Deck 44: Drugs for Pituitary, Thyroid, and Adrenal Disorders

Question 1

An older adult client has hypothyroidism. Which assessment finding would the nurse report to the physician immediately?

A) Dry skin
B) Generalized weakness
C) Muscle cramps
D) Slurred speech

Answer 1

Slurred speech

Question 2

The client is very distraught that her 12-year-old son is of very short stature. What is the best plan by the nurse?

A) Tell the client that treatment with growth hormone might result in acromegaly.
B) Tell the client that treatment for short stature is too expensive for many to afford.
C) Tell the client that treatment with growth hormone might help and refer her to an endocrinologist.
D) Tell the client that treatment with growth hormone can add 6 inches of height to her son.

Answer 2

Tell the client that treatment with growth hormone might help and refer her to an endocrinologist.

Question 3

Which finding is a symptom of Cushing's syndrome?

A) Hypoglycemia
B) Vomiting
C) Moon face
D) Diarrhea

Answer 3

Moon face

Question 4

The client has been diagnosed with diabetes insipidus. What will the best plan by the nurse include?

A) Assess for increased urine production.
B) Assess for hyperglycemia.
C) Assess for hyponatremia.
D) Assess for fluid retention.

Question 5

The client has hyperthyroidism. The nurse teaches the client to avoid which food selections?

A) Soy sauce
B) Milk products
C) High-calorie foods
D) Caffeine-free soda

Question 6

The client has been diagnosed with Cushing's syndrome. What will the nurse's assessment likely reveal?

A) Low blood pressure and hypoglycemia
B) Well-healed scars on the upper body
C) Upper body obesity
D) Thin, gaunt appearance of the face

Question 7

The nursing instructor teaches the student nurses about the endocrine system. The nursing instructor evaluates that learning has occurred when the student nurses make which statements?

A) "The hypothalamus secretes releasing hormones."
B) "Hormones released by the endocrine system influence every organ in the body."
C) "The hypothalamus is considered the master gland."
D) "The pituitary gland secretes TSH (thyroid-stimulating hormone)."
E) "The endocrine system is a major controller of homeostasis."

Question 8

Which finding is a sign or symptom of hypothyroidism?

A) Anxiety
B) Bradycardia
C) Tachycardia
D) Weight loss

Question 9

The primary goal of pharmacotherapy in hyperthyroidism (Graves' disease) is to

A) increase metabolism.
B) increase synthesis of corticosteroid.
C) lower the activity of the thyroid hormone.
D) increase the activity of the thyroid hormone.

Question 10

A client has diabetes insipidus and receives desmopressin (DDAVP). The nurse completes medication education and evaluates that learning has occurred when the client makes which statement?

A) "This medication is a potent vasodilator; my blood pressure can fall."
B) "This medication promotes diuresis in my body; my blood pressure can fall."
C) "This medication increases water reabsorption in my kidneys."
D) "This medication suppresses hormone secretion from my posterior pituitary gland."

Question 11

The client has hypothyroidism and is treated with levothyroxine (Synthroid). The nurse plans to do medication education. What will the best plan by the nurse include?

A) Monitor daily temperature
B) Assess for decreased appetite.
C) Assess weekly serum blood levels.
D) Assess for altered sleep patterns.

Question 12

Vasopressin is used in the treatment of

A) diabetes insipidus.
B) dehydration.
C) electrolyte imbalances.
D) diabetes mellitus.

Question 13

The client receives hydrocortisone therapy. The nurse will primarily assess for which electrolyte disturbance?

A) Hypernatremia and hyperglycemia
B) Hypernatremia and hyperkalemia
C) Hypercalcemia and hyperkalemia
D) Hypoglycemia and hyponatremia

Question 14

The client receives treatment with radioactive iodine (Iodine-131) therapy. What will the best evaluation by the nurse reveal?

A) The client will only temporarily accomplish the euthyroid state.
B) The client could safely become pregnant while receiving this treatment.
C) The client will most likely require thyroid replacement therapy.
D) The client does not have to distance herself from others.

Question 15

The nurse is reviewing the steps of the negative feedback regulation of thyroid hormone. The nurse would place these steps in which sequence?

A) Blood levels of thyroid hormone rise.
B) Hypothalamus secretes thyroid-releasing hormone (TRH).
C) Secretion of TSH and TRH are suppressed.
D) T₃ and T₄ are secreted.
E) The anterior pituitary secretes thyroid-stimulating hormone (TSH).

Question 16

The client receives glucocorticoid therapy. The nurse would prioritize assessment for which finding?

A) Hypothermia
B) Hypotension
C) Hypertension
D) Weight loss

Question 17

The nurse teaches the client about glucocorticoid therapy. The nurse evaluates that additional teaching is required when the client makes which statement?

A) "I can take the medication at any time as long as I don't forget it."
B) "I will monitor my blood sugar on a regular basis."
C) "I will eat a diet that is high in protein."
D) "I should take my medication after I have eaten."

Question 18

The function of the thyroid gland is to

A) stimulate growth.
B) control pituitary gland secretion.
C) conserve water in the body.
D) control basal metabolism.

Question 19

A client has been prescribed levothyroxine (Levothroid). What medication information should the nurse provide?

A) "It may take a few weeks for you to see the full benefits from this drug."
B) "Be sure to keep all of your follow-up appointments."
C) "Take this medication at whatever time you eat your evening meal."
D) "Do not start a fiber laxative without first discussing it with your health care team."
E) "Take your calcium supplement at least 4 hours after taking this drug."

Question 20

The nurse plans to administer intranasal desmopressin (DDAVP) to the client. What will the best plan by the nurse include?

A) Instruct the client to blow his nose following administration.
B) Be sure to have fresh water at the bedside.
C) Withhold other medications so absorption of desmopressin (DDAVP) will not be affected.
D) Direct the spray high into the nasal cavity.

Question 21

A patient has symptoms of adrenocorticoid insufficiency and is having diagnostic testing with administration of cosyntropin (Cortrosyn). The nurse would evaluate that this test shows secondary adrenocortical insufficiency if which result occurs?

A) The patient's plasma level of cortisol rises after injection.
B) The patient has carpal spasms following injection.
C) The patient's urine cortisol fails to rise after injection.
D) The patient flushes after injection.

Question 22

A patient has been prescribed long-term corticosteroid therapy. Which preventative information does the nurse provide?

A) Avoid carbonated beverages.
B) Participate in regular weight-bearing exercises.
C) Do not take any calcium supplements.
D) Schedule periodic colon studies.
E) Avoid caffeine in the diet.

Question 23

A client has been prescribed propylthiouracil (PTU). What medication education should the nurse provide?

A) "It may take several days or weeks for you to see effects of this drug."
B) "Take this drug with meals."
C) "Do not become pregnant while taking this medication."
D) "You may experience a rash while taking this drug."
E) "You may continue to breastfeed while taking this drug."

Question 24

A client has been taking propylthiouracil (PTU) for several weeks. Which client statements would the nurse interpret as indicating that the drug is having its desired effects?

A) "I am sleeping so much better."
B) "I can't seem to gain any weight no matter how much I eat."
C) "I don't feel as anxious as I once did."
D) "My heart doesn't seem to be racing anymore."
E) "My skin in not bruising as much."

Question 25

A patient has been prescribed corticosteroid therapy for the treatment of severe osteoarthritis. The nurse evaluates that teaching about this drug is understood if the patient makes which statement?

A) "If I get sick and cannot take my medicine for more than 3 days, I will contact my health care provider."
B) "I will take my medication at the same time every day."
C) "I will take my medication with food or a meal."
D) "I will avoid dairy products while taking this medication."
E) "If I notice my vision is changing, I will contact my health care provider."

Question 26

A client has been taking thyroid hormone replacement for several years. On today's clinic visit, the nurse remarks that the client has lost 20 pounds. The client states, "I was getting fat, so I started taking an extra thyroid pill every day or so." How should the nurse respond?

A) "Well, it certainly is working for you."
B) "You should follow the dosage instructions for your thyroid medication exactly as written."
C) "I'll ask your physician to increase the number of refills on your prescription."
D) "That could be dangerous to your health."
E) "I may ask the doctor to write a prescription for me."

Question 27

A client will be prescribed an oral corticosteroid for treatment of a rash. The prescriber says, "In order to avoid adverse effects, I am prescribing the smallest amount possible." What other prescribing regimens could the nurse suggest to achieve this same effect?

A) Give the oral medication every other day.
B) Administer a larger dose for a few days and then gradually decrease the dose until the medication is discontinued.
C) Use a topical application instead of an oral product.
D) Start with a small dose and work up to the desired dose.
E) Administer the doses intramuscularly for the first few days of treatment.

Question 28

A patient with hyperthyroidism presented with thyroid storm and high temperature. The nurse evaluates that measures to lower the temperature should be changed when which assessment is made?

A) The patient has received a second dose of propylthiouracil.
B) The patient develops crackles in both lung bases.
C) The patient begins to shiver.
D) The patient's blood glucose increases.

Question 29

A client diagnosed with an inoperable tumor of the adrenal gland is prescribed mitotane (Lysodren). The nurse would attribute which assessment finding as indicating an adverse reaction to the drug?

A) The client reports that food is not appealing.
B) The client reports joint pain.
C) The client reports ringing of the ears.
D) The client reports increasing depression.
E) The client reports dizziness.

Question 30

A patient was admitted with Addison's disease. Assessment now reveals nausea, vomiting, and confusion. The nurse anticipates which urgent intervention?

A) Placement of a nasogastric tube.
B) Administration of intravenous hydrocortisone.
C) Administration of intravenous diuretic.
D) Immediate endotracheal intubation.