Pharm II ch 36,37, 44 EAQs

Which statement by a nursing student indicates effective understanding of the mechanism of action of fludrocortisone?

"Fludrocortisone leads to sodium and water retention."

Which drug would be most appropriate for a patient who operates power equipment and has jaundice?

Baclofen

Which laboratory value does the nurse closely monitor in a patient who is taking warfarin (Coumadin) and levothyroxine (Synthroid)?

Sedimentation rate

When a patient receiving treatment for hyperthyroidism reports decreased appetite, weight gain, constipation, and intolerance to cold, the healthcare provider prescribes thyroid hormone replacement therapy. Which rationale is most likely for this intervention?

The patient has developed hypothyroidism as an adverse effect of taking radioactive iodine (iodine-131).

Which instruction does the nurse give to a patient for whom a centrally acting skeletal muscle relaxant has been ordered?

"Avoid activities that require full mental alertness until you see how the drug affects you."

While reviewing the record of a patient taking a medication for the treatment of a thyroid disorder, the nurse finds that the patient is also receiving warfarin (Coumadin). The nurse requests that the healthcare provider increase the dosage of warfarin (Coumadin). Which medication did the nurse find in the patient's prescription?

Methimazole (Tapazole)

Which laboratory value would the nurse monitor before administering methimazole (Tapazole) to a patient with hyperthyroidism?

Thyroid-stimulating hormone (TSH)

Which statement by the student nurse indicates a need for further education regarding nutrition during corticosteroid therapy?

"I will encourage patients to increase their daily fluid intake."

Which drug is contraindicated for a patient who operates heavy motor vehicles?

Cyclobenzaprine

A patient on corticosteroid therapy who is receiving postoperative care reports to the nurse, "When I took a deep breath, I felt a painful pop at the surgical site." Which condition does the nurse expect the patient has developed as an adverse effect of taking corticosteroids?

Dehiscence

Which information does the nurse include in the teaching plan for a patient whose corticosteroid therapy is to be discontinued?

The drug will be tapered off rather than abruptly discontinued.

Which statement by a patient prescribed mineralocorticoid therapy for the treatment of Addison's disease indicates a need for further education?

"I will take the medication on an empty stomach."

Which medication would the nurse expect to be prescribed in a patient with numbness, vertigo, and dysarthria?

Baclofen (Lioresal)

Which statement by a patient with rheumatoid arthritis indicates a correct understanding of prednisone (Deltasone) therapy?

"I will take this medication with an antacid."

Which statements made by a patient indicate effective learning about treatment with dantrolene?

"I will use sunscreen before going out." "I will use sunglasses while riding my bike." "I will notify my provider if I notice skin rashes."

A nurse is teaching a patient diagnosed with hypothyroidism who is prescribed levothyroxine about precautions to be taken to prevent drug interactions. Which statement by the patient indicates a need for further teaching?

"If I concurrently take levothyroxine and digoxin, I may need to decrease the dosage of digoxin."

Which statement by the student nurse indicates an effective understanding of the difference between the therapeutic outcomes expected from mineralocorticoids and glucocorticoids?

"Mineralocorticoid therapy helps control blood pressure, whereas glucocorticoid therapy reduces pain and inflammation."

A patient on glucocorticoid replacement therapy asks the nurse why two-thirds of the total daily dose is taken in the early morning and the remaining third in the late afternoon. Which response by the nurse is best?

"Normal circadian rhythms will be mimicked with this schedule."

A patient who is receiving high doses of a corticosteroid informs the healthcare provider about an upcoming scheduled root canal procedure. Which response does the nurse anticipate from the healthcare provider?

"Take an additional dose of the corticosteroid during the procedure."

Which statement made by the student about assessing a patient's hydration status before administering corticosteroids indicates a need for further education?

"To assess the patient's hydration status, I will check whether the patient has an elevated body temperature."

A patient reports tremors, a low-grade fever, an inability to sleep, and weight loss despite an increased appetite. Which further assessments does the nurse anticipate the healthcare provider will perform to accurately diagnose the patient's condition?

Checking the patient's voice for hoarseness Assessing the patient's eyeballs for exophthalmos Checking the patient's laboratory report for elevated circulating thyroid hormone levels

Which drug would be most effective for a patient with a history of recent head injury, vertigo, and spasticity who is now experiencing sudden numbness, aphasia, and dysarthria?

Dantrolene (Dantrium)

What is the mechanism of action of a muscle relaxant to a patient with a history of stroke syndrome with spasticity?

Decreases the force of reflex muscle contractions

Which drugs would be most effective to treat a patient with a third-degree sprain who also has spasticity due to a neurologic disorder?

Diazepam (Valium) Tizanidine (Zanaflex)

Which information does the nurse include when teaching a patient who has been prescribed colchicine for treatment of gout?

Drink 8 to 12 eight-ounce glasses of fluid daily. Return as scheduled for periodic routine lab studies. Do not exceed 1.8 mg of colchicine when addressing an acute episode.

A patient reports weight gain, intolerance to cold, and decreased appetite. The healthcare provider orders blood tests to accurately diagnose the patient's condition. Which findings would the nurse expect?

Elevated serum cholesterol levels Low circulating thyroid hormone levels

When findings from laboratory reports for a patient receiving mineralocorticoid therapy show increased sodium levels and decreased potassium levels, which etiology does the nurse anticipate is the reason behind these abnormal findings?

Excess of fludrocortisone

After assessing a patient, the healthcare provider confirms that the patient's condition can be treated with a subtotal thyroidectomy. Which characteristics of the patient helped the healthcare provider reach this conclusion?

Exophthalmos Hoarse, rapid speech Hyperactive reflexes and insomnia

Which statement best describes the difference between levothyroxine (Synthroid) and liothyronine (Cytomel)?

Levothyroxine (Synthroid) provides replacement of both T 3 and T 4.

The kidney function test results of a patient receiving treatment for a thyroid disorder show increased serum blood urea nitrogen (BUN) and creatinine levels, and the patient also reports decreased urine output. The nurse expects that the abnormal laboratory findings are caused by which condition?

Nephrotoxicity associated with methimazole (Tapazole)

How is propylthiouracil different from methimazole (Tapazole)?

Propylthiouracil causes a purpuric maculopapular rash

Which immediate interventions will aid a patient who has received rocuronium bromide and is having difficulty swallowing and a poor response to verbal commands after surgery?

Providing suction Providing mechanical ventilation Administering pyridostigmine bromide

A patient is prescribed fludrocortisone (Florinef) for the treatment of Addison's disease. The nurse questions the order after finding that the patient also has which condition?

peptic ulcer