to 320 mOsm/L

BDE B. Altered fat metabolism leading to ketones D. Sudden onset, triggered by acute illness E. Plasma osmolality of 300 to 320 mOsm/L Diabetic ketoacidosis is the most severe manifestation of insulin deficiency in patients with type 1 diabetes. It develops and worsens acutely over several hours to days. Alterations in fat metabolism lead to the production of ketones and ketoacids. Increased ketoacid levels lead to a fall in arterial blood pH below 7.35. Altered glucose metabolism leads to hyperglycemia, water loss, and an elevated plasma osmolality (285 to 295 mOsm/L).

Albuterol is an example of a __________________.

Bronchodilator

It is important to know that you give a _______________ before a steroid inhaler and to wait _______ minutes before administering each med.

Bronchodilator 5

A patient with Graves' disease is treated with iodine-131 therapy. Which statement by the patient would indicate understanding of the treatment's effects? A. "I'll have to isolate myself from my family so I don't expose them to radiation." B. "I'm looking forward to feeling better immediately after this treatment." C. "I'll tell my doctor if I have fatigue, hair loss, or cold intolerance." D. "I'll need to take this drug on a daily basis for at least 1 year."

C. "I'll tell my doctor if I have fatigue, hair loss, or cold intolerance." Iodine-131 usually is given as a single treatment to produce remission of Graves' disease. Fatigue, hair loss, and cold intolerance are signs of hypothyroidism, which is a complication of the treatment. Iodine-131 has a quick radioactive decay and half-life; therefore, isolation is not needed, but it can take up to 2 months for the desired response to develop.

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? A. 0.5 B. 1 C. 2 D. 4

C. 2 The ordered dose is 150 mcg. The available tablets are 75 mcg. 75 multiplied by 2 equals 150. Therefore, 2 tablets is the correct dose.

Assuming the patient eats breakfast at 8:30 AM, lunch at noon, and dinner at 6:00 PM, he or she is at highest risk of hypoglycemia following an 8:00 AM dose of NPH insulin at what time? A. 10:00 AM B. 2:00 PM C. 5:00 PM D. 8:00 PM

C. 5:00 PM Breakfast eaten at 8:30 AM would cover the onset of NPH insulin, and lunch will cover the 2 PM time frame. However, if the patient does not eat a mid-afternoon snack, the NPH insulin may be peaking just before dinner without sufficient glucose on hand to prevent hypoglycemia.

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

C. Beta human chorionic gonadotropin (hCG) test Any female patient of reproductive age requires a negative result on a beta hCG (pregnancy hormone) test before iodine-131 (131I) can be administered. 131I is a radioactive isotope used to treat hyperthyroidism and is contraindicated in pregnancy and lactation. A WBC count, ECG, and creatinine level are not indicated before treatment with iodine-131.

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

C. Blood pressure Vasopressin is a potent vasoconstrictor. Benefits derive from increased blood flow to the heart and brain during CPR. The blood pH, body temperature, and respiratory rate are not affected by vasopressin.

A patient who took NPH insulin at 0800 reports feeling weak and tremulous at 1700. Which action should the nurse take? A. Take the patient's blood pressure. B. Give the patient's PRN dose of insulin. C. Check the patient's capillary blood sugar. D. Advise the patient to lie down with the legs elevated.

C. Check the patient's capillary blood sugar. The patient is showing symptoms of hypoglycemia at 5 PM. NPH has a peak action of 8 to 10 hours after administration. Based on the duration of action of NPH insulin, the patient's hypoglycemic symptoms are from the 8 AM injection of NPH insulin. An injection of NPH insulin at 2 AM, 1 PM, or 3 PM would not cause hypoglycemic symptoms based on the average duration of action of NPH insulin.

Which is a priority nursing diagnosis for a patient receiving desmopressin (DDAVP)? A. Risk for injury B. Acute pain C. Excess fluid volume D. Deficient knowledge regarding medication

C. Excess fluid volume Desmopressin is a form of antidiuretic hormone, which increases sodium and water retention, leading to an alteration in fluid volume. Although the other nursing diagnoses may be appropriate, they are not a priority using Maslow's hierarchy of needs.

Which nursing diagnosis should be the priority for a patient who is receiving desmopressin [DDAVP]? A. Activity intolerance B. Alteration in comfort C. Fluid volume imbalance D. Deficient knowledge

C. Fluid volume imbalance Desmopressin is a form of antidiuretic hormone that increases sodium and water retention, leading to an alteration in fluid volume. Monitoring of urine volumes and body weights is essential to prevent complications. Alteration in comfort, deficient knowledge of the condition, and activity intolerance are important nursing problems; however, they are not priorities according to the Maslow hierarchy of needs.

The nurse is discussing with a patient the time of day for taking prednisone. What information would the nurse include in the teaching based on knowledge of glucocorticoids? A. It is usually administered early in the evening to coincide with the natural secretion pattern of the adrenal cortex. B. It is usually administered on a strict, unchanging schedule in order to prevent adverse reactions. C. It should be administered with food to diminish the risk of gastric irritation. D. It should be administered with the patient's morning coffee to enhance its effects.

C. It should be administered with food to diminish the risk of gastric irritation. Glucocorticoids can cause gastrointestinal distress and should be administered with food. The normal circadian secretion of the adrenal cortex is early morning to wake the person up, not early evening. These medications should be tapered off slowly to prevent adrenal crisis and can be administered intravenously. While glucocorticoids should be given in the morning, they should not be administered with coffee, which contains caffeine and may increase gastric irritation.

The nurse is teaching the patient taking an antithyroid medication to avoid foods high in iodine. Which food will the nurse advise the patient against? A. Milk B. Eggs C. Seafood D. Chicken

C. Seafood Seafood contains high amounts of iodine. The other choices do not.

A patient is taking glipizide [Glucotrol] and a beta-adrenergic medication. A nurse is teaching hypoglycemia awareness and should warn the patient about the presence of which symptom? A. Vomiting B. Muscle cramps C. Tachycardia D. Chills

C. Tachycardia Glipizide is a sulfonylurea oral hypoglycemic medication that acts to promote insulin release from the pancreas. Beta-adrenergic blockers can mask early signs of sympathetic system responses to hypoglycemia; the most important of these is tachycardia, which is the most common adverse effect of glipizide. Vomiting, muscle cramps, and chills are not symptoms of activation of the sympathetic nervous system that arise when glucose levels fall.

Which insulin can be administered by continuous intravenous infusion? A. insulin glargine (Lantus) B. insulin aspart (Novolog) C. regular insulin (Humulin R) D. insulin detemir (Levemir)

C. regular insulin (Humulin R) Regular insulin is the only insulin used for intravenous therapy.

Which oral hypoglycemic drug has a quick onset and short duration of action, enabling the patient to take the medication 30 minutes before eating and skip the dose if he or she does not eat? A. acarbose (Precose) B. metformin (Glucophage) C. repaglinide (Prandin) D. pioglitazone (Actos)

C. repaglinide (Prandin) Repaglinide is known as the "Humalog of oral hypoglycemic drugs." The drug's very fast onset of action allows patients to take the drug with meals and skip a dose when they skip a meal.

You should instruct patients taking Theophyline (Amniophyiline) to avoid any ______ stimulants.

CNS

You should teach a patient taking Benadryl that they should not take any other ________ depressants while on the med.

CNS

Theophyline (Amniophyiline) are used to treat _________ and _______.

COPD Asthma

Acarbose helps to delay the absorption of ________.

Carbs

Allegra is more commonly used for _________ allergies because it does not cause ____________.

Chronic Drowsiness

Intranasal corticosteriods are used for ________ nasal __________.

Chronic Congestion

Patients with diabetes insipidus tend to have huge amounts of ________, _______ urine

Clear Dilute

The health care provider indicates that the patient will be ordered an opioid antitussive. Which medication does the nurse anticipate the provider will order? Promethazine with dextromethorphan Benzonatate (Tessalon Perles) Codeine CSS II Levocetirizine (Xyzal)

Codeine CSS II Codeine CSS II is classified as an opioid antitussive. Promethazine with dextromethorphan and benzonatate (Tessalon Perles) are both nonopioid antitussives. Levocetirizine (Xyzal) is an antihistamine.

The nurse is caring for a patient with a theophylline level of 14 mcg/mL. What is the priority nursing intervention? Increase the IV drip rate. Monitor the patient for toxicity. Continue to assess the patient's oxygenation. Stop the IV for an hour then restart at lower rate.

Continue to assess the patient's oxygenation. The therapeutic theopylline level is 10 to 20 mcg/mL. The nurse should continue interventions and monitor oxygenation.

A person who has Addison's disease does not produce enough _____________.

Corticosteroids

_____________ can be used to diagnose a patient with Addison's.

Corticotropin

Prednisone can cause a patient to look like they have ____________ if it is taken for long periods of time and in high doses.

Cushings

The nurse would include which statement when teaching a patient about insulin glargine? A. "You should inject this insulin just before meals because it is very fast acting." B. "The duration of action for this insulin is approximately 8 to10 hours, so you will need to take it twice a day." C. "You can mix this insulin with NPH insulin to enhance its effects." D. "You cannot mix this insulin with regular insulin and thus will have to take two injections."

D. "You cannot mix this insulin with regular insulin and thus will have to take two injections." Insulin glargine is a long-acting insulin with duration of action up to 24 hours. It should not be mixed with any other insulins.

The nurse would question an order for aminoglutethimide in a patient with which condition? A. Metastatic breast cancer B. Cushing's syndrome C. Adrenal malignancy D. Addison's disease

D. Addison's disease Aminoglutethimide suppresses the adrenal cortex. Addison's disease presents with decreased adrenal secretion; thus you would not want to exacerbate this by administering aminoglutethimide. All of the other choices are indications for use for aminoglutethimide.

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 complication related to this condition? A. Blood glucose below 70 mg/dL B. Elevation of liver function test results C. Atrophy of sweat glands D. Enlarged heart on chest x-ray

D. Enlarged heart on chest x-ray Gigantism caused by GH excess can cause children not only to grow very tall but also to develop complications such as headache, profuse sweating, cardiomegaly (enlarged heart), and diabetes. Because of its effect on carbohydrate metabolism, excess GH may cause an elevated blood glucose level, not hypoglycemia. It does not damage the liver; therefore, liver function tests are not affected. It also does not cause the sweat glands to atrophy.

The nurse would suspect excessive thyroid replacement in a patient taking levothyroxine (Synthroid) when the patient is exhibiting which adverse effect? A. Depression B. Intolerance to cold C. Weight gain D. Irritability

D. Irritability Irritability is a symptom of hyperthyroidism. The other choices are signs of hypothyroidism.

A patient newly diagnosed with type 1 diabetes asks a nurse, "How does insulin normally work in my body?" The nurse explains that normal insulin has which action in the body? A. It stimulates the pancreas to reabsorb glucose. B. It promotes the synthesis of amino acids into glucose. C. It stimulates the liver to convert glycogen to glucose. D. It promotes the passage of glucose into cells for energy.

D. It promotes the passage of glucose into cells for energy. The hormone insulin promotes the passage of glucose into cells, where it is metabolized for energy. Insulin does not stimulate the pancreas to reabsorb glucose or synthesize amino acids into glucose. It does not stimulate the liver to convert glycogen into glucose.

After administering somatropin (Serostim), the nurse would assess for adverse effects by monitoring which parameters? A. Serum potassium levels B. Mental status C. Respiratory rate D. Serum glucose levels

D. Serum glucose levels Hyperglycemia and hypoglycemia are potential adverse effects of somatropin therapy.

A patient who has diabetes insipidus is receiving desmopressin [DDAVP]. Which laboratory test should a nurse obtain to evaluate the effectiveness of the medication? A. Urine ketones B. Blood urea nitrogen (BUN) C. Creatinine D. Urine specific gravity

D. Urine specific gravity Diabetes insipidus is characterized by a decrease in the urine specific gravity because of the excretion of large volumes of dilute urine. Desmopressin acts to prevent fluid loss through the renal tubules and increases the urine specific gravity. Urine ketones are present in type 1 diabetes mellitus. The BUN and creatinine are indicators of renal function but not of the effectiveness of treatment of hypothalamic diabetes insipidus.

The nurse admitting a patient with acromegaly anticipates administering which medication? A. desmopressin (DDAVP) B. corticotropin (Acthar) C. somatropin (Nutropin) D. octreotide (Sandostatin)

D. octreotide (Sandostatin) Octreotide suppresses growth hormone, the culprit of acromegaly.

Afrin is an example of a _____________.

Decongestant

Expectorants work by _______ the vicosity of secretions, allowing for the ejection of excessive mucus from resp. tract.

Decrease

When a person has hyperthyroidism they will have ____ TSH and ______ T3 and T4.

Decrease Increase

Three common side effects of diabetes insipidus are a ________ in BP, hypovolemia, and tachy_________.

Decrease Tachycardia

Which technique is most appropriate regarding mixing insulin when the patient must administer 30 units regular insulin and 70 units NPH insulin in the morning? Draw up the regular insulin into the syringe first, followed by the cloudy NPH insulin. Draw the medication into two separate syringes but inject into the same spot. Administer these insulins at least 10 minutes apart, so that you will know when they are working. Use the Z-track method for administration.

Draw up the regular insulin into the syringe first, followed by the cloudy NPH insulin. Drawing up the regular insulin into the syringe first prevents accidental mixture of NPH insulin into the vial of regular insulin, which could cause an alteration in the onset of action of the regular insulin. The medications do not have to be in separate syringes and can be administered together. Z-track is an IM technique.

Benadryl can cause ____________ and ___________ so you should instruct them to not drive a car

Drowsiness and sedation

Afrin can cause ______ _______ and increase in thirst.

Dry mouth.

Once a persons ____________ plates close they can no longer take somatropin

Epiphyseal

You should give your patient acarbose with the ________ bite of their meals.

First

You should instruct a person with hypothyroidism to not take their medications with _______.

Food

When a person is taking Flonase they will begin by using the medication ____________ until their symptoms _________.

Frequently Decrease

Prednisone can also cause _____ irritation such as bleeding and stomach problems.

GI

________________ can cause seizures, coma, resp. distress and depression.

Glipizide

As soon as you give a patient ______________ you should turn them to the side rescue position because it may cause them to ________ or to be unresponsive.

Glucagon Vomit

Cortisol and prednisone are examples of a ________________.

Glucocorticoid

Somatropin (STH) is an example of a ____________ hormone.

Growth

The health care provider indicates that the patient will be ordered an expectorant. Which medication does the nurse anticipate the provider will order? Brompheniramine maleate (DeCongest) Chlorpheniramine maleate (Chlor-Trimeton) Dexchlorpheniramine maleate (Polaramine) Guaifenesin (Robitussin)

Guaifenesin (Robitussin) Guaifenesin (Robitussin) is classified as an expectorant. The other drugs listed are classified as first-generation antihistamines.

A patient taking an oral theophylline drug is due for her next dose and has a blood pressure of 100/50 mm Hg and a heart rate of 110 bpm. The patient is irritable. What is the nurse's best action? Continue to monitor the patient. Call the health care provider. Hold the next dose of theophylline. Administer oxygen 2 L per minute via nasal cannula.

Hold the next dose of theophylline. The patient is displaying adverse reactions to theophylline, and her blood level should be assessed before another dose of the medication. The nurse should hold the medication.

Another name for _________________ is graves disease.

Hyperthyroidism

When a patient has ______________ they will typically be on propylthiouraci (PTU) or methimazole (Tapazole)

Hyperthyroidism

If a person has a tumor on their thyroid they can develop either __________________ or ________________________.

Hyperthyroidism Hypothyroidism

Levothyroxine sodium (synthroid) is a form of treatment for ______________.

Hypothyroidism

Myxedema and Hashimotos thyroiditis are other names for _________________.

Hypothyroidism

Glucagon is given by ______ injection.

IM

Aminophyiline is typically given by ______.

IV

Epinephrine is given by _______ for cardiac arrest

IV

You should teach your patient that if they have Addison's and they are sick and unable to keep their medication down that they should contact their HCP _______________.

Immediately

When a patient is on a decongestant you should teach them to __________ their fluid intake.

Increase

When a person has hypothyroidism they have an ______ TSH and a _______ T3 and T4

Increase Decrease

A person who has __________ levels of corticosteriods typically have Cushing's disease.

Increased

Inhaled corticosteriods are typically used to help with ___________.

Inflammation

Which is the most appropriate action for the nurse who is told that a patient typically takes his glipizide (Glucotrol) with food? Immediately check the patient's blood glucose level. Inform the patient that it is better to take the medication 30 minutes before a meal. Inform the patient that the medication must be taken 15 minutes after a meal. Immediately call the health care provider.

Inform the patient that it is better to take the medication 30 minutes before a meal. Food inhibits the absorption of glipizide (Glucotrol), the only sulfonylurea agent that should be given 30 minutes before a meal. The blood glucose level does not have to be taken right away. The medication is not to be taken after a meal. The health care provider does not have to be called; the nurse should intervene.

When mucomist is used for respiratory problems it is ___________.

Inhaled

Budenside (Pulmicort) is an example of an _____________ _______________.

Inhaled corticosteriods

Insulin isophane is an example of a ___________ ____________ insulin.

Intermediate acting

Flonase and Beclomethasone (Beconase) are both examples of ______________ ______________.

Intranasal corticosteroids

When a person has either hyperthyroidism or hypothyroidism they should avoid foods high in ________ such as shellfish.

Iodine

What will the nurse expect to find that would indicate a therapeutic effect of acetylcysteine (Mucomyst)? Decreased cough reflex Decreased nasal secretions Liquefying and loosening of bronchial secretions Relief of bronchospasms

Liquefying and loosening of bronchial secretions Acetylcysteine is a mucolytic drug used to liquefy and loosen bronchial secretions in order to enhance their expectoration.

Metformin can alter _________ function test.

Liver

When a person is taking Singular you should monitor their ________ enzymes.

Liver

What is the most important thing for the nurse to teach a patient who is switching allergy medications from diphenhydramine (Benadryl) to loratadine (Claritin)? Loratadine can potentially cause dysrhythmias. Loratadine has fewer sedative effects. Loratadine has increased bronchodilating effects. Loratadine causes less gastrointestinal upset.

Loratadine has fewer sedative effects. Loratadine (Claritin) does not affect the central nervous system and therefore is nonsedating. There is insufficient evidence to indicate that loratadine (Claritin) can cause dysrhythmias, can act as a bronchodilator, or cause gastrointestinal upset than other comparable medications.

You should give children and elderly _______ doses of Benadryl

Lower

Oral hypoglycemics are meds that are given to _______ blood glucose and should be taken on a ________ basis.

Lower Daily

The nurse administers NPH insulin at 8 AM. What intervention is essential for the nurse to perform? Assess the patient for hyperglycemia by 10 AM. Monitor fingerstick at 2 PM. Make sure patient eats by 5 PM. Administer the insulin via IV pump.

Make sure patient eats by 5 PM. NPH insulin may be peaking just before dinner without sufficient glucose on hand to prevent hypoglycemia. The patient needs to eat by 5 PM. The patient would not be at high risk for hypoglycemia at 10 AM. A fingerstick is not necessary at 2 PM. The insulin should not be routinely administered IV.

A patient with type 1 diabetes mellitus has been ordered insulin aspart (Novolog) 10 units at 7:00 AM. What nursing intervention will the nurse perform after administering this medication? Perform a fingerstick blood sugar test. Have the patient void and dipstick the urine. Make sure the patient eats breakfast immediately. Flush the IV.

Make sure the patient eats breakfast immediately. Insulin aspart (Novolog) is a rapid-acting insulin that acts in 15 minutes or less. It is imperative that the patient eat as it starts to work. The patient should have had a fingerstick blood sugar test done before receiving the medication. There is no need to check the urine. This medication is given subcutaneously.

You should give rapid acting insulin with ________.

Meals

Oxytocin is used to regulate a women's ______________ cycle.

Menstrual

Aldosterone and Fludrocortisone are examples of __________________.

Mineralocorticoids

A patient has taken metaproterenol (Alupent). What is the nurse's priority action? Monitoring for heart rate >100 beats/min Telling the patient not to drive for 2 hours Monitoring for sedation Assessing for elevated blood pressure

Monitoring for heart rate >100 beats/min The beta1 properties of this drug can cause increased heart rate and palpitations. The drug should not cause sedation or elevated blood pressure.

The patient is taking a nonselective adrenergic agonist bronchodilator and has a history of coronary artery disease. What is a priority nursing intervention? Monitoring patient for potential chest pain Monitoring blood pressure continuously Assessing daily for hyperkalemia Assessing 12-lead ECG each shift

Monitoring patient for potential chest pain Nonselective adrenergic agonist bronchodilators stimulate beta1 receptors in the heart and beta2 receptors in the lungs. Stimulation of beta1 receptors can increase heart rate and contractility, increasing oxygen demand. This increased oxygen demand may lead to angina or myocardial ischemia in patient with coronary artery disease. Cautious use of these agents is indicated if the patient has coronary artery disease.

Mucomist is an example of a ______________.

Mucolytic.

You should not give a patient Benadryl if they have _________ _________ glaucoma.

Narrow Angle

When a patient is on Flonase and their symptoms begin decrease they should begin to take the medication ______ time a day.

One

A patient should take Singulair ______ time a day in the evening to __________ absorption.

One Increase

Insulin gargine: Onset: Peak: Duration:

Onset: 1 hr Peak: 3-4 hrs Duration: 10-24 hrs

Insulin isophane Onset: Peak: Duration:

Onset: 1-2 hrs Peak: 4-12 Duration: 5-7

Insulin aspart: Onset: Peak: Duration.

Onset: 15 mins Peak: 1-3 hrs Duration: 3-5 hrs

Insulin regular: Onset: Peak: Duration:

Onset: 30-60 mins Peak: 2-4 hrs Duration: 5-7 hrs

Insulin lispro: Onset: Peak: Duration:

Onset: 5-15 mins Peak: 05. - 1 hr Duration: 3-4 hrs

Insulin detemir: Onset: Peak: Duration:

Onset: gradual over 24 hours Peak: 6-8 hours Duration: 24 hours

Acrabose (Precose), metformin (glucophage) and glipizide (glucotrol) are all ________ _______________.

Oral hypoglycemics

Singulair can only be given _______.

PO

Theophylline and theo-dur can be give _______ or _______.

PO IV

Children and elderly can sometimes have a _________ reaction to benadryl in which they will get hyper.

Paradoxical

You should instruct a patient taking Tiotropium that they cannot take it as a _______.

Pill

Tiotropium (Spiriva) comes in a ______ that then forms a ________ and you inhale it.

Pill Powder

Excess bacteria in the mouth from inhaled steroids can cause ______________.

Pneumonia

ADH(vasopressin) and oxytocin come from the _____________ _____________ gland.

Posterior pituitary

When someone has Addison's they are typically prescribed ___________ in PO form.

Prednisone PO

Zafirukast (Accolate) and Cromolyn (Intal) are examples of ________________.

Prophylaxis

Metaproterenol has a ___________ onset of action.

Rapid

Insulin aspart and insulin lispro are both __________ __________ insulin.

Rapid Acting

Before giving Theophyline (Amniophyiline) you should assess ______________ functions as well as vital signs.

Resp.

When a person is on glucosteroids you should assess their _______________ rate and _______________ sounds.

Respiratory Breath

When mucomist is inhaled it smells like _________ __________.

Rotten eggs

You should instruct a person with hypothyroidism to take their medications at the _________ time every day.

Same

Singulair is used for the treatment of ______________ and ____________ allergies.

Seasonal Chronic

Allegra is considered to be a ___________ generation antihistamine

Second

Insulin regular is an example of ________ _________ insulin.

Short acting

When giving Beclomethasone (Beconase) you should instruct the patient to be ____________ _________ and to clear the nose out before spraying.

Sitting up

What over-the-counter product will the nurse instruct the patient to avoid when taking montelukast (Singulair)? Acetaminophen (Tylenol) Echinacea Diphenhydramine (Benadryl) St. John's wort

St. John's wort St. John's wort has been shown to decrease serum montelukast (Singulair) levels. The other substances do not interact with montelukast.

A patient should not take Singular with ________ __________ _______, because it can cause a decrease in the serum Singular levels.

St. Johns Wort

When a person has Addison's they must take _______ for the rest of their life.

Steroids

You should inform patients that they cannot abruptly stop taking __________ and that they should ______________ their dosages over time.

Steroids Decrease

Exentide (Byetta) should be given __________ and is not effective for type _______ diabetes.

Sub Q 1

In discharge teaching, the nurse will emphasize to a patient receiving a beta-agonist bronchodilator the importance of reporting which side effect? Hypoglycemia Nonproductive cough Sedation Tachycardia

Tachycardia

The nurse is caring for a child who has been prescribed an inhaler for asthma control. The child is having difficulty using the inhaler. What will the nurse do? Tell the parent to hold the inhaler for the child. Ask the health care provider to switch to oral medications. Tell the parent that young children should not use inhalers. Teach the child to use a spacer.

Teach the child to use a spacer. If a child is unable to use the inhaler, the medication will be trapped in the mouth. Using a spacer helps the medication to be deposited to the lungs.

The nurse is caring for multiple patients on the pulmonary unit. The nurse would question the administration of prescribed epinephrine to which patient? The patient with a history of emphysema The patient with a history of type 2 diabetes The patient who is 16 years old The patient with atrial fibrillation with a rate of 100

The patient with atrial fibrillation with a rate of 100 The side effects of epinephrine include tachycardia, dysrhythmias, and palpitations. This patient should not receive epinephrine.

When a person has cushing's disease there is no _____________, they can only treat the signs and symptoms.

Treatment

Mucomist can be used as an antidote for ___________ OD and the patient has to _________ this medication.

Tylenol Drink

When a patient is on prednisone and they have pain you should tell them to take __________ and to never use __________.

Tylenol NSAIDS

Mucolytics work by making mucus __________ and by causing a _________ cough.

Watery Productive

Metformin can also be used for ___________ loss.

Weight

Antidiabetic drugs are designed to control signs and symptoms of diabetes mellitus. The nurse primarily expects a decrease in which? a.Blood glucose b.Fat metabolism c.Glycogen storage d.Protein mobilization

a.Blood glucose

A nurse is teaching a patient how to recognize symptoms of hypoglycemia. Which symptoms should be included in the teaching? (Select all that apply.) a.Headache b.Nervousness c.Bradycardia d.Sweating e.Thirst f.Sweet breath odor

a.Headache b.Nervousness d.Sweating

A patient with COPD is taking a leukotriene antagonist, montelukast (Singulair). The nurse is aware that this medication is given for which purpose? a.Maintenance treatment of asthma b.Treatment of acute asthmatic attack c.Reversing bronchospasm associated with COPD d.Treatment of inflammation in chronic bronchitis

a.Maintenance treatment of asthma

The nurse is administering vasopressin (Pitressin) to a patient. The nurse realizes that nursing implications for this drug would include which implications? (Select all that apply.) a.Record urinary output. b.Observe the patient's weight, and note edema. c.Monitor the patient for decreased blood pressure. d.Closely monitor the patient's blood glucose levels. e.Monitor the patient's pulse for increased heart rate. f.Record the patient's daily calcium levels.

a.Record urinary output. b.Observe the patient's weight, and note edema. c.Monitor the patient for decreased blood pressure. e.Monitor the patient's pulse for increased heart rate.

A patient is taking levothyroxine (Synthroid). For which adverse effect would the nurse monitor this patient? a.Tachycardia b.Drowsiness c.Constipation d.Weight gain

a.Tachycardia

A patient is given corticotropin (Acthar). The nurse knows to monitor the patient for which condition? a.Weight gain b.Hyperkalemia c.Hypoglycemia d.Dehydration

a.Weight gain

Benadryl and Allegra are both examples of ______________.

antihistamines

Robitussin is an example of an ______________.

antitussive

The nurse is teaching a patient about diphenhydramine (Benadryl). Which instructions should the nurse include in the patient's teaching plan? (Select all that apply.) a.Take medication on an empty stomach to facilitate absorption. b.Avoid alcohol and other central nervous system depressants. c.Notify the health care provider if confusion or hypotension occurs. d.Use sugarless candy, gum, or ice chips for temporary relief of dry mouth. e.Avoid handling dangerous equipment or performing dangerous activities until stabilized on the medication.

b.Avoid alcohol and other central nervous system depressants. c.Notify the health care provider if confusion or hypotension occurs. d.Use sugarless candy, gum, or ice chips for temporary relief of dry mouth. e.Avoid handling dangerous equipment or performing dangerous activities until stabilized on the medication.

A patient tells the nurse that he has started to take an over-the-counter (OTC) antihistamine, diphenhydramine (Benadryl). In teaching about side effects, what is most important for the nurse to tell the patient? a.Do not to take this drug at bedtime to avoid insomnia. b.Avoid driving a motor vehicle until stabilized on the drug. c.Nightmares and nervousness are more likely in an adult. d.Medication may cause him to have excessive secretions.

b.Avoid driving a motor vehicle until stabilized on the drug.

A patient is newly diagnosed with type 1 diabetes mellitus and requires daily insulin injections. Which instruction should the nurse include in the teaching of insulin administration? a.Teach family members how to administer glucagon by injection when the patient has a hyperglycemic reaction. b.Instruct the patient about the necessity for compliance with prescribed insulin therapy. c.Teach the patient that hypoglycemic reactions are more likely to occur at the onset of action time. d.Instruct the patient in the care and handling of the insulin container and syringe.

b.Instruct the patient about the necessity for compliance with prescribed insulin therapy.

An Advair Diskus, fluticasone propionate (Flonase) and salmeterol (Serevent) 100 mcg/50 mcg, is ordered for a patient with COPD. What does the nurse know about this medication? (Select all that apply.) a.It can be used to treat an acute attack. b.It is delivered as a dry powdered inhaler. c.It contains a beta1 agonist and Cromolyn. d.It is taken as one puff two times a day. e.It promotes bronchodilation.

b.It is delivered as a dry powdered inhaler. d.It is taken as one puff two times a day. e.It promotes bronchodilation.

A patient has been prescribed guaifenesin (Robitussin). The nurse understands that the purpose of the drug is to accomplish what? a.Treat allergic rhinitis and prevent motion sickness. b.Loosen bronchial secretions so coughing can eliminate them. c.Compete with histamine for receptor sites, thus preventing a histamine response. d.Stimulate alpha-adrenergic receptors, thus producing vascular constriction of capillaries in nasal mucosa.

b.Loosen bronchial secretions so coughing can eliminate them.

A patient has just begun taking calcitriol (Rocaltrol). Which is a nursing implication of this drug? a.Monitor the patient's weight. b.Monitor serum calcium levels. c.Teach side effects of alopecia and petechiae. d.Instruct the patient to avoid persons with respiratory infections.

b.Monitor serum calcium levels.

A nurse is administering prednisone (Deltasone) to a newly admitted patient who is taking multiple other drugs. The nurse should consider which drug interactions with prednisone? (Select all that apply.) a.Cardiac and CNS actions are increased when taken with an adrenergic agent. b.Potassium-wasting diuretics increase potassium loss, resulting in hypokalemia. c.Risk for GI bleeding and ulceration increases when taken with aspirin or other NSAIDs. d.Action of prednisone is decreased when taken with phenytoin (Dilantin) because phenytoin increases glucocorticoid metabolism. e.Risk for dysrhythmias and digitalis toxicity increases when taken with cardiac glycosides. f.Dosage of antidiabetic agents may need to be increased when taken concurrently with glucocorticoids.

b.Potassium-wasting diuretics increase potassium loss, resulting in hypokalemia. c.Risk for GI bleeding and ulceration increases when taken with aspirin or other NSAIDs. d.Action of prednisone is decreased when taken with phenytoin (Dilantin) because phenytoin increases glucocorticoid metabolism. e.Risk for dysrhythmias and digitalis toxicity increases when taken with cardiac glycosides.

A patient is prescribed glipizide (Glucotrol). The nurse knows that which side effects and adverse effects may be expected? (Select all that apply.) a.Tachypnea b.Tachycardia c.Increased alertness d.Increased weight gain e.Visual disturbances f.Hunger

b.Tachycardia e.Visual disturbances f.Hunger

A patient with COPD has an acute bronchospasm. The nurse anticipates that the health care provider will prescribe which medication? a.zafirlukast (Accolate) b.epinephrine (Adrenalin) c.dexamethasone (Decadron) d.oxtriphylline-theophyllinate

b.epinephrine (Adrenalin)

A patient is to receive insulin before breakfast, and the time of breakfast tray delivery is variable. The nurse knows that which insulin should not be administered until the breakfast tray has arrived and the patient is ready to eat? a.Humulin N b.lispro (Humalog) c.glargine (Lantus) d.Humulin R

b.lispro (Humalog)

You should not give decongestants at ________________.

bedtime

Neo-synephrine can cause vasoconstriction and an increase in ____________ ______________.

blood pressure

A patient is receiving a daily dose of Humulin N insulin at 7:30 am. The nurse expects the peak effect of this drug to occur at which time? a.8:15 am b.10:30 am c.5:00 pm d.11:00 pm

c.5:00 pm

A patient is given desmopressin acetate. The nurse knows that this drug is used to treat which condition? a.Gigantism b.Diabetes mellitus c.Diabetes insipidus d.Adrenal insufficiency

c.Diabetes insipidus

A patient is diagnosed with type 2 diabetes mellitus. The nurse is aware that which statement is true about this patient? a.Patient is most likely a teenager. b.Patient is most likely a child younger than 10 years. c.Heredity and obesity are major causative factors. d.Viral infections contribute most to disease development.

c.Heredity and obesity are major causative factors.

A patient is prescribed aminophylline-theophylline. For what adverse effect should the nurse monitor the patient? a.Drowsiness b.Hypoglycemia c.Increased heart rate d.Decreased white blood cell count

c.Increased heart rate

A patient is receiving IV aminophylline. The nurse checks the patient's lab values. The serum theophylline level is 32 mcg/mL. What action should the nurse take? a.Assess the patient's breath sounds for improvement. b.Increase the dosage per sliding scale directions. c.Notify the health care provider of the level. d.Have the laboratory collect another sample to verify the results.

c.Notify the health care provider of the level.

A patient complains of a sore throat and has been told it is due to beta-hemolytic streptococcal infection. The nurse anticipates that the patient has which acute condition? a.Rhinitis b.Sinusitis c.Pharyngitis d.Rhinorrhea

c.Pharyngitis

A patient is receiving the drug somatropin (Genotropin). The nurse understands that the action of this drug is to do what? a.Act as an antiinflammatory agent b.Increase metabolic rate and oxygen consumption c.Stimulate growth in long bones at epiphyseal plates d.Promote water reabsorption from the renal tubules

c.Stimulate growth in long bones at epiphyseal plates

Some side effects of Theophyline (Amniophyiline) are tachy__________, ______ distress, __________.

cardia GI Insomia

Dornase alfa is an enzyme for _________ __________.

cystic fibrosis

A patient is prescribed the decongestant oxymetazoline (Afrin) nasal spray. What will the nurse teach the patient? a.Take this drug at bedtime because it may cause drowsiness. b.Directly spray the medication away from the nasal septum, and gently sniff. c.This drug may be used in maintenance treatment for asthma. d.Limit use of the drug to 5 to 7 days to prevent rebound nasal congestion.

d.Limit use of the drug to 5 to 7 days to prevent rebound nasal congestion.

Beclomethasone (Beconase) has been prescribed for a patient with allergic rhinitis. What should the nurse teach the patient regarding this medication? a.This may be used for an acute attack. b.An oral form is available if the patient prefers to use it. c.Avoid large amounts of caffeine intake because an increased heart rate may occur. d.With continuous use, dryness of the nasal mucosa/lining may occur.

d.With continuous use, dryness of the nasal mucosa/lining may occur.

You should give long acting insulin in the __________.

evenings

Mucinex is an example of an _______________.

expectorant

As a nurse you know that you would be giving glucagon if the patient is _______________.

hypoglycemic

Prednisone can also be given for ___________.

inflammation

Insulin detemir and insulin glargine are examples of _______ ________ insulin.

long-acting

Prophylaxis means ______________.

preventative

Robitussin works by _____________ the cough.

supressing

Neo-synephrine is an example of a ____________ ___________.

systemic decongestant