Deck 66: Hypothalamic and Pituitary Drugs

Question 1

The nurse is preparing to administer somatatropin (Humatrope).In the process of planning care, the nurse is aware that the patient is likely to experience what minor side effects?
1)Nausea and vomiting
2)Diarrhea and abdominal cramps
3)Nasal congestion and flushing
4)Headache and joint ache

Answer 1

4

Question 2

The nurse is evaluating the outcomes of the care associated with administering desmopressin therapy.Which of the following provides the strongest evidence for a desired outcome in a 50-year-old male?
1)Urine specific gravity 1.015
2)Urine output 3,500 ml/day
3)Serum sodium 156 mEq/L
4)Edema of lower extremities absent

Answer 2

1

Question 3

The nurse is assessing the patient who will soon commence supplemental growth hormone therapy.Which parameters should the nurse assess?
1)Blood sugar, blood pressure, height, and weight
2)Height and weight, head circumference, and EKG
3)Urine specific gravity, serum osmolality, and serum electrolytes
4)Bowel sounds, vitamin B₁₂ level, and history of gallbladder disease

Answer 3

1

Question 4

A patient with metastatic abdominal cancer has become debilitated secondary to bowel-related signs and symptoms.The nurse is preparing to administer octreotide (Sandostatin).The nurse would anticipate:
1)Severe constipation and possible ileus.
2)Decrease in the number of diarrheal stools.
3)Decrease in nausea and vomiting episodes.
4)Decrease in gastric reflux signs and symptoms.

Question 5

The nurse is processing the history of a patient who underwent deep brain surgery that resulted in damage to the hypothalamus.The nurse recognizes that the patient's deficit of all pituitary hormones is related to the location of the hypothalamus, which is found:
1)Deep within the brainstem.
2)Within the parietal lobe of the brain.
3)Just anterior to the occipital lobe of the brain
4)In the diencephalon, just above the brainstem.

Question 6

The nurse is teaching a patient who is recovering from a hypophysectomy because of an anterior pituitary adenoma.The patient is learning about the need for supplemental thyroid hormone.The patient says, "I thought thyroid hormone came from a gland in my neck." Which follow-up statement by the nurse is most appropriate?
1)"Your thyroid gland was damaged because of the long surgical procedure."
2)"Your thyroid gland no longer gets messages from the pituitary."
3)"You will only need to take thyroid hormone until healing occurs."
4)"You need this hormone because your TSH is too high since surgery."

Question 7

A nurse is explaining the need to track blood sugar to a patient who will be receiving growth hormone injections.The explanation is based on the recognition that additional growth hormone will:
1)Decrease blood glucose levels.
2)Trigger type I diabetes mellitus.
3)Increase insulin resistance.
4)Promote very rapid growth.

Question 8

A nurse is giving a presentation on steroid abuse to a group of teens.One of the students comments that growth hormone is safe, because it is a natural product.The nurse's response would be based on the knowledge that:
1)Teenagers might abuse growth hormone to improve their athletic performance or to impress other teens with their enhanced appearance.
2)Teen rarely abuse growth hormone, because it is not as readily available as are anabolic steroids.
3)Growth hormone is more likely to be a drug of abuse among older individuals, because teens have sufficient growth hormone already present.
4)Growth hormone is safe for teenagers to use, but should not be used by anyone whose bone ends are fused.

Question 9

The nurse is establishing nursing diagnoses for a school-age child who is to receive growth hormone therapy.Which of the following has the highest priority?
1)Delayed Growth and Development related to low GH levels and height below the fifth percentile
2)Knowledge Deficit related to the purpose and side effects of GH therapy
3)Disturbed Body Image related to slow physical growth as compared to peer group
4)Anxiety related to the treatment process and potential outcomes of the GH therapy

Question 10

A nurse is administering desmopressin to a patient with a head injury that put pressure on the posterior pituitary.The nurse recognizes that this form of artificial ADH will have the most impact on which portion of the assessment?
1)Urine output and blood pressure
2)Peripheral nervous system function, including reflexes
3)Cardiac function, including the conduction system
4)The Glasgow coma scale.

Question 11

A nurse is conducting an admission assessment on a patient with an admission diagnosis of SIADH.The nurse would anticipate these physical findings to be consistent with:
1)Severe overhydration.
2)Severe dehydration.
3)A shock state.
4)Acute renal failure.

Question 12

The nurse is planning the discharge of a patient with a known long-term deficit of ADH.The nurse recognizes that the discharge orders for an ADH supplement will most likely require teaching about:
1)Self-administration of an oral or intranasal preparation.
2)Self-administration of a weekly intravenous preparation.
3)Self-administration of an every-third-day IM preparation.
4)Self-administration of a daily SQ preparation.

Question 13

Conivaptan (Vaprisol)is ordered for a patient with severe SIADH.The nurse preparing this medication recognizes that the desired outcome of this therapy is:
1)An increased urine output.
2)An increased blood pressure.
3)A decreased urine output.
4)An increased heart rate.

Question 14

The nurse is assessing a child at a well-child clinic.Although well nourished, the child is in the fourth percentile for height for his age.The nurse recognizes this child needs to be referred promptly because:
1)There is evidence the child has inadequate TSH levels.
2)There is evidence the child has inadequate ACTH levels.
3)There is evidence the child has inadequate GH levels.
4)There is evidence the child has inadequate FSH and LH levels.

Question 15

A 16-year-old patient with DI is being discharged with a script for nasal desmopressin.It is essential for the nurse to teach the patient and family the signs and symptoms associated with:
1)Hypoglycemic reaction.
2)Liver failure
3)Acute renal failure
4)Water intoxication

Question 16

A patient with long-term nephrogenic DI is admitted to a medical unit.During the medication reconciliation process, the nurse realizes it is crucial that which medication be included in the patient's regimen?
1)Intranasal or oral desmopressin
2)Conivaptan (Vaprisol)
3)Hydrochlorothiazide (HCTZ)
4)Chloropropamide

Question 17

A nurse is administering Lasix to a patient with SIADH.The desired outcome would be:
1)An increase in blood pressure.
2)A decrease in serum potassium.
3)An increase in urine output.
4)A decrease in serum osmolality.

Question 18

A patient with SIADH is upset about his doctor's order for fluid restriction.Which explanation by the nurse is most appropriate?
1)"Your body is retaining too much water.Decreasing your intake, along with the other medicine you are receiving, helps correct the problem."
2)"Your kidney is not working as it should.Decreasing your fluid intake allows your kidney to rest."
3)"Rinse your mouth with salt water.It will help to decrease your thirst."
4)"Your IV fluids are providing you with the liquids you need.You should not be thirsty."