Which pt should the RN expect to be most likely to be treated with somatropin?

A 7-year-old diagnosed with growth hormone deficiency

After administering corticotropin, what assessments are priorities for the RN? (SATA)

Glucose levels, Intake and output, Changes in vision, Serum sodium levels

A pt asks the RN to explain the action of glucocorticoids. Which statement is the RN’s best response

“Glucocorticoids influence carbohydrate, lipid, and protein metabolism.”

The pt is taking an antithyroid med. Which foods should the RN teach the pt to avoid eating?

Shrimp cocktail, boiled lobster, spinach salad without dressing, water

Which is the most appropriate action for the RN who is told that a pt typically takes his glipizide with food?

Inform the pt that it is better to take the medication 30min before a meal.

A pt with DMI is ordered insulin aspart 10 units at 0700. What nursing intervention should be performed after admin?

Make sure the patient eats breakfast immediately.

A pt on propylthiouracil (PTU) asks the RN how this med will relieve symptoms. Which statement is the best response?

“It inhibits the formation of new thyroid hormone."

The RN is caring for a pt who is taking levothyroxine & warfarin. Which intervention is a priority for the RN?

Monitor the patient for increased risk of bleeding.

Which statement indicates to the RN that the pt needs additional teaching on oral hypoglycemic agents?

“I will take the medication only when I need it.”

The pt newly diagnosed with DMII is ordered insulin glargine. What information is essential for the RN to teach?

“This medication has a duration of action of 24h.”

The RN administers NPH insulin at 8 AM. What intervention is essential for the RN to perform?

Make sure patient eats by 5 PM.

The pt with DMI asks, “Why can’t I take a sulfonylurea like my friend who has diabetes?” What is the RN’s best response?

“Sulfonylurea increases beta-cell stimulation to secrete insulin."

When assessing for potential side effects of fludrocortisone, what is a priority for the RN to monitor?

Serum potassium levels for hypokalemia

What should the RN include in the plan of care for the pt beginning prednisone therapy?

Take the medication with food to diminish the risk of gastric irritation.

The RN should include which statement when teaching a pt about insulin glargine?

“You cannot mix this insulin with any other insulin in the same syringe.”

A RN is teaching a pt who needs to mix 30 units regular insulin & 70 units NPH insulin. Which admin method is correct?

Draw up the regular insulin first, then the cloudy NPH insulin.

Which pt statement demonstrates understanding of the RN’s teaching for levothyroxine?

“I will take this medication first thing in the morning.”

What assessment finding indicates to the RN that vasopressin has been effective?

Increased urine specific gravity

The pt is receiving corticotropin for ACTH deficiency. Which statement indicates a need for additional teaching?

“When my symptoms are resolved, I can discontinue the drug.”

What information will the RN teach the pt who has been prescribed an alpha glucosidase inhibitor?

“This med will delay the absorption of carbohydrates from the intestines.”

The RN is teaching the pt how to administer insulin. What information is essential to include in the plan?

“For the most consistent absorption, inject the insulin into the abdomen.”

The RN is teaching a pt who has been prescribed repaglinide. Which information should the RN include in the teaching?

“You will need to be sure you eat as soon as you take this medication.”

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Ch's 46 & 47

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Questions 28

Answers

1
Which pt should the RN expect to be most likely to be treated with somatropin?
A 17-year-old who is 5 feet tall
A 10-year-old of short stature who has severe asthma
An 8-year-old with Prader-Willi syndrome
A 7-year-old diagnosed with growth hormone deficiency
2
What nursing diagnosis is a priority for a pt receiving desmopressin (DDAVP)?
Knowledge deficit
Fluid volume excess
Alteration in comfort
Risk for injury
3
After administering corticotropin, what assessments are priorities for the RN? (SATA)
C-reactive protein levels
Glucose levels
Intake and output
Changes in vision
Serum sodium levels
Acid and alkaline phosphatase levels
4
A pt asks the RN to explain the action of glucocorticoids. Which statement is the RN’s best response
“Glucocorticoids decrease serum sodium and glucose levels.”
“Glucocorticoids influence carbohydrate, lipid, and protein metabolism.”
“Glucocorticoids stimulate defense mechanisms to produce immunity.”
“Glucocorticoids are produced in decreased amounts during times of stress.”
5
The pt is taking an antithyroid med. Which foods should the RN teach the pt to avoid eating?
Shrimp cocktail, boiled lobster, spinach salad without dressing, water
Hamburger on sesame roll, salad with French dressing, milk
Chicken salad sandwich with mayonnaise, vegetable soup, milk
Ham and cheese omelet, rye toast with butter, orange juice
6
Which is the most appropriate action for the RN who is told that a pt typically takes his glipizide with food?
Immediately check the patient’s blood glucose level.
Inform the pt that it is better to take the medication 30min before a meal.
Inform the patient that the medication must be taken 15 min after a meal.
Immediately call the health care provider.
7
A pt with DMI is ordered insulin aspart 10 units at 0700. What nursing intervention should be performed after admin?
Perform a fingerstick blood sugar test.
Have the patient void and dipstick the urine.
Flush the IV.
Make sure the patient eats breakfast immediately.
8
What is the RN’s best action when finding a pt with DMI unresponsive, cold, & clammy?
Draw blood glucose level and send to the laboratory.
Start an insulin drip.
Administer glucagon.
Administer subcutaneous regular insulin immediately.
9
A pt on propylthiouracil (PTU) asks the RN how this med will relieve symptoms. Which statement is the best response?
“PTU helps the thyroid gland use iodine and synthesize hormones better.”
“It inhibits the formation of new thyroid hormone."
“PTU inactivates thyroid hormone, decreasing s/s of hyperthyroidism."
“It stimulates the pituitary gland to secrete thyroid-stimulating hormone."
10
The RN is caring for a pt who is taking levothyroxine & warfarin. Which intervention is a priority for the RN?
Monitor the patient for cardiac dysrhythmias.
Weigh patient daily for excessive weight loss.
Monitor the patient for increased risk of bleeding.
Assess peripheral pulses and Homans sign daily.
11
Which statement indicates to the RN that the pt needs additional teaching on oral hypoglycemic agents?
“I will report symptoms of fatigue and loss of appetite.”
“I will monitor my blood sugar daily.”
“I will take the medication only when I need it.”
“I will limit my alcohol consumption.”
12
The pt newly diagnosed with DMII is ordered insulin glargine. What information is essential for the RN to teach?
“This med is very expensive, but you will only have it for a short time.”
“This med is very short acting. You must eat after injecting it.”
“This medication has a duration of action of 24h.”
“This medication should be mixed with the regular insulin each morning."
13
The RN caring for several pts receiving glucocorticoid therapy. Which pt should be assessed first based on clinical d_x?
Uncontrolled diabetes mellitus
Chronic rheumatoid arthritis
Recovering from septic shock
Exacerbation of asthma controlled using oxygen therapy.
14
The RN administers NPH insulin at 8 AM. What intervention is essential for the RN to perform?
Administer the insulin via IV pump.
Assess the patient for hyperglycemia by 10 AM.
Make sure patient eats by 5 PM.
Monitor fingerstick at 2 PM.
15
The pt with DMI asks, “Why can’t I take a sulfonylurea like my friend who has diabetes?” What is the RN’s best response?
“Sulfonylurea increases beta-cell stimulation to secrete insulin."
“Without insulin you can't store glucose, this helps with glucose storage."
“Sulfonylurea will lower your blood sugar too much causing hypoglycemia.”
“You must be mistaken. If your friend has DM, she is taking insulin.”
16
When assessing for potential side effects of fludrocortisone, what is a priority for the RN to monitor?
Serum potassium levels for hypokalemia
Intake and output for potential fluid volume deficit
Serum sodium levels for potential hyponatremia
Serum calcium levels for hypercalcemia
17
What should the RN include in the plan of care for the pt beginning prednisone therapy?
Admin the med in the early evening.
Plan to keep a strict, unchanging schedule to prevent adverse reactions.
Take the medication with food to diminish the risk of gastric irritation.
Take the med every other day to decrease the risk of adrenal hyperplasia.
18
The RN should include which statement when teaching a pt about insulin glargine?
“You can mix this insulin with Lente insulin to enhance its effects.”
“You cannot mix this insulin with any other insulin in the same syringe.”
“Inject this insulin just before meals as it is very fast acting.”
“The DoA for this insulin is approx 8–10h, you will need to take it BID."
19
The RN admitting a pt with acromegaly anticipates administering which medication?
Desmopressin
Octreotide
Corticotropin
Somatropin
20
A RN is teaching a pt who needs to mix 30 units regular insulin & 70 units NPH insulin. Which admin method is correct?
Draw up the regular insulin first, then the cloudy NPH insulin.
Use the Z-track method for administration.
Admin these insulins at least 10 min apart.
Draw the meds into 2 separate syringes but inject into the same spot.
21
Which pt statement demonstrates understanding of the RN’s teaching for levothyroxine?
“I will take this medication first thing in the morning.”
“It is best to take the medication with food to prevent GI upset.”
“I can expect to see relief of my symptoms within 1 week.”
“I will double my dose if I gain more than 1 pound/day.”
22
What assessment finding indicates to the RN that vasopressin has been effective?
Decreased adrenocorticotropic hormone levels
Increased urine specific gravity
Relief of pain
Increased serum albumin levels
23
The pt is receiving corticotropin for ACTH deficiency. Which statement indicates a need for additional teaching?
“The drug may suppress symptoms of infection.”
“I need to eat foods high in potassium.”
“I can administer the drug subcutaneously.”
“When my symptoms are resolved, I can discontinue the drug.”
24
What information will the RN teach the pt who has been prescribed an alpha glucosidase inhibitor?
“This med will delay the absorption of carbohydrates from the intestines.”
“This medication will increase the sensitivity of insulin receptor sites.”
“This med cannot be used in combination with other antidiabetic agents.”
“This medication will stimulate pancreatic insulin release.”
25
The RN is teaching the pt how to administer insulin. What information is essential to include in the plan?
“Avoid administering the insulin into your arm.”
“Inject the insulin at a 30-degree angle between the fat and muscle.”
“For the most consistent absorption, inject the insulin into the abdomen.”
“Do not mix any insulins in the same syringe.”
26
The RN is teaching a pt who has been prescribed repaglinide. Which information should the RN include in the teaching?
“This medication will not cause hypoglycemia.”
“This medication has no side effects.”
“You will need to be sure you eat as soon as you take this medication.”
“This medication is compatible with all of your cardiac medications.”
27
A RN providing teaching for a pt receiving glucocorticoids. Which med should the RN expect to be included for pain mgt?
Ibuprofen
Acetaminophen
Aspirin
Naproxen sodium
28
The RN is caring for a pt who is starting levothyroxine. What assessment finding is a priority for the RN to address?
Intolerance to cold
Heart rate 55 beats/min
Irritability
Weight gain of 3 pounds in the last week

Ch's 46 & 47 Flashcards | StudBud