Deck 18: Hormones and Steroids

Question 1

A patient is taking insulin each morning.When the insulin peaks,the patient should be observed for which signs of hypoglycemia?

A) Nervousness, hunger, weakness, pallor, and confusion
B) Tachycardia and acetone breath
C) Tachycardia, loss of consciousness, and Kussmaul respirations
D) Serum glucose greater than 150 mg/dL, hunger, and confusion

Answer 1

Nervousness, hunger, weakness, pallor, and confusion

Question 2

A patient came to the clinic for follow-up care after his last visit.His laboratory tests for serum T? and TSH confirm hypothyroidism.The nurse expects that this patient will be started on which medication?

A) Prednisone
B) Hydrocortisone
C) Levothyroxine
D) Danazol

Answer 2

Levothyroxine

Question 3

A newly diagnosed type 2 diabetic patient is started on a new drug that comes from incretin hormones.Glucagon-like peptide 1 (GLP1)is used because of which effect?

A) It has the least allergic effect.
B) It is easy to administer.
C) It inhibits glucagon secretion.
D) It slows islet growth.

Answer 3

It inhibits glucagon secretion.

Question 4

What should patients taking antidiuretic hormone (ADH)be monitored frequently for?

A) Increase in urination
B) Urinary acidity
C) Dehydration
D) Urinary alkalinity

Question 5

In instructing a patient about corticosteroid therapy,the patient asks if he can just stop this medication before returning to the physician's office.Which would be the nurse's best response?

A) "Take this medication until you've completed it."
B) "The medication must be slowly reduced."
C) "Go ahead; there is no real precaution with this drug therapy."
D) "The amount you're taking is small, so stopping is all right at any time."

Question 6

A patient is started on Byetta,one of the new antidiabetic agents.The patient asks how this medication will help lower blood sugar.Which is the best response made by the nurse?

A) It takes the place of insulin.
B) It restores insulin secretion.
C) It is taken with insulin to make it last.
D) It decreases the thirst for water.

Question 7

A 56-year-old patient has had late-onset type 2 diabetes (NIDDM)for the past 5 years.He has been taking a variety of oral hypoglycemic agents,but his blood sugar level is getting higher.He comes in today with blurred vision,lethargy,polyuria,polyphagia,and polydipsia.Which therapy is the doctor most likely to recommend?

A) Switching to another oral hypoglycemic agent because the patient has developed insulin resistance
B) Switching to another oral hypoglycemic agent because the patient has developed the Somogyi effect
C) Switching to another oral hypoglycemic agent because the patient has developed an allergy to the product
D) Switching to insulin because the oral pills have been ineffective

Question 8

Which hormones are used in the suppression of ovulation?

A) Estrogens and progestins
B) Luteinizing hormone and follicle-stimulating hormone
C) Androgens and progestins
D) Endorphins and androgens

Question 9

Which best defines lipodystrophy?

A) Decrease and shrinkage of fatty tissues
B) Increase in fatty tissue in buttocks
C) Overgrowth of breast tissue
D) Increase in fatty tissue on abdomen

Question 10

When used for a short period to treat dysfunctional bleeding,progestins will have which effect?

A) They will cause breakthrough bleeding in 24 hours.
B) They will stop bleeding and cause the endometrium to shed.
C) They will decrease the risk for endometrial cancer.
D) They will stop all side effects of the drug.

Question 11

Which is true about vasopressin?

A) It is an anterior pituitary hormone.
B) It is an antidiuretic hormone.
C) It is used in adrenal insufficiency.
D) It is used to increase smooth-muscle contraction in the digestive tract and vascular bed.

Question 12

A patient comes in with a bad case of poison ivy.He has been scratching the red,swollen area on his arm because it itches.The arm has become increasingly swollen over the last 3 days.The nurse anticipates the doctor is most likely to order what drug?

A) Somatotropin
B) A corticosteroid
C) A mineralocorticoid
D) Luteinizing hormone

Question 13

When a female patient is on hormone replacement therapy,the nurse should regularly monitor the patient for which change?

A) Weight loss
B) Increase in body hair
C) Increase in body heat
D) Weight gain

Question 14

A patient is found to have hyperthyroidism.The health care provider wants to start the patient on medication before performing surgery and would most likely prescribe which medication?

A) Propylthiouracil
B) Thyroglobulin
C) Liothyronine
D) Levothyroxine

Question 15

Which are two of the major glucocorticoids produced by the adrenal glands?

A) Vasopressin and aldosterone
B) Hydrocortisone and cortisone
C) Prednisone and hydrocortisone
D) Deltasone and Solu-Cortef

Question 16

Which laboratory findings are found in thyroid disease?

A) Elevated red blood cell count
B) Reduced free T4 index
C) Decreased TSH
D) Elevated phosphorus

Question 17

Lispro,a rapid-onset,short-acting insulin,differs from regular insulin in which way?

A) Longer duration
B) Shorter duration
C) Costs more to produce
D) Costs less to produce

Question 18

A patient is taking 36 units of glargine insulin (Lantus)each morning.This insulin's duration is in which range?

A) 1 to 3 hours
B) 6 to 8 hours
C) 20 to 24 hours
D) 24 to 48 hours

Question 19

A 14-year-old boy is excessively small for his age.He has also failed to develop any secondary sex characteristics.After endocrine evaluation,the physician decides to institute hormone therapy to stimulate growth.Which is the general category of drugs that would be ordered?

A) Androgens
B) Posterior pituitary hormones
C) Adrenal hormones
D) Corticosteroids

Question 20

Myxedema is the most severe form of hypothyroidism.Which signs are related to this condition?

A) Doughy skin
B) Increased body hair
C) Skin hot to the touch
D) Decreased body weight

Question 21

A patient comes into the clinic with complaints of feeling shaky and nervous.This patient has a history of type 2 diabetes and alcohol use.He admits to drinking two beers before coming into the clinic.What should the nurse assess the patient for?

A) Alcohol in the blood
B) Other drugs in the blood
C) Hyperglycemia
D) Hypoglycemia

Question 22

Insulin needs may increase due to which insulin antagonists? (Select all that apply.)

A) Corticosteroids
B) Epinephrine
C) Alcohol
D) Thyroid hormone
E) Oral contraceptives

Question 23

On a cool day,a patient complains of tachycardia,diaphoresis,and being warm.The patient has no known health problems.The health care provider will assess the patient for which conditions? (Select all that apply.)

A) Diabetes
B) Thyroid disease
C) Posterior pituitary hormone deficiency
D) Hypertension
E) Pregnancy

Question 24

Which methods should be used to stop steroid therapy? (Select all that apply.)

A) Therapy is stopped immediately.
B) The medication is tapered gradually.
C) After shorter courses, the dosage may be reduced by 50% each day.
D) The dosage may be reduced at consistent intervals.
E) Therapy is stopped once symptoms are improved.

Question 25

A type 2 diabetic patient is learning to control his condition with diet and exercise.The patient was started on Januvia,a new incretin.The nurse expects the dose adjustment to be based on which lab value?

A) CBC
B) TSH
C) Creatinine clearance
D) BUN

Question 26

What should the intensity of uterine contractions be no more than when using drugs for labor?

A) 50 mm Hg
B) 20 mm Hg
C) 80 mm Hg
D) 10 mm Hg

Question 27

A patient is 2 weeks past the delivery date of her baby.Her physician has admitted her into the hospital to induce her delivery.Which is the drug of choice for the induction of labor?

A) Ergonovine
B) Methylergonovine
C) Oxytocin
D) Clomiphene

Question 28

Which are the drugs of choice for the induction of labor? (Select all that apply.)

A) Oxytocin
B) Ergonovine
C) Dexamethasone
D) Prostaglandins
E) Clomiphene

Question 29

A female patient is on estrogen therapy for ovarian failure.The nurse suspects the patient is experiencing an adverse reaction when the patient reports which symptoms? (Select all that apply.)

A) Hypotension
B) Intolerance to contact lenses
C) Vomiting
D) Constipation
E) Edema