Deck 38: Corticosteroids

Question 1

What is the rationale for administering glucocorticoid therapy as an adjunct to chemotherapeutic agents?

A) Assists with pain control
B) Raises blood sugar to meet the increased metabolic needs
C) Produces immunosuppression effects
D) Reduces mucositis

Answer 1

Produces immunosuppression effects

Question 2

The nurse is assessing a patient for adverse effects of long-term glucocorticoid therapy. Which condition would most likely be present?

A) Dehydration
B) Hypotension
C) Osteoporosis
D) Thrombocytopenia

Answer 2

Osteoporosis

Question 3

Which condition would require mineralocorticoid replacement?

A) Addison's disease
B) Diabetes insipidus
C) Myxedema
D) Glomerulonephritis

Answer 3

Addison's disease

Question 4

Which will the nurse include in the teaching plan for a patient asking about the use of salt substitutes while on a sodium-restricted diet?

A) Salt substitutes may be high in potassium and should be used sparingly.
B) Salt substitutes are safe for unlimited use.
C) The salty flavor is reduced, so additional amounts are needed for desired flavor.
D) Salt substitutes may interact with the patient's medications.

Question 5

What is the rationale for monitoring vital signs of patients receiving corticosteroids?

A) Orthostatic hypotension
B) Malignant hyperthermia
C) Infection
D) Hyperglycemia

Question 6

A patient on a high dosage of corticosteroids over a period of time may develop which type of psychiatric complication?

A) Lethargy
B) Psychotic behaviors
C) Manic phases
D) Anxiety attacks

Question 7

A patient with type 1 diabetes was prescribed a glucocorticoid for COPD. Which will the nurse expect in the treatment plan?

A) A decrease in the amount of insulin needed
B) No change in the amount of insulin needed
C) An increase in the need for carbohydrates
D) An increase in the insulin needed

Question 8

A patient with type 2 diabetes is being discharged on glucocorticoid (prednisone) therapy for rheumatoid arthritis. Which information will the nurse include in discharge teaching? (Select all that apply.)

A) "Daily, single-dose therapy should be taken in the morning."
B) "The metabolic needs of your body will be increased."
C) "Steroids should never be abruptly discontinued."
D) "Signs and symptoms of infections may not be evident."
E) "Blood glucose levels will be elevated on corticosteroid therapy."

Question 9

Which are appropriate measures for monitoring hydration and fluid balance in the patient on steroid therapy? (Select all that apply.)

A) Daily weights
B) Abdominal girth measurements
C) Reports of thirst
D) Neurologic assessment
E) Assessment for alteration in skin integrity

Question 10

The nurse is instructing a patient about adverse effects associated with corticosteroid therapy. Which information would be important to include? (Select all that apply.)

A) Avoid crowds or people with an infection.
B) Monitor and care for your skin daily; change positions frequently.
C) Take medication on an empty stomach.
D) During periods of physical or psychological stress, higher doses of corticosteroids are necessary. Contact your health care provider.
E) Follow a diet low in sodium.

Question 11

Which fluid replacement method will the nurse identify for a patient on a fluid restriction?

A) Freely throughout the day and evening shift
B) One third of the allowed volume on each shift
C) Half the volume with meals and the remainder divided among shifts
D) As the patient desires

Question 12

A patient has been diagnosed with rheumatoid arthritis and will begin daily oral corticosteroid treatment. Which baseline assessments are important for a patient receiving corticosteroids? (Select all that apply.)

A) Baseline weight
B) Blood pressure
C) Complete blood cell count
D) Electrolyte studies
E) Hydration status

Question 13

What are the primary therapeutic outcomes expected from fludrocortisone (Florinef) therapy? (Select all that apply.)

A) Reduced inflammation
B) Pain relief
C) Blood pressure control
D) Restored fluid and electrolyte balance

Question 14

A patient has been on high-dose corticosteroid therapy for the treatment of lupus erythematosus. In addition to monitoring electrolyte levels, which laboratory studies will the nurse monitor?

A) Complete blood count
B) Partial thromboplastin time
C) Liver function panel
D) Blood glucose levels

Question 15

Which is a function of glucocorticoids? (Select all that apply.)

A) Maintain fluid and electrolyte balance
B) Have anti-inflammatory activities
C) Regulate protein, carbohydrate, and fat metabolism
D) Provide relief of rheumatoid arthritis
E) Include aldosterone

Question 16

A patient who has been taking glucocorticoids over the past 3 months for Crohn's disease comes in for a follow-up visit. On assessment, the nurse notes facial edema, thinning extremities, and a fatty deposition (buffalo hump) on the scapular area. The patient reports the symptoms of the Crohn's disease are "somewhat better." What will the nurse expect the treatment to be?

A) Decrease the steroid dosage by one half.
B) Increase the steroid dosage.
C) Maintain the steroid dosage.
D) Immediately stop the steroid dosage.