Deck 48: Drugs Affecting the Adrenal Cortex

Question 1

The nurse determines that a client is tolerating drug therapy with prednisone (Deltasone)by noting the absence of which of the following adverse effects?

A) Gastrointestinal upset
B) Yellow vision
C) Lethargy
D) Anorexia

Answer 1

Gastrointestinal upset

Question 2

Which of the following statements about glucocorticoids as a drug class is most accurate?

A) Their functioning is influenced by circadian and ultradian rhythms
B) They block the vasoconstriction action of histamines
C) They increase the rate of antibody metabolism
D) Their intermittent functions are not influenced by daily rhythms

Answer 2

Their functioning is influenced by circadian and ultradian rhythms

Question 3

A client has an order for hydrocortisone (Cortef).The nurse plans to schedule the ordered doses according to which commonly accepted pattern for this drug?

A) Half in the morning and half at night
B) The entire dose at bedtime
C) Two thirds of the dose in the evening and one third in the morning
D) Two thirds of the dose in the morning and one third in the evening

Answer 3

Two thirds of the dose in the morning and one third in the evening

Question 4

Which statement indicates that the client needs more client teaching about steroid therapy?

A) "I need to take my medicine as scheduled by the doctor."
B) "I sure have been feeling better lately."
C) "Oh,I'm not worried about a little fever or cold."
D) "Well,I really try to eat a banana every day."

Question 5

The nurse would administer methylprednisolone (Solu-Medrol)carefully to a client with which of the following health problems because of adverse effects that could aggravate the condition?

A) Diabetes mellitus
B) Asthma
C) Status post cranial surgery
D) Spinal cord injury

Question 6

Which of the following actions is not true of glucocorticoids as a drug group?

A) Antiinflammatory actions
B) Pulse and heart rate maintenance actions
C) Eosinopenic actions
D) Fat-metabolizing actions

Question 7

The nurse is assigned to a client receiving corticosteroid therapy as part of treatment for shock.While in the hospital,the nurse anticipates that the dosage will be tapered down how frequently to avoid addisonian crisis?

A) Every day
B) Every 2 days
C) Every 4 days
D) Every 7 days

Question 8

The nurse would plan to administer ordered doses of a steroid cautiously to a client with a history of which of the following conditions?

A) Arthritis
B) Depression
C) Emphysema
D) Hypertension

Question 9

Which of the following would alert the nurse that steroids are problematic for a client with a history of chronic obstructive pulmonary disease,heart failure,and hypertension?

A) Increased specific gravity of urine
B) Sudden increase in weight
C) Decrease in weight
D) Increase in mobility

Question 10

What type of dietary considerations are necessary for the nurse to teach the client who is receiving fludrocortisone (Florinef)?

A) High fiber
B) Low fat
C) High potassium
D) High sodium

Question 11

The nurse plans to incorporate in client teaching about a newly ordered mineralocorticoid that it has which of the following pharmacologic actions?

A) Antiinflammatory effects
B) Maintenance of blood pressure
C) Fat,carbohydrate,and protein metabolism
D) Reabsorption of sodium in the renal distal tubules

Question 12

A client is being tapered from a systemic corticosteroid.The nurse would alert the physician that the client is not tolerated dosage tapering if which of the following symptoms is noted?

A) Hyperactivity
B) Lethargy
C) Insomnia
D) Hyperglycemia

Question 13

The nurse would question an order for an antiadrenal medication such as aminoglutethimide (Cytadren)for which of the following clients?

A) A child
B) A client recently exposed to the measles
C) A client recently exposed to chickenpox
D) A client with genital herpes

Question 14

The nurse planning drug therapy to coincide with natural rhythms in the body understands that plasma cortisol levels will be increased at which time of the day?

A) Early morning
B) Early afternoon
C) Late afternoon
D) Late evening

Question 15

The nurse would assess for which of the following adverse effects in a client receiving prednisone (Deltasone)?

A) Declining blood pressure
B) Weight loss
C) Mood changes
D) Hypoglycemia

Question 16

In a teaching plan,the nurse should state that alcohol and aspirin should not be used while taking steroids because of which of the following associated effects?

A) Decreased absorption
B) Increased metabolism
C) Insomnia
D) Gastric irritation

Question 17

Which of the following symptoms would not be part of the baseline of a client with Cushing's syndrome who is starting drug therapy with aminoglutethimide (Cytadren)?

A) Buffalo hump
B) Thickened skin
C) Darkened pigmentation
D) Increased facial hair growth

Question 18

The nurse expects that aldosterone,as a mineralocorticoid,will primarily affect the client's metabolism of which of the following?

A) Fat and carbohydrates
B) Protein and carbohydrates
C) Minerals and water
D) Vitamins and minerals

Question 19

The nurse who is reviewing a client's medication administration record notes that an ordered glucocorticoid is least likely to interact adversely with which of the following types of drugs?

A) An antacid
B) An analgesic
C) A diuretic
D) An oral antidiabetic agent

Question 20

The nurse is teaching a client how to monitor for fluid retention at home while taking prednisone (Deltasone).The nurse explains that the client should measure which of the following each day as the best indicator of fluid status?

A) Urine output
B) Weight
C) Blood pressure
D) Pulse

Question 21

The nurse explains to a client beginning therapy with a corticosteroid drug that reducing the intake of food sources of which electrolyte may be helpful to minimize adverse effects?

A) Potassium
B) Calcium
C) Sodium
D) Magnesium

Question 22

The nurse determines that a client taking a parenteral corticosteroid drug understands a key adverse effect by stating that which of the following symptoms is important to report?

A) Leg pain
B) Fever
C) Hair loss
D) Thickened nails

Question 23

A client has an order to receive a single daily dose of a corticosteroid drug.The nurse plans to administer the dose with which of the following beverages to reduce the risk of an adverse effect?

A) Water
B) Apple juice
C) Coffee
D) Milk

Question 24

The nurse would assess for which of the following as an adverse drug effect in a client who has started drug therapy with fludrocortisone (Florinef)?

A) Hypotension
B) Hyperkalemia
C) Dizziness
D) Reduced joint mobility