Question 1

A patient is taking fludrocortisone (Florinef)for Addison's disease.His wife is concerned about all the problems that may occur with this therapy.Which of the following is a true statement about fludrocortisone therapy?

A)It may cause severe postural hypotension.
B)It should be taken with food or milk to minimize gastrointestinal upset.
C)The medication should be stopped immediately if nausea or vomiting occurs.
D)Weight gain of 2.25 kg or more in 1 week is an expected adverse effect.

Accepted Answer

Patients receiving fludrocortisone should take it with food or milk to minimize gastrointestinal upset
Hypotension is a sign and symptom of Addison's disease or adrenal insufficiency;it is not a problem that will occur as a result of taking fludrocortisone.Weight gain of more than 2.25 kg in 1 week should be reported to the physician.Abrupt withdrawal is not recommended because it may precipitate an adrenal crisis.

Question 2

Which of the following types of drugs can have an adverse interaction with corticosteroids?&#10;A)Nonsteroidal anti-inflammatory drugs (NSAIDs)&#10;B)Antibiotics&#10;C)Narcotic analgesics&#10;D)Oral anticoagulants

Accepted Answer

The use of corticosteroids with NSAIDs produces adverse gastrointestinal effects.

Question 3

Which of the following may be caused by systemically administered glucocorticoids?&#10;A)Dehydration&#10;B)Hypokalemia&#10;C)Hyperkalemia&#10;D)Hypoglycemia

Accepted Answer

Systemic glucocorticoid drugs may cause hyperkalemia.

Question 4

Which of the following are expected symptoms of undersecretion of adrenocortical hormones?&#10;A)Osteoporosis&#10;B)Steroid psychosis&#10;C)Dehydration and weight loss&#10;D)Water retention

Accepted Answer

Dehydration and weight loss are associated with Addison's disease.

Question 5

Which of the following are indications for glucocorticoid drugs? Select all that apply.&#10;A)Glaucoma&#10;B)Cerebral edema&#10;C)Chronic obstructive pulmonary disease and asthma&#10;D)Organ transplantation&#10;E)Varicella&#10;F)Spinal cord injury&#10;G)Septicemia&#10;H)Rhinitis

Accepted Answer

Cerebral edema,chronic obstructive pulmonary disease and asthma,organ transplantation,spinal cord injury,and rhinitis are indications for glucocorticoid therapy.
Glaucoma,varicella,and septicemia are contraindications to glucocorticoid therapy.

Question 6

What important information is appropriate for the nurse to tell a patient about taking adrenal drugs?&#10;A)Oral drugs should be taken before meals to maximize absorption.&#10;B)Rinse the oral cavity after using the steroid inhalers.&#10;C)Take the corticosteroids before bedtime to minimize adrenal suppression.&#10;D)Discontinue the medication immediately if a weight gain of more than 2.25 kg is experienced in 1 week.

Accepted Answer

After using the steroid inhalers,rinsing the oral cavity helps to prevent oral fungal infections from developing.
Adrenal drugs should be taken with meals to minimize gastrointestinal upset and in the morning to minimize adrenal suppression.Adrenal drugs should be discontinued by weaning,not by stopping abruptly.

Question 7

A patient is concerned about the body changes that have resulted from long-term prednisone (Winpred)therapy for the treatment of lupus erythematosus.Which of the following effects of this drug therapy supports the nursing diagnosis of disturbed body image?

A)Weight loss
B)Weight gain
C)Pale skin colour
D)Loss of hair

Accepted Answer

Facial erythema,weight gain,hirsutism,and "moon face" (characteristic of Cushing's syndrome)are body changes that may occur with long-term prednisone therapy.

Question 8

Which of the following are contraindications to the administration of glucocorticoid drugs?&#10;A)Glaucoma and mental health illnesses&#10;B)Peptic ulcer disease and dizziness&#10;C)Varicella infection and headaches&#10;D)Cataracts and nausea

Accepted Answer

Contraindications to the administration of glucocorticoids include drug allergy,cataracts,glaucoma,peptic ulcer disease,mental health illnesses,and diabetes because glucocorticoids can intensify these diseases.These drugs are also often avoided in cases of infection.

Question 9

Which of the following is a true statement about prednisone (Winpred)?&#10;A)It is a short-acting glucocorticoid.&#10;B)It has potent mineralocorticoid activity.&#10;C)It is the preferred oral glucocorticoid for anti-inflammatory purposes.&#10;D)It may be administered by inhalation for the treatment of bronchial asthma.

Accepted Answer

Prednisone is the preferred oral glucocorticoid for anti-inflammatory purposes and is intermediate acting.

Deck 33: Adrenal Drugs