Pharm Exam #8
Alendronate (Fosamax) is prescribed for a patient. Which statement made by the patient will indicate to the nurse that further instruction is needed?
"I can go back to bed as soon as I take this drug."
A nurse is providing health education to a client who will be discharged home with a prescription for hydrocortisone. What instruction should the nurse convey to the client?
"Make sure that you take this medication with food."
A nurse is caring for a patient with Cushing's disease who asks why he is receiving ketoconazole (Nizoral), an antifungal medication. What is an appropriate response by the nurse?
"The medication will decrease cortisol levels."
The patient receiving ketoconazole (Nizoral) for Cushing's disease reports a headache. What is the best advice for the nurse to give the patient?
"This might be a reaction to the medication. Talk to your health care provider."
A pregnant client asks about the safety of taking thyroid hormone replacement drugs during her pregnancy. What is the nurse's best response?
"Thyroid hormones are pregnancy category A drugs and should be taken during pregnancy."
The nurse is caring for a client who is being monitored for hypercalcemia. The nurse understands that what calcium level is considered a medical emergency?
12mg/dL
The pediatric nurse is caring for an infant who has been prescribed hydrocortisone 2.5 mg/kg IV. The infant weighs 13.2 lbs (6 kg). How many mg of hydrocortisone should the nurse prepare to administer?
15 6X2.5=15
Some hormones are secreted in cyclic patterns. How long is the time pattern related to secretion of estrogen and progesterone?
28 days
Elderly clients are at increased risk for adverse cardiovascular reactions when taking thyroid drugs; therefore, increases in dosage, if needed, are made in smaller increments during a period of how many weeks?
8 weeks
The health care provider suspects that a client has Addison disease. The nurse knows that the provider will perform what test to confirm this diagnosis?
ACTH stimulation test
A client has a blood calcium level of 4.6 mg/dL and is experiencing twitching of the facial muscles and tingling of the lips, fingers and toes. What is the priority action by the nurse?
Administer calcium gluconate IV as prescribed.
A client is prescribed methimazole for the treatment of hyperthyroidism. Which is a rare adverse effect or set of effects related to the administration of methimazole?
Agranulocytosis
A nurse is caring for a patient suffering from a severe form of hyperthyroidism called thyrotoxicosis or thyroid storm. Which of the following should the nurse observe in the patient as a characteristic of thyroid storm?
Altered mental status
The home care nurse may be involved in a wide range of activities when caring for the client with hyperthyroidism or hypothyroidism. What would be included in the client's plan of care? (Select all that apply.)
Assessing the client's response to therapy Teaching about the disease process Preventing and managing adverse drug effects
A nurse's assessment of a client has revealed signs and symptoms of Paget's disease. Which of the following is one of the signs the nurse may have observed?
Bone Deformity
The nurse should review which lab result before advising a client about taking the first dose of ibandronate (Boniva)?
Calcium
A client who is taking tetracycline has been prescribed a calcium supplement. What guidance should the nurse include in medication teaching?
Calcium should be taken at least 2 hours before or after taking tetracycline.
The pharmacology instructor is discussing hormones with the nursing students. What hormone, important in the digestive process, is secreted by the gastrointestinal mucosa?
Cholecystokinin
The primary function of the thyroid gland includes:
Control of the cellular metabolic activity
The adrenal cortex influences glucose levels through the production of which hormone?
Cortisol
The nurse is caring for a client who would like to increase her phosphorus intake. The nurse instructs the client to increase the amount of what foods that are high in phosphorus?
Dairy products
Which symptom, if found in the patient being treated for Cushing's disease, indicates medication therapy is therapeutic?
Decreased peripheral edema
After administering desmopressin to a client with diabetes insipidus, which would the nurse identify as indicating drug effectiveness?
Decreased reports of thirst
A head injury has resulted in the hospitalization of a client. Nursing assessments confirm that the client is producing substantial amounts of dilute urine and is consuming large amounts of liquids. Considering the history and assessment findings support the possibility of what metabolic disorder?
Diabetes insipidus (DI)
The nurse is caring for a patient who has been prescribed fludrocortisone and furosemide (Lasix). What assessment is essential to monitor for potential complications with this patient?
Electrolytes
During initial therapy with levothyroxine (Synthroid), what are some of the most common reactions a nurse might observe in a client? (Select all that apply.)
Elevated body temp Weight loss Tachycardia Insomnia
A nurse should recognize that a client taking antithyroid medication may be developing thyrotoxicosis if the client exhibits which of the following symptoms?
Extreme tachycardia
Osteoporosis is characterized by decreased bone density (osteopenia) and weak, fragile bones. Which of the following are risk factors for osteoporosis? Choose all that apply.
Female gender Lean body mass Smoking
The nurse would contact the health care provider prior to administering desmopressin to a client with a history of what condition?
Heart attack
The nurse is preparing to administer levothyroxine to a client. Which assessment finding would cause the nurse to hold the medication?
Heart rate of 110 beats per minute
A child diagnosed with adrenal insufficiency takes PO hydrocortisone daily. The client is followed regularly by a nurse, who assesses the child every 3 months. What assessment data should the nurse prioritize during these assessments?
Height and weight
A female client presents to the health care provider's office for a routine physical examination. The nurse assesses her current over-the-counter drug history and discovers that she takes vitamin D 600 international units daily. The nurse recognizes that the client is at risk for what condition?
Hypercalcemia
A patient is diagnosed with hypercalcemia. The nurse knows that which statement regarding hypercalcemia is correct?
Hypercalcemia can lead to calcium deposits that damage the kidneys.
The anatomy and physiology instructor is discussing hormones with the pre-nursing class. Which gland would the instructor tell the students controls secretions of the pituitary gland?
Hypothalamus
The nurse is caring for a 77-year-old client and understands that calcium deficiency commonly occurs in the elderly because of what factors? (Select all that apply.)
Impaired absorption of calcium from the intestine Lack of exposure to sunlight Impaired liver or kidney metabolism of vitamin D
The nurse is caring for a client with a possible calcium deficiency and reads the client's history to see if the client has experienced which common reasons for calcium deficiency? (Select all that apply.)
Impaired absorption of calcium from the intestine Long-term dietary deficiencies of calcium and vitamin D Lack of exposure to sunlight
A nurse is caring for a client with subacute lymphocytic thyroiditis. The health care provider prescribes thyroid hormones to the client. From which sign during ongoing assessment should the nurse conclude that the client is responding to the therapy?
Increased appetite
The pharmacology instructor is providing education regarding propylthiouracil to the nursing students. What would the instructor identify as the primary mode of action for this medication?
Inhibition of production of thyroid hormone
A client is diagnosed with liver disease. How would this affect the metabolism of the drugs used to treat the client's hypothyroidism?
It would be prolonged
The nurse knows that phosphates should be given only when hypercalcemia is accompanied by hypophosphatemia. Hypophosphatemia is assumed when the serum phosphorus is less than what level?
Less than 3 mg/dL
Which agent would a nurse expect to administer to a client with hypothyroidism?
Levothyroxine
An older adult has been prescribed a thyroid hormone replacement medication. The nurse should first clarify which prescription?
Levothyroxine (Synthroid) 150 mcg orally once per day
The nurse cares for a client who was admitted for multiple bone fractures resulting from a fall. The client has a comorbidity of hypothyroidism. Which diet is the most appropriate for this client?
Low calorie, high fiber
Which of the following are strong sources of calcium? Choose all that apply.
Milk Spinach Oysters
The nurse is caring for a client with inoperable adrenocortical carcinoma and is aware that the health care provider will most likely order which medication?
Mitotane
A client is brought to the emergency department after taking an overdose of levothyroxine. When assessing this client, what adverse effects would the nurse expect to find?
Nervousness and tachycardia
A client admitted to the hospital with hyperthyroidism treated with propylthiouracil suddenly develops a skin rash. Which action would the nurse implement first?
Notify the primary health care provider
A patient with hypothyroidism is at increased risk for respiratory depression and myxedema coma if given what category of drugs?
Opioid analgesics
The nurse is discussing the use of corticosteroids with a group of nursing students and tells that students that both men and women who take corticosteroids are at risk for what side effect?
Osteoporosis
After reviewing the hormonal secretion of the pituitary gland, the students demonstrate understanding when they identify which hormone as being released by the posterior lobe?
Oxytocin
An instructor is preparing a teaching plan for a class on the various pituitary hormones. Which hormone would the instructor include as being released by the posterior pituitary gland?
Oxytocin
The nurse would administer what to a client in labor to improve her uterine contractions?
Oxytocin
The nursing class is studying family nursing. What hormone would the instructor tell the students plays a part in milk production?
Prolactin
Which hormone is important for milk production in a lactating woman?
Prolactin
Thioamide antithyroid drugs treat hyperthyroidism by inhibiting the synthesis of thyroid hormone. What is the prototype of the thioamide anti-thyroid drugs?
Propylthiouracil
What does release of antidiuretic hormone (ADH) cause?
Reabsorption of water
Which laboratory value monitored in a patient receiving fludrocortisone acetate requires immediate action by the nurse?
Sodium 150 mEq/L
After teaching a group of students about growth hormone agonists and antagonists, the instructor determines that additional teaching is needed when the students identify which agent as a growth hormone antagonist?
Somatropin
Growth hormones cause all of the following EXCEPT:
Suppression of triglyceride synthesis
A client is receiving a thyroid hormone to treat hypothyroidism. Which would indicate to the nurse that the client needs a reduced dosage of the drug?
Tachycardia
During a general health assessment, a client indicates taking thyroid medication to increase weight loss. What statement should be the basis of the nurse's response?
Taking excessive or unnecessary thyroid medication may produce serious or life-threatening manifestations of toxicity.
The nurse is evaluating the effectiveness of treatment for a client diagnosed with hypocalcemia. What outcome does the nurse assess that would indicate treatment has been effective?
The client reports a decrease in muscle spasms and decreased paresthesia.
The nurse administers hydrocortisone cypionate (Cortef). What intervention is appropriate for this medication?
The nurse will monitor the patient's blood glucose level.
Which patient should not receive mitotane as ordered?
The patient experiencing shock
Which action indicates to the nurse that the patient with Cushing's disease is adhering to teaching goals for medication therapy?
The patient reports weight gain while on the medication.
The nurse is assessing the patient on mitotane therapy. Which assessment finding requires action by the nurse?
The patient's blood pressure is 140/90 mm Hg sitting and 90/50 mm Hg standing.
Following an assessment by her primary care provider, a 70-year-old resident of an assisted living facility has begun taking daily oral doses of levothyroxine. Which assessment finding should prompt the nurse to withhold a scheduled dose of levothyroxine?
The resident's apical heart rate is 112 beats/minute with a regular rhythm.
A female client is diagnosed with a pituitary hormone deficiency. She reports that her drug dosages are modified frequently. The nurse explains that the dosage of all pituitary hormones must be individualized. The nurse knows that what factor determines the dosage?
The responsiveness of affected tissues, which varies
What is the duration of action of water-soluble, protein-derived hormones compared to that of lipid-soluble steroid and thyroid hormones?
The water-soluble hormones have a shorter duration of action.
The nurse is assessing a child who is receiving growth hormone therapy. What would the nurse identify as suggesting glucose intolerance?
Thirst
Which of the following hypothalamic hormones causes the release of TSH in response to stress, such as exposure to cold?
Thyrotropin-releasing hormone (TRH)
Your client, an 18-year-old bodybuilder, indicates that he is considering using growth hormones to increase his muscle mass. When discussing this, you would advise him about all of the following EXCEPT:
Using growth hormone in moderate amounts can make the heart function more efficiently.
Which statement reflects the relationship between calcium and phosphate?
When there is an increase in calcium, the phosphate is decreased.
The nurse is providing education to a client who is taking calcium for the treatment of osteopenia. What is the rationale for the nurse suggesting that the client limit whole grains in the diet?
Whole grains are known to interfere with calcium absorption.
The process in which hormone secretion is stimulated when hormones are needed and inhibited when they are not needed is known as:
a negative feedback system
A client with a visible "buffalo hump" and a history of impaired wound healing has been referred for care to the endocrinology department. This client's signs and symptoms are most likely to be attributed to what factor?
adrenocortical excess
When describing desmopressin to a group of students, the instructor explains that it is a synthetic form of:
antidiuretic hormone
Which hormone is released in the presence of low blood volume?
antidiuretic hormone (ADH)
A patient with osteoporosis has bones that become progressively porous, brittle, and especially prone to fracture. This increased susceptibility to fracture manifests most commonly as:
compression fracture of the vertebrae
A nurse is organizing the care of a child who takes somatotropin. The desired outcome the nurse should prioritize in the planning of this child's care is that the client will:
demonstrate in increase in linear growth
A nurse is caring for a 70-year-old client who is taking desmopressin (DDAVP). The client has a history of cardiovascular disease. The nurse will prioritize the assessment of:
electrolyte levels
What is the most common cause of subclinical hyperthyroidism?
excess thyroid hormone therapy
During a general health assessment, a client indicates taking thyroid medication to increase weight loss. What should the nurse teach the client about this use of the medication?
excessive or unnecessary antithyroid medication may produce serious or life-threatening manifestations of toxicity.
The nurse is caring for a school-age child who is receiving long-term hydrocortisone therapy to treat adrenal insufficiency. When providing ongoing care for the child, what assessment should the nurse prioritize?
growth and development
Hypothalamic hormones must be given by what route to avoid destruction? Select all that apply.
injection nasal inhalation
Calcium preparations can be given by two different routes. Which of the following are those routes?
intravenous oral
When describing thyroid function, the nurse would emphasize the need for intake of:
iodine
With regard to the functioning of the thyroid gland, which is an essential element for the manufacturing of thyroxine and triiodothyronine?
iodine
In addition to calcium, what electrolyte affects parathyroid hormone (PTH) secretion?
magnesium
A client diagnosed with excessive parathyroid production is prone to develop:
osteopenia
What organ provides the control over the amount of calcium in the blood?
parathyroid glands
A hospital client's current medication administration record specifies oral administration of propylthiouracil (PTU) every 8 hours. What sign or symptom may have originally prompted the care provider to prescribe this drug?
persistent tachycardia
Bisphosphonates are drugs that bind to bone and inhibit calcium resorption from bone. These drugs are used to treat hypercalcemia. Which of the following are bisphosphonates? Choose all that apply.
risedronate (Actonel) ibandronate (Boniva) alendronate (Fosamax)
The nurse is caring for a client who takes alendronate. What laboratory result best demonstrates successful treatment?
serum calcium 2.45 mmol/L (9.8 mg/dL)
Which hormones are responsible for the growth of the body during childhood, especially the growth of muscles and bones?
somatotropin
Alendronate (Fosamax) is prescribed for a 67-year-old postmenopausal woman. In order to help prevent gastrointestinal distress, the nurse will advise the patient to:
stand or sit upright for at least 30 minutes after taking alendronate
A nurse is caring for a patient undergoing thyroid hormone replacement therapy. What should the nurse inform this patient regarding administration of the drug?
take the drug before breakfast
The control mechanisms for most metabolic functions of the body, as well as the maintenance of homeostasis, is the function of:
the hypothalamus and the pituitary gland
Diabetes insipidus is treated with replacement of which hormones?
vasopressin
What medication creates a safety risk when combined with long-term fludrocortisone therapy?
warfarin
