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Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 4/E Chapter 43

Question 1 Type: MCMA The nursing instructor teaches the student nurses about the endocrine system. The nursing instructor evaluates that learning has occurred when the student nurses make which statements? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. "The hypothalamus secretes releasing hormones." 2. "Hormones released by the endocrine system in luence every organ in the body." 3. "The hypothalamus is considered the master gland." 4. "The pituitary gland secretes TSH !thyroid stimulating hormone"." 5. "The endocrine system is a ma#or controller o homeostasis." Corre t Ans!er: $%&%'%( "ationa#e 1) The hypothalamus secretes releasing hormones. "ationa#e 2) Hormones released by the endocrine system in luence every organ in the body. "ationa#e 3) The pituitary% not the hypothalamus% is o ten called the master gland* however% the pituitary and hypothalamus are best visuali+ed as an integrated unit. "ationa#e 4) The pituitary gland secretes TSH !thyroid stimulating hormone". "ationa#e 5) The endocrine system is a ma#or controller o homeostasis. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy+ing C#ient )eed: ,hysiological -ntegrity C#ient )eed Su%: ,hysiological Adaptation )ursin&/*nte&rated Con epts: .ursing ,rocess) /valuation (earnin& +ut ome: '01$ Question 2 Type: MCSA
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, '2/ Copyright &3$' by ,earson /ducation% -nc.

The client is very distraught that her $&1year1old son is o very short stature. 4hat is the best plan by the nurse? 1. Tell the client that treatment with growth hormone might result in acromegaly. 2. Tell the client that treatment or short stature is too e5pensive or many to a ord. 3. Tell the client that treatment with growth hormone might help% and re er her to an endocrinologist. 4. Tell the client that treatment with growth hormone can add 6 inches o height to her son. Corre t Ans!er: 0 "ationa#e 1) Acromegaly is the result o too much growth hormone in adults. "ationa#e 2) Treatment with growth hormone is very e5pensive% but it is up to the client to decide whether or not to pursue treatment. "ationa#e 3) Clients should be re erred to endocrinologists to discuss the uses o this hormone. "ationa#e 4) -n order to achieve this much additional growth% treatment would have to be started very early in li e% not at age $&. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: ,hysiological -ntegrity C#ient )eed Su%: ,harmacological and ,arenteral Therapies )ursin&/*nte&rated Con epts: .ursing ,rocess) -mplementation (earnin& +ut ome: '010 Question 3 Type: MCSA A client has diabetes insipidus and receives desmopressin !77A8,". The nurse completes medication education and evaluates that learning has occurred when the client makes which statement? 1. "This medication is a potent vasodilator* my blood pressure can all." 2. "This medication promotes diuresis in my body* my blood pressure can all." 3. "This medication increases water reabsorption in my kidneys." 4. "This medication suppresses hormone secretion rom my posterior pituitary gland." Corre t Ans!er: 0

Adams, Pharmacology for Nurse: A Pathophysiologic Approach, '2/ Copyright &3$' by ,earson /ducation% -nc.

"ationa#e 1) 7esmopressin is a potent vasoconstrictor% not a vasodilator% and can cause blood pressure to rise% not all. "ationa#e 2) 7esmopressin promotes water retention* blood pressure can rise% not all. "ationa#e 3) 7esmopressin is the same as A7H !antidiuretic hormone"% and acts on the collecting ducts in the kidney to increase water reabsorption. "ationa#e 4) 7esmopressin does not suppress hormone secretion rom the posterior pituitary gland. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy+ing C#ient )eed: ,hysiological -ntegrity C#ient )eed Su%: ,harmacological and ,arenteral Therapies )ursin&/*nte&rated Con epts: .ursing ,rocess) /valuation (earnin& +ut ome: '01' Question 4 Type: MCSA The client has been diagnosed with Cushing9s syndrome. 4hat will the nurse:s assessment likely reveal? 1. ;ow blood pressure and hypoglycemia 2. 4ell1healed scars on the upper body 3. <pper body obesity 4. Thin% gaunt appearance o the ace Corre t Ans!er: 0 "ationa#e 1) Hypertension and hyperglycemia are commonly seen. "ationa#e 2) 7elayed wound healing is a sign o Cushing:s disease. "ationa#e 3) ,rimary symptoms o Cushing9s syndrome include upper body obesity. "ationa#e 4) A redistribution o at around the ace results in a =moon ace> appearance. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: ,hysiological -ntegrity C#ient )eed Su%: ,hysiological Adaptation )ursin&/*nte&rated Con epts: .ursing ,rocess) Assessment
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, '2/ Copyright &3$' by ,earson /ducation% -nc.

(earnin& +ut ome: '01? Question 5 Type: MCSA The client has been diagnosed with diabetes insipidus. 4hat will the best plan by the nurse include? 1. Assess or increased urine production. 2. Assess or hyperglycemia. 3. Assess or hyponatremia. 4. Assess or luid retention. Corre t Ans!er: $ "ationa#e 1) 7iabetes insipidus results rom decreased A7H !antidiuretic hormone" production% so the client will have increased urine output. "ationa#e 2) Hyperglycemia is not an e ect o diabetes insipidus. "ationa#e 3) Hypernatremia results rom the volume o luid that is lost* the client will not have hyponatremia. "ationa#e 4) The client will have increased urine output and luid volume depletion% not retention. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: ,hysiological -ntegrity C#ient )eed Su%: ,hysiological Adaptation )ursin&/*nte&rated Con epts: .ursing ,rocess) ,lanning (earnin& +ut ome: '01@ Question , Type: MCSA The client has hypothyroidism and is treated with levothyro5ine !Synthroid". The nurse plans to do medication education. 4hat will the best plan by the nurse include? 1. Monitor daily weights. 2. Assess or decreased appetite. 3. Assess weekly serum blood levels. 4. Assess or altered sleep patterns.
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, '2/ Copyright &3$' by ,earson /ducation% -nc.

Corre t Ans!er: ' "ationa#e 1) 4eights can be monitored on a weekly% not daily% basis with clients receiving levothyro5ine !Synthroid".. "ationa#e 2) The appetite tends to increase% not decrease% with clients receiving levothyro5ine !Synthroid". "ationa#e 3) Serum blood levels are not reAuired on a weekly basis with clients receiving levothyro5ine !Synthroid". "ationa#e 4) -nsomnia is an adverse e ect o levothyro5ine !Synthroid"* altered sleep patterns must be assessed. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy+ing C#ient )eed: ,hysiological -ntegrity C#ient )eed Su%: ,harmacological and ,arenteral Therapies )ursin&/*nte&rated Con epts: .ursing ,rocess) ,lanning (earnin& +ut ome: '01$3 Question Type: MCSA An elderly client has hypothyroidism. 4hich assessment inding would the nurse report to the physician immediately? 1. 7ry skin 2. Benerali+ed weakness 3. Muscle cramps 4. Slurred speech Corre t Ans!er: ' "ationa#e 1) 7ry skin is an early sign o hypothyroidism and is not an emergent situation. "ationa#e 2) Benerali+ed weakness is an early sign o hypothyroidism and is likely the reason the client sought treatment. -t is not emergent. "ationa#e 3) Muscle cramps are an early sign o hypothyroidism and are not emergent. "ationa#e 4) Slurring o the speech in an elderly client may be related to one o the more severe symptoms o hypothyroidism or may be related to a neurological condition such a C8A. This inding should be reported. $#o%a# "ationa#e:
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, '2/ Copyright &3$' by ,earson /ducation% -nc.

Co&niti'e (e'e#: Analy+ing C#ient )eed: ,hysiological -ntegrity C#ient )eed Su%: ,hysiological Adaptation )ursin&/*nte&rated Con epts: .ursing ,rocess) Assessment (earnin& +ut ome: '01( Question . Type: MCSA The client receives treatment with radioactive iodine !-odine1$0$" therapy. 4hat will the best evaluation by the nurse reveal? 1. The client will only temporarily accomplish the euthyroid state. 2. The client could sa ely become pregnant while receiving this treatment. 3. The client will most likely reAuire thyroid replacement therapy. 4. The client does not have to distance hersel rom others. Corre t Ans!er: 0 "ationa#e 1) Treatment with radioactive iodine !-odine1$0$" usually results in a permanent euthyroid state. "ationa#e 2) This therapy is contraindicated in pregnant clients. "ationa#e 3) Clients treated with radioactive iodine !-odine1$0$" therapy o ten end up with hypothyroidism and reAuire replacement therapy. "ationa#e 4) ,hysical distancing is necessary or others to prevent e5posure to radiation. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy+ing C#ient )eed: ,hysiological -ntegrity C#ient )eed Su%: ,harmacological and ,arenteral Therapies )ursin&/*nte&rated Con epts: .ursing ,rocess) /valuation (earnin& +ut ome: '016 Question / Type: MCSA The client has hyperthyroidism. The nurse teaches the client to avoid which ood selections? 1. Soy sauce 2. Milk products
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, '2/ Copyright &3$' by ,earson /ducation% -nc.

3. High1calorie oods 4. Ca eine1 ree soda Corre t Ans!er: $ "ationa#e 1) Coods high in iodine% such as soy sauce% can a ect the e ectiveness o medication therapy or clients who are diagnosed with hyperthyroidism. "ationa#e 2) Milk products should be included in the diet or the client with hyperthyroidism because they are high in protein and calcium. "ationa#e 3) High1calorie oods are important or clients with hyperthyroidism in order to meet metabolic demands. "ationa#e 4) There is no reason to restrict ca eine1 ree soda. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: ,hysiological -ntegrity C#ient )eed Su%: ,harmacological and ,arenteral Therapies )ursin&/*nte&rated Con epts: .ursing ,rocess) -mplementation (earnin& +ut ome: '01@ Question 10 Type: MCSA The client receives hydrocortisone therapy. The nurse will primarily assess or which electrolyte disturbance? 1. Hypernatremia and hyperglycemia 2. Hypernatremia and hyperkalemia 3. Hypocalecmia and hyperkalemia 4. Hypoglycemia and hyponatremia Corre t Ans!er: $ "ationa#e 1) Hypernatremia and hyperglycemia are seen due to the aldosterone e ects !mineralcorticoid activity" causing sodium and luid retention% and elevations o blood glucose due to promotion o gluconeogenesis. "ationa#e 2) Hypernatremia would be seen% but hypokalemia would be seen% not hyperkalemia. "ationa#e 3) Hypercalcemia and hypokalemia would be seen with this therapy. "ationa#e 4) Hypoglycemia and hyponatremia would not be seen with hydrocortisone therapy.
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, '2/ Copyright &3$' by ,earson /ducation% -nc.

$#o%a# "ationa#e: Co&niti'e (e'e#: Analy+ing C#ient )eed: ,hysiological -ntegrity C#ient )eed Su%: ,harmacological and ,arenteral Therapies )ursin&/*nte&rated Con epts: .ursing ,rocess) Assessment (earnin& +ut ome: '01D Question 11 Type: MCSA The client receives glucocorticoid therapy. The nurse would prioriti+e assessment or which inding? 1. Hypothermia 2. Hypotension 3. Hypertension 4. 4eight loss Corre t Ans!er: 0 "ationa#e 1) Hypothermia would not be seen* temperature regulation is not related to glucocorticoid therapy. "ationa#e 2) Hypertension would be e5pected related to the increased production o angiotensin --. "ationa#e 3) Hypertension would be e5pected related to the increased production o angiotensin --. "ationa#e 4) 4eight loss would not be seen* weight gain is more likely with glucocorticoid therapy. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy+ing C#ient )eed: ,hysiological -ntegrity C#ient )eed Su%: ,harmacological and ,arenteral Therapies )ursin&/*nte&rated Con epts: .ursing ,rocess) Assessment (earnin& +ut ome: '01$ Question 12 Type: MCSA The nurse teaches the client about glucocorticoid therapy. The nurse evaluates that additional teaching is reAuired when the client makes which statement? 1. "- can take the medication at any time as long as - don9t orget it."
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, '2/ Copyright &3$' by ,earson /ducation% -nc.

2. "- will monitor my blood sugar on a regular basis." 3. "- will eat a diet that is high in protein." 4. "- should take my medication a ter - have eaten." Corre t Ans!er: $ "ationa#e 1) The medication must be taken at the same time o day to maintain serum levels. "ationa#e 2) -t is important or the client to monitor blood glucose levels with glucocorticoid medications. "ationa#e 3) A high1protein diet is necessary with glucocorticoid medications. "ationa#e 4) Blucocorticoid medications should be taken a ter eating. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy+ing C#ient )eed: ,hysiological -ntegrity C#ient )eed Su%: ,harmacological and ,arenteral Therapies )ursin&/*nte&rated Con epts: .ursing ,rocess) /valuation (earnin& +ut ome: '01$3 Question 13 Type: MCSA The nurse plans to administer intranasal desmopressin !77A8," to the client. 4hat will the best plan by the nurse include? 1. -nstruct the client to blow his nose ollowing administration. 2. Ee sure to have resh water at the bedside. 3. 4ithhold other medications so absorption o desmopressin !77A8," will not be a ected. 4. 7irect the spray high into the nasal cavity. Corre t Ans!er: ' "ationa#e 1) -ntranasal sprays o desmopressin !77A8," should be alternately rotated between nares. There is no need or the client to blow his nose ollowing administration o intranasal desmopressin !77A8,". "ationa#e 2) Cresh water is a good idea% but not necessary with intranasal desmopressin !77A8,". "ationa#e 3) There is no need to withhold other medications when a client receives intranasal desmopressin !77A8,".
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, '2/ Copyright &3$' by ,earson /ducation% -nc.

"ationa#e 4) The spray should be directed high into the nasal cavity% not into the nasopharyn5. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy+ing C#ient )eed: ,hysiological -ntegrity C#ient )eed Su%: ,harmacological and ,arenteral Therapies )ursin&/*nte&rated Con epts: .ursing ,rocess) ,lanning (earnin& +ut ome: '01@ Question 14 Type: MCSA .egative eedback loop ensures endocrine homeostasis by 1. stimulating secretion rom the irst hormone. 2. inhibiting release o the second hormone. 3. preventing under the responses o the endocrine system. 4. inhibiting secretion rom the irst hormone. Corre t Ans!er: ' "ationa#e 1) .egative eedback does not stimulate secretion rom the irst hormone. "ationa#e 2) .egative eedback does not stimulate secretion rom the second hormone. "ationa#e 3) .egative eedback does not prevent a response rom the endocrine system. "ationa#e 4) .egative eedback loop inhibits secretion o the irst hormone. $#o%a# "ationa#e: Co&niti'e (e'e#: Femembering C#ient )eed: ,hysiological -ntegrity C#ient )eed Su%: ,hysiological Adaptation )ursin&/*nte&rated Con epts: .ursing ,rocess) Assessment (earnin& +ut ome: '0.& Question 15 Type: MCSA 8asopressin is used in the treatment o 1. diabetes insipidus.
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, '2/ Copyright &3$' by ,earson /ducation% -nc.

2. dehydration. 3. electrolyte imbalances. 4. diabetes mellitus. Corre t Ans!er: $ "ationa#e 1) 8asopressin and lypressin are used to treat diabetes insipidus. "ationa#e 2) 8asopressin is not used to treat dehydration. "ationa#e 3) 8asopressin is not used to treat electrolyte imbalances. "ationa#e 4) 8asopressin is not used to treat diabetes mellitus. $#o%a# "ationa#e: Co&niti'e (e'e#: Femembering C#ient )eed: ,hysiological -ntegrity C#ient )eed Su%: ,harmacological and ,arenteral Therapies )ursin&/*nte&rated Con epts: .ursing ,rocess) ,lanning (earnin& +ut ome: '01' Question 1, Type: MCSA The unction o the thyroid gland is to 1. stimulate growth. 2. control pituitary gland secretion. 3. conserve water in the body. 4. control basal metabolism. Corre t Ans!er: ' "ationa#e 1) Browth hormone stimulates growth. "ationa#e 2) The thyroid gland does not control the pituitary. "ationa#e 3) Antidiuretic hormone conserves water in the body. "ationa#e 4) The unction o the thyroid gland is to control basal metabolism and a ect every cell in the body. $#o%a# "ationa#e:
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, '2/ Copyright &3$' by ,earson /ducation% -nc.

Co&niti'e (e'e#: Femembering C#ient )eed: ,hysiological -ntegrity C#ient )eed Su%: ,hysiological Adaptation )ursin&/*nte&rated Con epts: (earnin& +ut ome: '01$ Question 1Type: MCSA 4hich o the ollowing is a sign or symptom o hypothyroidism? 1. An5iety 2. Eradycardia 3. Tachycardia 4. 4eight loss Corre t Ans!er: & "ationa#e 1) An5iety is a symptom o hyperthyroidism. "ationa#e 2) Eradycardia can be a more severe symptom o hypothyroidism. "ationa#e 3) Tachycardia is symptom o hyperthyroidism. "ationa#e 4) 4eight loss is a sign o hyperthyroidism. $#o%a# "ationa#e: Co&niti'e (e'e#: <nderstanding C#ient )eed: ,hysiological -ntegrity C#ient )eed Su%: Feduction o Fisk ,otential )ursin&/*nte&rated Con epts: .ursing ,rocess) Assessment (earnin& +ut ome: '01( Question 1. Type: MCSA The primary goal o pharmacotherapy in hyperthyroidism !Braves9 disease" is to 1. increase metabolism. 2. increase synthesis o corticosteroid.
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, '2/ Copyright &3$' by ,earson /ducation% -nc.

3. lower the activity o the thyroid hormone. 4. increase the activity o the thyroid hormone. Corre t Ans!er: 0 "ationa#e 1) -ncreased metabolism is a sign o hyperthyroidism. "ationa#e 2) Adrenal drugs increase synthesis o corticosteroids. "ationa#e 3) The goal is to lower the activity o the thyroid hormone. "ationa#e 4) -ncreased activity o the thyroid hormone is a physiological mechanism o hyperthyroidism. $#o%a# "ationa#e: Co&niti'e (e'e#: Femembering C#ient )eed: ,hysiological -ntegrity C#ient )eed Su%: ,harmacological and ,arenteral Therapies )ursin&/*nte&rated Con epts: .ursing ,rocess) -mplementation (earnin& +ut ome: '016 Question 1/ Type: MCSA 4hich o the ollowing is a symptom o Cushing9s syndrome? 1. Hypoglycemia 2. 8omiting 3. Moon ace 4. 7iarrhea Corre t Ans!er: 0 "ationa#e 1) Hypoglycemia is a symptom o Addison9s disease. "ationa#e 2) 8omiting is a sign o Addison9s disease. "ationa#e 3) A moon ace is caused rom long1term glucocorticoids. "ationa#e 4) 7iarrhea is a symptom o Addison9s disease. $#o%a# "ationa#e: Co&niti'e (e'e#: <nderstanding
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C#ient )eed: ,hysiological -ntegrity C#ient )eed Su%: ,hysiological Adaptation )ursin&/*nte&rated Con epts: .ursing ,rocess) Assessment (earnin& +ut ome: '01? Question 20 Type: MCMA A client has been prescribed levothyro5ine !;evothroid". 4hat medication in ormation should the nurse provide? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. =-t may take a ew weeks or you to see the ull bene its rom this drug.> 2. =Ee sure to keep all o your ollow1up appointments.> 3. =Take this medication at whatever time you eat your evening meal.> 4. =7o not start a iber la5ative without irst discussing it with your health care team.> 5. =Take your calcium supplement at least ' hours a ter taking this drug.> Corre t Ans!er: $%&%'%( "ationa#e 1) 4hen given orally% it may take up to 0 weeks or the ull e ect o the drug to be reali+ed. "ationa#e 2) Serum TSH levels will be drawn reAuently as the client begins this therapy and to monitor its e ectiveness as therapy continues. "ationa#e 3) The medication should be taken at the same time every day% not at variable meal times. -t should be taken in the morning to decrease insomnia. "ationa#e 4) 7ietary iber may bind to and decrease the absorption o levothyro5ine. "ationa#e 5) Calcium and iron supplements should be taken at least ' hours a ter taking levothyro5ine to prevent inter erence with drug absorption. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: ,hysiological -ntegrity C#ient )eed Su%: ,harmacological and ,arenteral Therapies )ursin&/*nte&rated Con epts: .ursing ,rocess) -mplementation (earnin& +ut ome: '0.$3
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Question 21 Type: MCMA A client has been prescribed propylthiouracil !,T<". 4hat medication education should the nurse provide? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. =-t may take several days or weeks or you to see e ects o this drug.> 2. =Take this drug with meals.> 3. =7o not become pregnant while taking this medication.> 4. =Gou may e5perience a rash while taking this drug.> 5. =Gou may continue to breast eed while taking this drug.> Corre t Ans!er: $%&%0%' "ationa#e 1) The action o this drug may be delayed rom several days to as long as 61$& weeks. "ationa#e 2) This drug may cause gastric upset% which is decreased i the drug is taken with ood. "ationa#e 3) This is a pregnancy class 7 drug. "ationa#e 4) Fash is one o the most reAuent adverse e ects. "ationa#e 5) This drug should not be taken while breast eeding. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: ,hysiological -ntegrity C#ient )eed Su%: ,harmacological and ,arenteral Therapies )ursin&/*nte&rated Con epts: .ursing ,rocess) -mplementation (earnin& +ut ome: '0.$3 Question 22 Type: MCMA A client has been taking propylthiouracil !,T<" or several weeks. 4hich client statements would the nurse interpret as indicating that the drug is having its desired e ects? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
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Standard Text: Select all that apply. 1. =- am sleeping so much better.> 2. =- can:t seem to gain any weight no matter how much - eat.> 3. =- don:t eel as an5ious as - once did.> 4. =My heart doesn:t seem to be racing anymore.> 5. =My skin in not bruising as much.> Corre t Ans!er: $%0%' "ationa#e 1) A reduction in insomnia is a desired e ect o this drug. "ationa#e 2) A desired e ect o this drug is that the client will gain weight. "ationa#e 3) Feduction o an5iety is a desired e ect o this drug. "ationa#e 4) A slower pulse rate is a desired e ect o this drug. "ationa#e 5) Skin bruising is not an e ect o hyperthyroidism% so this e ect would not be e5pected. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy+ing C#ient )eed: ,hysiological -ntegrity C#ient )eed Su%: ,harmacological and ,arenteral Therapies )ursin&/*nte&rated Con epts: .ursing ,rocess) /valuation (earnin& +ut ome: '0.$3 Question 23 Type: MCMA A client diagnosed with an inoperable tumor o the adrenal gland is prescribed mitotane !;ysodren". The nurse would attribute which assessment inding as indicating an adverse reaction to the drug? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. The client reports that ood is not appealing. 2. The client reports #oint pain. 3. The client reports ringing o the ears.
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4. The client reports increasing depression. 5. The client reports di++iness. Corre t Ans!er: $%'%( "ationa#e 1) About D3H o clients started on this drug will report anore5ia. "ationa#e 2) Ioint pain is not an e5pected adverse e ect o this drug. "ationa#e 3) This is not an e5pected e ect o this drug. "ationa#e 4) About '3H o people taking this drug will e5perience depression. "ationa#e 5) About '3H o the people taking this drug report di++iness. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: ,hysiological -ntegrity C#ient )eed Su%: ,harmacological and ,arenteral Therapies )ursin&/*nte&rated Con epts: .ursing ,rocess) /valuation (earnin& +ut ome: '0.$$ Question 24 Type: MCMA A client will be prescribed an oral corticosteroid or treatment o a rash. The prescriber says% =-n order to avoid adverse e ects% - am prescribing the smallest amount possible.> 4hat other prescribing regimens could the nurse suggest to achieve this same e ect? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Bive the oral medication every other day. 2. Administer a larger dose or a ew days and then gradually decrease the dose until the medication is discontinued. 3. <se a topical application instead o an oral product. 4. Start with a small dose and work up to the desired dose. 5. Administer the doses intramuscularly or the irst ew days o treatment. Corre t Ans!er: $%&%0
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"ationa#e 1) Alternate day administration can limit adrenal atrophy. "ationa#e 2) There are speci ic ormulations o corticosteroids that are packaged or use o a large dose initially which is then tapered o until all the medication is gone. "ationa#e 3) Topical application does not cause as many systemic e ects as oral dosage. "ationa#e 4) Corticosteroid doses are generally started high and worked down to discontinuance. "ationa#e 5) <sing a less systemic approach would lessen e ects. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy+ing C#ient )eed: ,hysiological -ntegrity C#ient )eed Su%: ,harmacological and ,arenteral Therapies )ursin&/*nte&rated Con epts: .ursing ,rocess) ,lanning (earnin& +ut ome: '0.$$ Question 25 Type: MCMA A client has been taking thyroid hormone replacement or several years. Jn today:s clinic visit% the nurse remarks that the client has lost &3 pounds. The client states% =- was getting at% so - started taking an e5tra thyroid pill every day or so.> How should the nurse respond? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. =4ell% it certainly is working or you.> 2. =Gou should ollow the dosage instructions or your thyroid medication e5actly as written.> 3. =-:ll ask your physician to increase the number o re ills on your prescription.> 4. =That could be dangerous to your health.> 5. =- may ask the doctor to write a prescription or me.> Corre t Ans!er: &%' "ationa#e 1) Thyroid medications should not be used in this manner. "ationa#e 2) Thyroid medications are o various strengths and should be taken as prescribed. "ationa#e 3) The nurse should not provide additional medication to this client.
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, '2/ Copyright &3$' by ,earson /ducation% -nc.

"ationa#e 4) Taking e5cess thyroid medication is dangerous. "ationa#e 5) The nurse should not encourage the misuse o prescription medications. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy+ing C#ient )eed: ,hysiological -ntegrity C#ient )eed Su%: ,harmacological and ,arenteral Therapies )ursin&/*nte&rated Con epts: .ursing ,rocess) -mplementation (earnin& +ut ome: '0.@

Adams, Pharmacology for Nurse: A Pathophysiologic Approach, '2/ Copyright &3$' by ,earson /ducation% -nc.