Deck 65: Hypothalamic and Pituitary Drugs

Question 1

The nurse is assessing a client who is newly prescribed to receive supplemental growth hormone therapy.Which parameters should the nurse assess?

A)Bowel sounds,vitamin B₁₂ level,and history of gallbladder disease
B)Height and weight,head circumference,and EKG
C)Blood sugar,blood pressure,height,and weight
D)Urine specific gravity,serum osmolality,and serum electrolytes

Answer 1

Blood sugar,blood pressure,height,and weight

Question 2

An adolescent client is prescribed nasal desmopressin for treatment of diabetes insipidus (DI).It is essential for the nurse to teach the client and family the signs and symptoms associated with:

A)acute renal failure.
B)hypoglycemic reaction.
C)liver failure.
D)water intoxication.

Answer 2

water intoxication.

Question 3

A nurse is administering Lasix to a client with SIADH.The desired outcome would be:

A)a decrease in serum potassium.
B)an increase in blood pressure.
C)a decrease in serum osmolality.
D)an increase in urine output.

Answer 3

an increase in urine output.

Question 4

The nurse is evaluating outcomes after administering desmopressin therapy.Which assessment finding is considered a desired outcome in an adult male client?

A)Urine output of 3,500 mL/day
B)Urine specific gravity of 1.015
C)Edema of lower extremities absent
D)Serum sodium 156 mEq/L

Question 5

An adult client is receiving treatment for a growth hormone deficiency.What effects of treatment will the nurse expect to assess in the client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Increased lean body mass
B)Decreased fat mass
C)Increased bone mineral density
D)Decreased lipid levels
E)Decreased insulin resistance

Question 6

The nurse is teaching a client about the need for supplemental thyroid hormone following a hypophysectomy because of an anterior pituitary adenoma.The client says,"I thought thyroid hormone came from a gland in my neck." Which follow-up statement by the nurse is most appropriate?

A)"Your thyroid gland no longer gets messages from the pituitary."
B)"You will only need to take thyroid hormone until healing occurs."
C)"You need this hormone because your TSH is too high since surgery."
D)"Your thyroid gland was damaged because of the long surgical procedure."

Question 7

A client with long-term nephrogenic diabetes insipidus (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 client's regimen?

A)Chlorpropamide
B)Hydrochlorothiazide (HCTZ)
C)Intranasal or oral desmopressin
D)Conivaptan (Vaprisol)

Question 8

An adult client diagnosed with a malfunctioning hypothalamus is experiencing hormone deficiencies.Which hormones will the nurse expect to be prescribed for this client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Thyroid hormone
B)Corticosteroids
C)Estrogen
D)Progesterone
E)Gonadotropin-releasing hormone

Question 9

A nurse is administering desmopressin to a client recovering from a head injury that increased pressure on the posterior pituitary gland.The nurse recognizes that this form of artificial antidiuretic hormone (ADH)will have the most impact on which portion of the assessment?

A)Peripheral nervous system function,including reflexes
B)Cardiac function,including the conduction system
C)Urine output and blood pressure
D)The Glasgow coma scale

Question 10

A client 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:

A)a decrease in gastric reflux signs and symptoms.
B)a decrease in nausea and vomiting episodes.
C)severe constipation and possible ileus.
D)a decrease in the number of diarrheal stools.

Question 11

A nurse is giving a presentation on steroid abuse to a group of adolescents.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:

A)growth hormone is more likely to be a drug of abuse among older individuals,because adolescents have sufficient growth hormone already present.
B)adolescents rarely abuse growth hormone because it is not as readily available as anabolic steroids.
C)adolescents might abuse growth hormone to improve their athletic performance or to impress others with their enhanced appearance.
D)growth hormone is safe for adolescents to use but should not be used by anyone whose bone ends are fused.

Question 12

The nurse is preparing to administer somatropin (Humatrope).In the process of planning care,the nurse is aware that the client is likely to experience what minor adverse effects?

A)Headache and joint ache
B)Nausea and vomiting
C)Diarrhea and increased flatus
D)Nasal congestion and flushing

Question 13

A nurse is explaining the need to track blood glucose levels to a client who will be receiving growth hormone injections.The explanation is based on the recognition that additional growth hormone will:

A)increase insulin resistance.
B)decrease blood glucose levels.
C)promote very rapid growth.
D)trigger type I diabetes mellitus.

Question 14

A nurse is assessing a client with the diagnosis of SIADH.The nurse would anticipate the client's physical findings to be consistent with:

A)severe overhydration.
B)acute renal failure.
C)severe dehydration.
D)a shock state.

Question 15

A client is prescribed octreotide (Sandostatin)but has no evidence of acromegaly.The nurse realizes that this medication is indicated for which other health problems? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Severe diarrhea
B)Portal hypertension
C)Bleeding esophageal varices
D)Pancreatic fistulas
E)Diabetes mellitus

Question 16

The nurse is planning the discharge of a client 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:

A)self-administration of an every-third-day intramuscular preparation.
B)self-administration of a weekly intravenous preparation.
C)self-administration of an oral or intranasal preparation.
D)self-administration of a daily subcutaneous preparation.

Question 17

A client with SIADH is upset about being prescribed a fluid restriction.Which explanation by the nurse is most appropriate?

A)"Your IV fluids are providing you with the liquids you need.You should not be thirsty."
B)"Your body is retaining too much water.Decreasing your intake,along with the other medicine you are receiving,helps correct the problem."
C)"Rinse your mouth with salt water.It will help to decrease your thirst."
D)"Your kidney is not working as it should.Decreasing your fluid intake allows your kidney to rest."

Question 18

A preschool-age client is well nourished but is in the fourth percentile for height according to age.The nurse recognizes this client needs to be referred promptly because:

A)there is evidence the client has inadequate GH levels.
B)there is evidence the client has inadequate ACTH levels.
C)there is evidence the child has inadequate TSH levels.
D)there is evidence the child has inadequate FSH and LH levels.

Question 19

Conivaptan (Vaprisol)is prescribed for a client with severe SIADH.The nurse preparing this medication recognizes that the desired outcome of this therapy is:

A)a decreased urine output.
B)an increased urine output.
C)an increased blood pressure.
D)an increased heart rate.

Question 20

The nurse is caring for a client who had deep brain surgery that resulted in damage to the hypothalamus.The nurse recognizes that the client's deficit of all pituitary hormones is related to the location of the hypothalamus,which is found:

A)just anterior to the occipital lobe of the brain.
B)in the diencephalon,just above the brainstem.
C)deep within the brainstem.
D)within the parietal lobe of the brain.

Question 21

A client will be self-administering desmopressin (DDAVP)intranasally at home after discharge.What should the nurse instruct the client regarding the administration of this medication? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Direct the nasal spray high into the nasal cavity.
B)Shake the medication before use.
C)Store the medication at room temperature.
D)Warm the solution in the microwave before use.
E)Discard the solution if any particles are present in the solution.

Question 22

The nurse realizes that a client with a growth hormone deficiency is not a candidate to receive somatropin (Humatrope)because of which health problems? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Sleep apnea
B)Morbid obesity
C)Chronic renal failure
D)Type 2 diabetes mellitus
E)Foot wound

Question 23

The nurse is concerned that a client prescribed octreotide (Sandostatin)is at risk for drug interactions because the client is currently prescribed which medications? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Antidiabetic agent
B)Beta blocker
C)Calcium channel blocker
D)Antidiarrheal
E)Antibiotics

Question 24

The nurse caring for a client diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH)will prepare to administer which medications to this client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Furosemide (Lasix)
B)Conivaptan (Viprostol)
C)Demeclocycline (Declomycin)
D)Tetracycline
E)Bleomycin