Question 1

The nurse is caring for a patient who is receiving desmopressin acetate (DDAVP).Which assessments are important while caring for this patient?

Accepted Answer

Desmopressin is an antidiuretic hormone.The nurse should monitor intake and output as well as serum sodium levels.

Question 2

A patient who has hyperthyroidism will begin treatment with an antithyroid medication.The patient asks the nurse about dietary requirements.The nurse will counsel the patient to avoid which food(s)?

Accepted Answer

Patients should be advised about the effects of iodine and its presence in foods such as shellfish.There is no need to avoid fava beans,purine,or grapefruit.

Question 3

A patient with Graves disease exhibits tachycardia,heat intolerance,and exophthalmos.Prior to surgery,which drug is used to alter thyroid hormone levels?

Accepted Answer

Propylthiouracil is a potent antithyroid drug used in preparation for a subtotal thyroidectomy.Liotrix and thyroid are used as thyroid replacement.Propranolol is used to treat hypertension associated with hyperthyroidism.

Question 4

A patient is receiving a glucocorticoid medication to treat an inflammatory condition,and the provider has ordered a slow taper in order to discontinue this medication.The nurse explains to the patient that this is done to prevent which condition?

Accepted Answer

Patients receiving glucocorticoids stop making their own cortisol.These drugs should be tapered slowly to allow the body to resume making this hormone.Acromegaly is associated with growth hormone hypersecretion.Hypertensive crisis and thyroid storm are associated with thyroid replacement.

Question 5

The nurse provides teaching for a patient receiving corticotropin.The nurse will instruct the patient to contact the provider if which condition occurs?

Accepted Answer

Ecchymosis is an adverse reaction to corticotropin and should be reported.Constipation and nausea are known side effects but are not serious.Myalgia is not common.

Question 6

A patient has hypocalcemia caused by parathyroid hormone deficiency.Which medication will the nurse anticipate giving to this patient?

Accepted Answer

Calcitriol is given for management of hypocalcemia caused by parathyroid hormone deficiency.Calcitonin is used to treat hyperparathyroidism.Calcium and vitamin D are not useful in parathyroid deficiency.

Question 7

The nurse is caring for a patient who is receiving growth hormone.Which assessment will the nurse monitor daily?

Accepted Answer

Growth hormone antagonizes insulin secretion,so serum glucose should be monitored.

Question 8

The nurse is caring for a patient who is being treated for hypothyroidism.The patient reports insomnia,nervousness,and flushing of the skin.Before notifying the provider,the nurse will perform which action?

Accepted Answer

The patient has signs of a thyroid crisis,which can occur with excess ingestion of thyroid hormone.The nurse should evaluate heart rate before notifying the provider.These are not symptoms of hypoglycemia.The symptoms are not indicative of infection.

Question 9

The nurse is preparing to administer piperacillin to a patient to treat an infection caused by pseudomonas.The nurse learns that the patient receives corticotropin to treat multiple sclerosis.The nurse will request an order for

Accepted Answer

Corticotropin can interact with piperacillin to cause hypokalemia,so serum electrolytes should be monitored.It is not necessary to change the antibiotic.Blood glucose monitoring and cardiac monitoring are not indicated.

Question 10

A patient who takes warfarin (Coumadin)and digoxin (Lanoxin)develops hypothyroidism and will begin taking levothyroxine (Synthroid).The nurse anticipates which potential adjustments in dosing for this patient?

Accepted Answer

Thyroid preparations increase the effect of oral anticoagulants,so the warfarin dose may need to be decreased.Levothyroxine can decrease the effectiveness of digoxin,so this dose may need to be increased.

Question 11

A 35-year-old woman reports lethargy,difficulty remembering things,facial edema,dry skin,and cessation of menses.The nurse notes a heart rate of 60 beats per minute and a weight increase of 5 pounds from a previous visit.The nurse will notify the provider of which possible condition?

Accepted Answer

Myxedema is severe hypothyroidism characterized by this woman's symptoms.Cretinism is congenital hypothyroidism.Early menopause is not characterized by memory loss,facial edema,dry skin,or bradycardia.Hyperthyroidism would include tachycardia and weight loss.

Question 12

A child exhibits acromegaly caused by a tumor that cannot be destroyed with radiation.Which medication will most likely be used to treat this child?

Accepted Answer

Bromocriptine is a prolactin-release inhibitor and is used to inhibit release of growth hormone from the pituitary gland if the tumor cannot be destroyed by radiation.Octreotide may be used as well,but it is expensive and is typically used as adjunct therapy to radiation.Somatrem and somatropin are used to treat growth hormone deficiency and would make acromegaly worse.

Question 13

The parents of an 11-year-old boy ask about growth hormone therapy for their child who is shorter than his 10-year-old sister.The nurse will tell the parents that growth hormone

Accepted Answer

Growth hormone is given only when growth hormone deficiency is determined.It cannot be given orally.It antagonizes insulin secretion and thus can lead to the development of diabetes mellitus.It cannot be given after the epiphyses are fused.

Question 14

Which would be a contraindication for hormone therapy with somatropin (Genotropin)in a school-age child?

Accepted Answer

Fatalities associated with risks of taking growth hormone with Prader-Willi syndrome have been reported,so it is contraindicated in patients with this syndrome.It is not contraindicated in patients with asthma or enuresis.Dwarfism is an indication for hormone therapy.

Question 15

The nurse is caring for a patient who has experienced head trauma in a motor vehicle accident.The patient is having excessive output of dilute urine.The nurse will notify the provider and will anticipate administering which medication?

Accepted Answer

The posterior pituitary gland secretes antidiuretic hormone (ADH)(vasopressin).When there is a deficiency of ADH,sometimes caused by head trauma,patients excrete large amounts of dilute urine.ADH replacement is necessary to prevent fluid imbalance.Calcifediol is used to treat parathyroid disorders.Corticotropin and prednisolone do not prevent diuresis.

Question 16

A patient is admitted to the hospital to treat hypothyroidism.For rapid improvement in symptoms,the nurse will expect to administer which medication?

Accepted Answer

Liothyronine has a short half-life and rapid onset of action and is not recommended for maintenance therapy but is used as initial therapy for severe myxedema.Levothyroxine is the drug of choice for replacement therapy.Liotrix is a second-line drug.Thyroid desiccated is used for hypothyroidism to reduce goiter size.

Question 17

The nurse is caring for a patient who has hypothyroidism.To assist in differentiating between primary and secondary hypothyroidism,the nurse will expect the provider to order which drug?

Accepted Answer

Thyrotropin is a purified extract of thyroid-stimulating hormone and is used as a diagnostic agent to differentiate between primary and secondary hypothyroidism.Liothyronine and liotrix are thyroid replacement drugs.Methimazole is used to decrease thyroid hormone secretion.

Question 18

The nurse administers intravenous corticotropin (Acthar)to a patient.A serum cortisol level drawn 60 minutes later shows no change in serum cortisol levels from prior to the dose.What is the nurse's first action?

Accepted Answer

Corticotropin is given to diagnose adrenal gland disorders as well as to treat adrenal gland insufficiency.When given intravenously,the serum cortisol level should increase within 30 to 60 minutes if the adrenal gland is functioning.The nurse should report adrenal gland dysfunction.The provider will determine how to treat.Since the levels should increase in 30 to 60 minutes,there is no need to repeat the test in 1 to 2 hours.

Question 19

The parents of a 16-year-old boy who plays football want their child to receive growth hormone to improve muscle strength.What will the nurse tell the parents?

Accepted Answer

Athletes should be advised not to take growth hormone to build muscle because of its effects on blood sugar and other side effects.

Question 20

A patient who takes the oral antidiabetic agent metformin (Glucophage)will begin taking levothyroxine (Synthroid).The nurse will teach this patient to monitor for

Accepted Answer

Insulin and oral antidiabetic drugs may need to be increased in patients taking levothyroxine.Patients should be taught to monitor for hyperglycemia,because of the reduced effects of these drugs.

Quiz 51: Endocrine Drugs: Pituitary, Thyroid, Parathyroid, and Adrenal Disorders

The nurse is caring for a patient who is receiving desmopressin acetate (DDAVP) .Which assessments are important while caring for this patient?

A patient who has hyperthyroidism will begin treatment with an antithyroid medication.The patient asks the nurse about dietary requirements.The nurse will counsel the patient to avoid which food(s) ?