Question 1

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

Accepted Answer

Somatotropin (Humatrope) is a form of human growth hormone used to treat growth failure in children and adults who lack natural growth hormone. Common minor side effects of somatotropin include headache and joint ache, as it can affect fluid retention and bone growth.

Question 2

The nurse is evaluating the outcomes of the care associated with administering desmopressin therapy.Which of the following provides the strongest evidence for a desired outcome in a 50-year-old male?

Accepted Answer

DDesmopressin is a medication used to treat conditions like diabetes insipidus, which is characterized by excessive urination and thirst. A desired outcome of desmopressin therapy is to normalize urine concentration and volume. A urine specific gravity of 1.015 indicates a more concentrated urine, suggesting effective therapy. Additionally, the absence of edema in the lower extremities (D) can indicate effective fluid management, another goal of desmopressin therapy. Urine output of 3,500 ml/day (B) is excessive and not a desired outcome, and a serum sodium of 156 mEq/L (C) indicates hypernatremia, which is also not a desired outcome of desmopressin therapy.

Question 3

The nurse is assessing the patient who will soon commence supplemental growth hormone therapy.Which parameters should the nurse assess?

Accepted Answer

Growth hormone therapy can affect blood sugar levels due to its anti-insulin effects, necessitating monitoring of blood sugar. Blood pressure, height, and weight are also important to assess for baseline measurements and to monitor therapy effects.

Question 4

A patient 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:

Accepted Answer

Octreotide is used to reduce diarrhea in patients with metastatic abdominal cancer by inhibiting the release of certain hormones and substances that contribute to diarrhea.

Question 5

The nurse is processing the history of a patient who underwent deep brain surgery that resulted in damage to the hypothalamus.The nurse recognizes that the patient's deficit of all pituitary hormones is related to the location of the hypothalamus, which is found:

Accepted Answer

The hypothalamus is located in the diencephalon, just above the brainstem. It plays a crucial role in the regulation of the pituitary gland and, consequently, the secretion of hormones. Damage to the hypothalamus can lead to a deficit of all pituitary hormones due to its regulatory function over the pituitary gland.

Question 6

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

Accepted Answer

The pituitary gland, often referred to as the "master gland," controls the function of other endocrine glands, including the thyroid gland. The anterior pituitary produces Thyroid Stimulating Hormone (TSH), which signals the thyroid gland to produce thyroid hormones. After a hypophysectomy (surgical removal of the pituitary gland), the patient's thyroid gland won't receive TSH signals from the pituitary, leading to the need for supplemental thyroid hormone.

Question 7

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

Accepted Answer

Growth hormone can increase insulin resistance, which may lead to higher blood glucose levels. This is why monitoring blood sugar is important for patients receiving growth hormone injections.

Question 8

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

Accepted Answer

Growth hormone abuse among teenagers is a concern because they might use it to enhance athletic performance or physical appearance, despite potential health risks.

Question 9

The nurse is establishing nursing diagnoses for a school-age child who is to receive growth hormone therapy.Which of the following has the highest priority?

Accepted Answer

Delayed Growth and Development related to low GH levels and height below the fifth percentile is the highest priority because it directly addresses the primary health issue the therapy aims to treat, which is the underlying cause of the other potential diagnoses.

Question 10

A nurse is administering desmopressin to a patient with a head injury that put pressure on the posterior pituitary.The nurse recognizes that this form of artificial ADH will have the most impact on which portion of the assessment?

Accepted Answer

Desmopressin is a synthetic form of antidiuretic hormone (ADH) that primarily affects the kidneys, leading to decreased urine output and potential increases in blood pressure by promoting water reabsorption in the kidneys. This is particularly relevant in patients with conditions affecting the posterior pituitary, which naturally secretes ADH.

Question 11

A nurse is conducting an admission assessment on a patient with an admission diagnosis of SIADH.The nurse would anticipate these physical findings to be consistent with:

Accepted Answer

SIADH (Syndrome of Inappropriate Antidiuretic Hormone) leads to water retention and hyponatremia, causing symptoms of overhydration such as fluid overload and swelling, rather than dehydration, shock, or acute renal failure.

Question 12

The nurse is planning the discharge of a patient 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:

Accepted Answer

ADH (Antidiuretic Hormone) supplements for long-term deficits are commonly administered either orally or intranasally, making these methods the most likely for patient self-administration post-discharge.

Question 13

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

Accepted Answer

Conivaptan is a vasopressin antagonist used to treat hyponatremia (low sodium levels) associated with Syndrome of Inappropriate Antidiuretic Hormone (SIADH). By blocking the action of antidiuretic hormone (ADH), it increases urine output, helping to correct the sodium imbalance.

Question 14

The nurse is assessing a child at a well-child clinic.Although well nourished, the child is in the fourth percentile for height for his age.The nurse recognizes this child needs to be referred promptly because:

Accepted Answer

The child's low height percentile, despite being well-nourished, suggests a potential deficiency in Growth Hormone (GH), which is crucial for normal growth in children. TSH, ACTH, FSH, and LH are related to other endocrine functions not directly associated with height.

Question 15

A 16-year-old patient with DI is being discharged with a script for nasal desmopressin.It is essential for the nurse to teach the patient and family the signs and symptoms associated with:

Accepted Answer

Desmopressin is a synthetic form of vasopressin, the hormone that reduces urine production. Overdose or improper administration can lead to water retention and hyponatremia, symptoms of which are similar to water intoxication. This includes headache, nausea, vomiting, and in severe cases, seizures and coma. It's crucial for patients and families to recognize these signs to prevent or manage potential complications.

Question 16

A patient with long-term nephrogenic 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 patient's regimen?

Accepted Answer

Hydrochlorothiazide (HCTZ) is used in the management of nephrogenic diabetes insipidus (DI) because it can reduce urine volume. Although it may seem counterintuitive to use a diuretic to treat a condition characterized by excessive urination, HCTZ can decrease polyuria in nephrogenic DI by inducing a mild volume depletion, which leads to increased proximal tubule sodium and water reabsorption.

Question 17

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

Accepted Answer

Lasix (furosemide) is a diuretic, and its administration in SIADH is aimed at increasing urine output to help eliminate excess water and correct fluid balance.

Question 18

A patient with SIADH is upset about his doctor's order for fluid restriction.Which explanation by the nurse is most appropriate?

Accepted Answer

In SIADH (Syndrome of Inappropriate Antidiuretic Hormone), the body retains too much water due to excessive release of antidiuretic hormone. Fluid restriction, along with medication, helps to manage the water balance and correct the condition.

Quiz 66: Hypothalamic and Pituitary Drugs

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