Chapter 51: Endocrine Drugs: Pituitary, Thyroid, Parathyroid, and Adrenal Disorders Nursing School Test Banks

Kee: Pharmacology, 7th Edition

Chapter 51: Endocrine Drugs: Pituitary, Thyroid, Parathyroid, and Adrenal Disorders

Test Bank

MULTIPLE CHOICE

1. The client is being treated with growth hormone. During treatment, the nurse monitors the client closely for evidence of:

a.

diabetes mellitus.

b.

gastrointestinal distress.

c.

hypotension.

d.

dwarfism.

ANS: A

Growth hormone antagonizes insulin secretion and thus can lead to the development of diabetes mellitus.

DIF: Cognitive Level: Application REF: p. 764

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

2. A client is noted to have Cushing syndrome. The highest priority nursing intervention related to the clients electrolyte levels is to monitor for evidence of:

a.

sodium retention.

b.

water depletion.

c.

hypocalcemia.

d.

hyperkalemia.

ANS: A

Sodium and water levels are affected by Cushing syndrome.

DIF: Cognitive Level: Application REF: p. 777

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pathophysiology

3. The nurse teaches the client the signs and symptoms of hypothyroidism. The client is taught to self-monitor closely for:

a.

tachycardia.

b.

palpitations.

c.

intolerance to heat.

d.

weight gain.

ANS: D

Hypothyroidism can lead to a hypometabolic state. This may be manifested by weight gain.

DIF: Cognitive Level: Application REF: p. 770

TOP: Nursing Process: Assessment

MSC: CONTENT CATEGORY: Physiological Integrity: Pathophysiology

4. Client teaching on proper administration of a thyroid replacement drug includes which instruction?

a.

Advise the client to report symptoms of hypothyroidism.

b.

Instruct the client to take the drug at the same time each day.

c.

Instruct the client to eat foods that inhibit thyroid secretion.

d.

Teach the client to take the medication on a full stomach.

ANS: B

The drug works in concert with circadian rhythms and so should be taken at the same time each day and on an empty stomach.

DIF: Cognitive Level: Application REF: p. 770

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

5. The client is being treated with a glucocorticoid medication. The nurse plans to monitor him closely for evidence of:

a.

hypertension.

b.

hypoglycemia.

c.

hypovolemia.

d.

hyperkalemia.

ANS: A

Steroids may lead to fluid overload and hypertension.

DIF: Cognitive Level: Application REF: pp. 774, 776

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

6. The healthcare provider left an order to discontinue prednisone (Deltasone, Meticorten, Orasone, others). The highest priority action for the nurse is to:

a.

contact the healthcare provider to determine a tapering schedule.

b.

explain to the client that the drug will be immediately stopped.

c.

contact the pharmacist to determine a tapering schedule.

d.

begin gradually decreasing the prednisone dose.

ANS: A

Prednisone must be tapered to avoid adrenal insufficiency.

DIF: Cognitive Level: Analysis REF: p. 777

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

7. Health teaching for the client receiving prednisone (Deltasone, Meticorten, Orasone, others) to decrease the inflammatory effects related to arthritis includes which instruction?

a.

Instruct the patient that the dose can be stopped as needed.

b.

Advise the patient to avoid foods rich in potassium.

c.

Inform the patient that prednisone should be taken between meals and without food.

d.

Teach the client the signs and symptoms of excessive use of glucocorticoids.

ANS: D

It is important to teach clients the signs and symptoms of excessive use.

DIF: Cognitive Level: Application REF: p. 777

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

8. A client is found to be deficient in a mineralocorticoid. The nurse assesses the client for manifestation of this deficiency by noting evidence of:

a.

hypotension.

b.

hypertension.

c.

bradycardia.

d.

edema.

ANS: A

A severe decrease in the mineralocorticoid aldosterone leads to hypotension and vascular collapse, such as in Addisons disease.

DIF: Cognitive Level: Application REF: p. 776

TOP: Nursing Process: Assessment

MSC: CONTENT CATEGORY: Physiological Integrity: Pathophysiology

9. A school-aged client with growth hormone (GH) deficiency is recommended for growth hormone injections. What in the clients history would warrant contacting the primary healthcare provider?

a.

Asthma

b.

Obesity

c.

Apnea

d.

Seizure disorder

ANS: B

Obesity is a contraindication for GH therapy, such as would be present in a client with Prader-Willi syndrome.

DIF: Cognitive Level: Application REF: p. 764

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

10. A client sustains a brain injury. The client is being treated with desmopressin acetate. What would indicate a positive outcome from the medication?

a.

Reduction in urine output

b.

Increase in urine output

c.

Decrease in reabsorption of water in the renal tubules

d.

Elevation of the clients heart rate

ANS: A

The medication secretes the hormone to retain fluid, causing a reduction in urine output.

DIF: Cognitive Level: Application REF: p. 777

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

11. The nurse provides medication instructions to a client prescribed liothyronine sodium (Cytomel) for treatment of hypothyroidism. Which symptoms should the client be taught to monitor for that will indicate an overaccumulation of this drug?

a.

Dry mouth and lack of ability to urinate

b.

Rapid or racing heat rate

c.

Lethargy and fatigue

d.

Nausea and constipation

ANS: B

An overaccumulation of Cytomel may increase thyroid stimulation and may cause tachycardia.

DIF: Cognitive Level: Application REF: p. 770

TOP: Nursing Process: Assessment

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

12. The client is being treated with prednisone. Her treatment regimen includes estrogen replacement therapy. The nurse anticipates that the interaction of the two medications will result in:

a.

increased effects from the estrogen.

b.

increased effects from the prednisone.

c.

an anaphylactic reaction.

d.

toxicity from the prednisone dosage.

ANS: B

The interaction of prednisone and estrogen will result in increased effect from the prednisone.

DIF: Cognitive Level: Application REF: p. 774

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

13. The client is being treated with prednisone. His treatment regimen includes aspirin. The nurse anticipates that the interaction of the two medications will result in _____ toxicity.

a.

cardiac

b.

genitourinary

c.

gastrointestinal

d.

respiratory

ANS: C

The interaction of prednisone and aspirin will result in gastrointestinal toxicity.

DIF: Cognitive Level: Application REF: p. 774

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

14. The client is being treated with calcitriol. Her treatment regimen includes thiazide diuretics. The highest priority nursing intervention based on this drug interaction is to monitor serum _____ level.

a.

calcium

b.

potassium

c.

sodium

d.

magnesium

ANS: A

The interaction of calcitriol and a thiazide diuretic will tend to increase the clients calcium level.

DIF: Cognitive Level: Application REF: p. 772

TOP: Nursing Process: Intervention

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

15. The client is being treated with calcitriol. He complains of changes in his vision. The nurse recognizes that this symptom is most likely ________ the medication.

a.

an anaphylactic reaction to

b.

indicative of a toxic dosage of

c.

an adverse reaction to

d.

a side effect of

ANS: D

A side effect of treatment with calcitriol can be dizziness and photophobia.

DIF: Cognitive Level: Application REF: p. 772

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

16. The client is scheduled to be treated with corticotropin. Which aspect of her client history would cause the nurse to contact the primary healthcare provider?

a.

Peptic ulcer

b.

Arthritis

c.

Glaucoma

d.

Dysphagia

ANS: A

Peptic ulcer is a contraindication for treatment with corticotropin.

DIF: Cognitive Level: Application REF: p. 766

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

17. The client is being treated with potassium iodide. In instructing the client on self-administration of the medication, what is the highest priority nursing instruction?

a.

Drink the medication at room temperature.

b.

Swallow the medication in the form of a wafer.

c.

Sip the medication through a straw.

d.

Chew the tablets thoroughly before swallowing.

ANS: C

The client should sip the medication through a straw to avoid discoloration of the teeth.

DIF: Cognitive Level: Application REF: p. 771

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

18. Dietary instructions for the client who is being treated with glucocorticoids includes eating a diet high in:

a.

vitamin A.

b.

potassium.

c.

iron.

d.

magnesium.

ANS: B

Advise the client who is being treated with a glucocorticoid medication to eat foods rich in potassium, such as fresh and dried fruits, vegetables, meats, and nuts, because prednisone promotes potassium loss and hypokalemia.

DIF: Cognitive Level: Application REF: p. 777

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

19. The client is an older adult who is being treated with a glucocorticoid medication. The highest priority nursing intervention with this client is to monitor for evidence of:

a.

cardiac dysrhythmias.

b.

visual disturbances.

c.

cognitive deterioration.

d.

increased osteoporosis.

ANS: D

Monitor older adults for signs and symptoms of increased osteoporosis because glucocorticoids promote calcium loss from bone.

DIF: Cognitive Level: Application REF: p. 777

TOP: Nursing Process: Intervention

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

20. The client is being treated with thyroid replacement therapy. What is the highest priority nursing instruction regarding dietary requirements?

a.

Avoid eating shellfish.

b.

Avoid eating steak.

c.

Increase intake of spinach.

d.

Increase intake of strawberries.

ANS: A

Iodine is found in shellfish, and clients being treated with thyroid replacement therapy should avoid excessive iodine.

DIF: Cognitive Level: Application REF: p. 770

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

MULTIPLE RESPONSE

1. A client is diagnosed with hypothyroidism. What is characteristic of this condition? (Select all that apply.)

a.

Constipation

b.

Vomiting

c.

Bradycardia

d.

Weight gain

e.

Racing heart beats

f.

Irregular menses

g.

Intolerance to heat

ANS: A, C, D, F

These symptoms are indicative of hypothyroidism. The others indicate a hypermetabolic state.

DIF: Cognitive Level: Application REF: p. 770

TOP: Nursing Process: Assessment

MSC: CONTENT CATEGORY: Physiological Integrity: Pathophysiology

Copyright 2012, 2009, 2006, 2003 by Saunders, an imprint of Elsevier Inc.

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