Prep Quiz #7 - Endocrine drugs
A nurse cares for a patient with diabetes mellitus who asks, "Why do I need to administer more than one injection of insulin each day?" How would the nurse respond?
"A single dose of insulin each day would not match your blood insulin levels and your food intake patterns."
The nurse is teaching a client with newly diagnosed type 1 diabetes about insulin therapy. Which statements indicate the client needs more teaching concerning insulin therapy?
"Because I am taking my insulin daily I do not have to adhere to a diabetic diet."
A client with thyroid cancer has just received 131I ablative therapy. Which statement by the client indicates a need for further teaching?
"I'm ready to hold my newborn grandson now."
The nurse is teaching a client about thyroid replacement therapy. Which statement by the client indicates a need for further teaching?
"If I continue to lose weight, I may need an increased dose."
A nurse teaches a patient with diabetes mellitus about sick-day management. Which statement would the nurse include in this patient's teaching?
"Monitor your blood glucose levels at least every 4 hours while sick."
A client is taking methimazole (Tapazole) for hyperthyroidism and would like to know how soon this medication will begin working. What is the nurse's best response?
"You will see some effects of this medication within 2 weeks."
A nurse cares for a patient who has hypothyroidism as a result of Hashimoto's thyroiditis. The patient asks, "How long will I need to take this thyroid medication?" How does the nurse respond?
"You'll need thyroid pills for life because your thyroid won't start working again."
A nurse is preparing to administer vasopressin 5 units IM to a client. Available is vasopressin 20 units/mL. How many mL should the nurse administer? (Round the answer to the nearest hundredth. Use a leading zero if it applies. Do not use a trailing zero.)
0.25 ml
A nurse is preparing to administer morphine 4 mg IV bolus every 3 hr PRN pain. Available is morphine injection 10 mg/mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)
0.4 ml
A client with type 1 diabetes mellitus received regular insulin at 7:00 a.m. The client will need to be monitored for hypoglycemia at which time?
11:00am
A nurse cares for a patient who has diabetes mellitus. The nurse administers 6 units of regular insulin and 10 units of NPH insulin at 07:00. At which time would the nurse assess the patient for potential problems related to the NPH insulin?
16:00
A diabetic patient has the following presentation: unresponsive to voice or touch, tachycardia, diaphoresis, and pallor. Which of the following actions by the healthcare provider is the priority?
Administer 50% dextrose IV per hypoglycemia protocol
A client presents to the emergency department with a history of adrenal insufficiency. The following laboratory values are obtained: Na+ 130 mEq/L (130 mmol/L), K+ 6.6 mEq/L (6.6 mmol/L), and glucose 72 mg/dL (4 mmol/L). Which prescription will the nurse implement first?
Administer insulin with dextrose in normal saline.
A nurse cares for a patient with diabetes mellitus who is prescribed metformin (Glucophage) and is scheduled for a contrast-enhanced CT. What action should the nurse take first?
Contact the provider and recommend discontinuing the metformin.
A nurse cares for a patient who has elevated levels of antidiuretic hormone (ADH). Which disorder should the nurse identify as a trigger for the release of this hormone?
Dehydration
The healthcare provider is teaching a group of students about the characteristics of type 1 diabetes mellitus. Which of the following describe the underlying cause of the disease?
Destruction of pancreatic beta cells resulting in lack of insulin
An unresponsive patient who has diabetes is brought to the emergency department with slow, deep respirations. Additional findings include: blood glucose 450 mg/dL (24.9 mmol/L), arterial pH 7.2 (acidosis), and urinalysis showing presence of ketones and glucose. Which of the following best describes the underlying cause of this patient's presentation?
Diabetic Ketoacidosis (DKA)
A nurse is providing teaching to a client who is about to begin levothyroxine therapy to treat hypothyroidism. Which of the following instructions should the nurse include?
Expect life-long therapy with the drug.
The client is taking fludrocortisone (Florinef) for adrenal hypofunction. The nurse instructs the client to report which symptom while taking this drug?
Headache
A nurse on a medical unit is assisting with the orientation of a newly licensed nurse. The nurse should remind the newly licensed nurse to have a second nurse review the dosage of which of the following medications prior to administration?
Heparin
A nurse is preparing to administer insulin subcutaneously to a client. The nurse should document the administration of the medication immediately after which of the following actions?
Injecting the insulin
A nurse assesses a patient with diabetes mellitus who self-administers subcutaneous insulin. The nurse notes a spongy, swelling area at the site the patient uses most frequently for insulin injection. What action would the nurse take?
Instruct the patient to rotate sites for insulin injection.
Which of the following insulins have no peak but a duration of 24 hours?
Lantus (insulin glargine)
A patient has been prescribed pharmacologic doses of glucocorticoids. It is most important for the nurse to teach the patient to do what?
Never abruptly withdraw therapy.
When is a patient most susceptible to hypoglycemic symptoms after the administration of insulin?
Peak
A nurse is speaking with a client who is taking glipizide to treat type 2 diabetes mellitus and has called to report feeling shaky, hungry, and fatigued. Which of the following actions should the nurse instruct the client to take?
Perform a fingerstick blood glucose check.
A patient is admitted for diabetic ketoacidosis (DKA), and an IV drip titrated to maintain blood glucose levels between 120 and 200 is ordered (intravenous infusion). The only insulin that would be administered IV is:
Regular insulin
A nurse is caring for a client who takes repaglinide 15 to 30 min before each meal to treat type 2 diabetes mellitus. The client asks, "If I skip a meal, what should I do?" Which of the following responses should the nurse make?
Skip the dose.
A client with type 2 diabetes controlled with Metformin is recovering from surgery. The primary health care provider has placed the client on insulin in addition to the metformin. What is the nurse's best response about why the client needs to take insulin?
Stress, such as surgery, increases blood glucose levels. You'll need insulin to control your blood glucose temporarily."
A nurse is caring for a client who is taking pioglitazone to treat type 2 diabetes mellitus. The nurse should monitor for which of the following findings?
WEIGHT GAIN
A nurse is caring for a client who is taking metformin and is scheduled to undergo angiography using iodine-containing contrast dye. The nurse should identify that an interaction between metformin and the IV contrast dye increases the client's risk for which of the following conditions?
acute renal failure
A nurse discovers a medication error in which the client received twice the prescribed amount of medication. Which of the following actions should the nurse take first?
assess the client
A nurse is caring for a client who is about to begin insulin glargine therapy. The nurse should identify the need for additional precautions because the client also takes which of the following types of drugs?
betablockers
A nurse is teaching a client about acarbose therapy to treat type 2 diabetes mellitus. Which of the following instructions should the nurse include?
eat more iron rich food
Which of the following drugs should a nurse have available for a client who is experiencing insulin toxicity?
glucagon
When considering replacement therapy options for a client who has chronic adrenocortical insufficiency, a nurse should recognize that the provider will choose which of the following drugs?
hydrocortisone
A nurse is caring for a client who is taking propylthiouracil (PTU) and reports weight gain, drowsiness, and depression. The nurse should identify that the client is experiencing which of the following adverse reactions to the drug?
hypothyroidism
A nurse is caring for a client who is about to begin taking propylthiouracil (PTU) to treat hyperthyroidism. The nurse should instruct the client to report which of the following adverse effects? (Select all that apply.)
joint pain sore throat bradycardia rash
A nurse is caring for a client who is taking metformin to treat type 2 diabetes mellitus and reports muscle pain. Which of the following adverse reactions should the nurse suspect?
lactic acidosis
A nurse is teaching a client about self-administering regular insulin. The nurse should instruct the client to rotate injection sites to prevent which of the following?
lipohypertrophy
A nurse is caring for a client who is about to begin taking pioglitazone to treat type 2 diabetes mellitus. The nurse should explain to the client about the need to monitor which of the following laboratory values? (Select all that apply.)
liver enzymes(AST, ALT) LDL
A nurse is caring for a client who is about to begin taking somatropin. The nurse should explain the need to monitor which of the following laboratory values? (Select all that apply.)
urine calcium blood glucose
A client with typically well controlled diabetes has a glycosylated hemoglobin (HbA1C) level of 9.4%. Which response by the nurse is most appropriate?
"Have you been doing something differently?
A nurse is preparing to administer furosemide 30 mg IV bolus stat. Available is furosemide injection 10 mg/mL. How many mL should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
3 ML
Which of the following insulins have an onset of 15 minutes, Peak of 1 hour, and duration of 3 hours:
Aspart insulin
A nurse is teaching a client who has a prescription for glipizide therapy to treat type 2 diabetes mellitus. Which of the following instructions should the nurse include?
Avoid alcohol
A nurse assesses a patient who is prescribed levothyroxine (Synthroid) for hypothyroidism. Which assessment finding alerts the nurse that the medication therapy is effective?
Heart rate is 70 beats/min and regular.
The healthcare provider is assessing the glucose level of a patient with a diagnosis of diabetes. Which of these is most helpful in evaluating this patient's long-term glucose management?
Hemoglobin A1c (Hgb A1C)
When considering replacement therapy options for a patient who has Adrenocortical insufficiency, the nurse should recognize that the provider will choose which of the following drugs?
Hydrocortisone
A nurse cares for a patient who presents with bradycardia secondary to hypothyroidism. Which medication does the nurse prepare to administer?
Levothyroxine sodium (Synthroid)
Which of the following insulins are given ONCE daily for the treatment of Type I or Type II Diabetes?
Long-acting insulin (Lantus / Glargine)
A patient diagnosed with type 2 diabetes mellitus is admitted to the medical unit with pneumonia. The patient's oral antidiabetic medication has been discontinued and the patient is now receiving insulin for glucose control. Which of the following statements best explains the rationale for this change in medication?
Stress-related states such as infections increase risk of hyperglycemia
A nurse is teaching a client who has a prescription for pramlintide therapy to treat type 1 diabetes mellitus. Which of the following instructions should the nurse include?
administer before meals
A nurse is assessing a client who has a new prescription for levothyroxine. The nurse should identify which of the following findings as a contraindication for this drug?
recent MI
A nurse is caring for a client who is taking desmopressin. The nurse should make which of the following assessments to evaluate the drug's effectiveness?
urine output
