Description
Introduction to Clinical Pharmacology 6th Edition Edmunds Test Bank
ISBN:
0323056202
ISBN-13:
9780323056205
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Edmunds: Introduction to Clinical Pharmacology, 6th Edition
Chapter 20: Hormones and Steroids
Test Bank
MULTIPLE CHOICE
- The patient is found to have hyperthyroidism. The health care provider wants to start the patient on medication before performing surgery and would most likely prescribe:
| 1. | propylthiouracil. |
| 2. | thyroglobulin. |
| 3. | liothyronine. |
| 4. | levothyroxine. |
ANS: 1
Propylthiouracil is an antithyroid product used to treat hyperthyroidism or to improve hyperthyroidism in preparation for surgery or radioactive iodine therapy.
DIF: Cognitive Level: Application REF: Page 360, Table 20-12
OBJ: 6 TOP: Antithyroid Products
KEY: Nursing Process Step: N/A
MSC: NCLEX: Physiological Integrity: Reduction of risk potential
- In instructing a patient about corticosteroid therapy, the patient asks if he can just stop this medication before returning to the physician’s office. Your best response is:
| 1. | “Take this medication until you’ve completed it.” |
| 2. | “The medication must be slowly reduced.” |
| 3. | “Go ahead; there is no real precaution with this drug therapy.” |
| 4. | “The amount you’re taking is small, so stopping is alright anytime.” |
ANS: 2
Corticosteroids cannot be stopped without tapering, or slowly reducing the dose over time. Stopping the drug suddenly leads to steroid withdrawal syndrome.
DIF: Cognitive Level: Application REF: Page 346 OBJ: 4
TOP: Corticosteroids KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
- A patient comes in with a bad case of poison ivy. He has been scratching the red, swollen area on his arm because it itches. The arm has been getting increasingly swollen over the last 3 days. The doctor is most likely to order:
| 1. | somatotropin. |
| 2. | a corticosteroid. |
| 3. | a mineralocorticoid. |
| 4. | luteinizing hormone. |
ANS: 2
Corticosteroid hormones regulate glucose, fat, and protein metabolism and control the antiinflammatory response and the immune response system.
DIF: Cognitive Level: Application REF: Page 342 OBJ: 3
TOP: Adrenocortical Hormones KEY: Nursing Process Step: N/A
MSC: NCLEX: Physiological Integrity
- A newly diagnosed type 2 diabetic patient is started on a new drug that comes from incretin hormones. Glucagon-like peptide 1 (GLP1) is used because of what effect it has on the body?
| 1. | It has the least allergic effect. |
| 2. | It is easy to administer. |
| 3. | It inhibits glucagon secretion. |
| 4. | It slows islet growth. |
ANS: 3
The incretin that has received the most attention is GLP1. It regulates homeostasis and inhibits endogenous glucagon secretion.
DIF: Cognitive Level: Knowledge REF: Page 333 OBJ: 1
TOP: Antidiabetic Agents KEY: Nursing Process Step: N/A
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
- A 56-year-old patient has had late-onset type 2 (NIDDM) diabetes for the past 5 years. He has been taking a variety of oral hypoglycemic agents, but his blood sugar level is getting higher. He comes in today with blurred vision, lethargy, polyuria, polyphagia, and polydipsia. The doctor may suggest:
| 1. | switching to another oral hypoglycemic agent because the patient has developed insulin resistance. |
| 2. | switching to another oral hypoglycemic agent because the patient has developed Somogyi effect. |
| 3. | switching to another oral hypoglycemic agent because the patient has developed an allergy to the product. |
| 4. | switching to insulin because the oral pills have been ineffective. |
ANS: 4
Patients with type 2 diabetes may require insulin because of oral antidiabetic agent failure or to give an additional glucose-lowering effect.
DIF: Cognitive Level: Application REF: Page 332 OBJ: 1
TOP: Antidiabetic Agents KEY: Nursing Process Step: N/A
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
- A patient is taking 36 units of Human Extended Zinc (Ultralente) insulin each morning. The insulin action will peak between:
| 1. | 1 to 3 hours. |
| 2. | 6 to 8 hours. |
| 3. | 10 to 30 hours. |
| 4. | 24 to 48 hours. |
ANS: 3
Extended Zinc (Ultralente) is a long-acting insulin that peaks between 10 to 30 hours.
DIF: Cognitive Level: Application REF: Page 336, Table 20-2
OBJ: 1 TOP: Insulin Action
KEY: Nursing Process Step: N/A
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
- A patient is started on Byetta, one of the new antidiabetic agents. The patient asks how this medication will help lower blood sugar. Your response is:
| 1. | It takes the place of insulin. |
| 2. | It restores insulin secretion. |
| 3. | It is taken with insulin to make it last. |
| 4. | It decreases the thirst for water. |
ANS: 2
Another new drug, Byetta, is the first drug that has been shown to restore first-phase insulin secretion when it is missing in type 2 diabetics.
DIF: Cognitive Level: Application REF: Page 338 OBJ: 1
TOP: Antidiabetic Agents KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
- A patient is taking insulin each morning. When the insulin peaks, the patient should be observed for which of the following signs of hypoglycemia?
| 1. | Nervousness, hunger, weakness, pallor, and confusion |
| 2. | Tachycardia and acetone breath |
| 3. | Tachycardia, loss of consciousness, and Kussmaul respirations |
| 4. | Serum glucose greater than 150 mg/dl, hunger, and confusion |
ANS: 1
Hypoglycemia is serum glucose of < 60 mg/dL, which is caused by taking too much insulin. Symptoms include nervousness; hunger; weakness; cold, clammy skin; and change in the level of consciousness.
DIF: Cognitive Level: Application REF: Page 333 OBJ: 1
TOP: Hypoglycemia KEY: Nursing Process Step: Evaluation
MSC: NCLEX: Physiological Integrity
- A 14-year-old boy is excessively small for his age. He has also failed to develop any secondary sex characteristics. After endocrine evaluation, the physician decides to institute hormone therapy to stimulate growth. The general category of drugs that would be ordered is:
| 1. | androgens. |
| 2. | posterior pituitary hormones. |
| 3. | adrenal hormones. |
| 4. | corticosteroids. |
ANS: 1
The main action of androgens is to develop secondary male sex characteristics. Androgens are anabolic, increasing the building of tissue.
DIF: Cognitive Level: Application REF: Page 348 OBJ: 5
TOP: Androgens KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
- Two of the major glucocorticoids produced by the adrenal glands are:
| 1. | vasopressin and aldosterone. |
| 2. | hydrocortisone and cortisone. |
| 3. | prednisone and hydrocortisone. |
| 4. | Deltasone and Solu-Cortef. |
ANS: 2
Hydrocortisone and cortisone are two of the many glucocorticoids produced by the adrenal glands.
DIF: Cognitive Level: Knowledge REF: Page 344 OBJ: 3
TOP: Adrenocortical Hormones KEY: Nursing Process Step: N/A
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
- Vasopressin is:
| 1. | an anterior pituitary hormone. |
| 2. | an antidiuretic hormone. |
| 3. | used in adrenal insufficiency. |
| 4. | used to increase smooth-muscle contraction of the digestive tract and vascular bed. |
ANS: 2
The posterior pituitary gland produces the antidiuretic hormone (ADH) vasopressin.
DIF: Cognitive Level: Knowledge REF: Page 343 OBJ: 3
TOP: Pituitary Hormone KEY: Nursing Process Step: N/A
MSC: NCLEX: Physiological Integrity: Reduction of risk potential
- Hormones used in the suppression of ovulation include:
| 1. | estrogens and progestins. |
| 2. | luteinizing hormone and follicle-stimulating hormone. |
| 3. | androgens and progestins. |
| 4. | endorphins and androgens. |
ANS: 1
Estrogen, progesterone, and a combination of the two hormones are very effective as oral contraceptives. They prevent ovulation and cause a state that mimics pregnancy in the female.
DIF: Cognitive Level: Knowledge REF: Page 348 OBJ: 5
TOP: Sex Hormones KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
- When used for a short period to treat dysfunctional bleeding, progestins will:
| 1. | cause breakthrough bleeding in 24 hours. |
| 2. | stop bleeding and cause the endometrium to shed. |
| 3. | decrease the risk for endometrial cancer. |
| 4. | stop all side effects of the drug. |
ANS: 2
Progestins can be used to control uterine bleeding and cause the uterine endometrium to shed.
DIF: Cognitive Level: Comprehension REF: Page 350 OBJ: 5
TOP: Progestins KEY: Nursing Process Step: N/A
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
- Laboratory findings in thyroid disease may include which of the following:
| 1. | Elevated red blood cell count |
| 2. | Reduced free T4 index |
| 3. | Decreased TSH |
| 4. | Elevated phosphorus |
ANS: 2
Laboratory findings in thyroid disease may include reduced free T4 index and elevated serum TSH.
DIF: Cognitive Level: Comprehension REF: Page 358 OBJ: 6
TOP: Thyroid Hormone KEY: Nursing Process Step: N/A
MSC: NCLEX: Physiological Integrity: Reduction of risk potential
- A patient came to the clinic for follow-up care after his last visit. His laboratory test for serum T4 and TSH confirms hypothyroidism. The nurse expects that this patient will be started on which of the following medications?
| 1. | Prednisone |
| 2. | Hydrocortisone |
| 3. | Levothyroxine |
| 4. | Danazol |
ANS: 3
Levothyroxine is the drug of choice in the treatment of thyroid replacement.
DIF: Cognitive Level: Application REF: Page 358 OBJ: 6
TOP: Thyroid Replacement KEY: Nursing Process Step: Diagnosis
MSC: NCLEX: Physiological Integrity
- Myxedema is the most severe form of hypothyroidism. Changes with this condition include:
| 1. | doughy skin. |
| 2. | increased body hair. |
| 3. | skin hot to the touch. |
| 4. | decreased body weight. |
ANS: 1
On examination you may find skin changes associated with myxedema, the most severe form of hypothyroidism. These changes include nonpitting edema; doughy skin; puffy face; large tongue; decreased body hair, and cool, dry skin.
DIF: Cognitive Level: Comprehension REF: Page 358 OBJ: 6
TOP: Thyroid Hormone KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
- When a patient is on hormone replacement therapy, the nurse should regularly monitor the patient for:
| 1. | weight loss. |
| 2. | increase in body hair. |
| 3. | increase in body heat. |
| 4. | weight gain. |
ANS: 4
Estrogen therapy affects many body systems. Women who use estrogen are at risk for fluid retention, resulting in weight gain.
DIF: Cognitive Level: Comprehension REF: Page 351 OBJ: 5
TOP: Hormone Therapy KEY: Nursing Process Step: Evaluation
MSC: NCLEX: Physiological Integrity
- Patients taking ADH need to be monitored frequently for which of the following?
| 1. | Increase in urination |
| 2. | Urinary acidity |
| 3. | Dehydration |
| 4. | Urinary alkalinity |
ANS: 3
A patient on ADH should be monitored for a decrease in the frequency and the amount of urination, the specific gravity of the urine, and water intoxication or signs of dehydration.
DIF: Cognitive Level: Comprehension REF: Page 344 OBJ: 3
TOP: Pituitary Hormones KEY: Nursing Process Step: Evaluation
MSC: NCLEX: Physiological Integrity: Reduction of risk potential
- Lipodystrophy is best defined as a(n):
| 1. | decrease and shrinkage of fatty tissues. |
| 2. | increase in fatty tissue in buttocks. |
| 3. | overgrowth of breast tissue. |
| 4. | increase in fatty tissue on abdomen. |
ANS: 1
Lipodystrophy, or shrinkage and loss of fatty tissue, occurs when insulin is given in the same spot too frequently.
DIF: Cognitive Level: Knowledge REF: Page 332 OBJ: 1
TOP: Insulin Therapy KEY: Nursing Process Step: N/A
MSC: NCLEX: Physiological Integrity: Reduction of risk potential
- Lispro, a rapid-onset, short-acting insulin, differs from regular insulin in which of the following ways?
| 1. | Longer duration |
| 2. | Shorter duration |
| 3. | Costs more to produce |
| 4. | Costs less to produce |
ANS: 2
Lispro has a rapid onset and shorter duration of action than regular insulin and provides insulin with action more like that produced by the body.
DIF: Cognitive Level: Comprehension REF: Page 332 OBJ: 1
TOP: Antidiabetic Medication KEY: Nursing Process Step: N/A
MSC: NCLEX: Physiological Integrity: Reduction of risk potential
- A patient comes into the clinic with complaints of feeling shaky and nervous. This patient has a history of type 2 diabetes and alcohol use. He admits to drinking two beers before coming into the clinic. The nurse should check this patient for:
| 1. | alcohol in the blood. |
| 2. | other drugs in the blood. |
| 3. | hyperglycemia. |
| 4. | hypoglycemia. |
ANS: 4
Diabetic patients should avoid drinking alcohol, because it can intensify hypoglycemia produced by insulin, causing blood glucose levels to fall too fast.
DIF: Cognitive Level: Application REF: Page 337 OBJ: 1
TOP: Insulin KEY: Nursing Process Step: Assessment
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
- A patient is 2 weeks past the delivery date of her baby. Her physician has admitted her into the hospital to induce her delivery. The nurse would expect to administer what drug of choice for the induction of labor?
| 1. | Ergonovine |
| 2. | Methylergonovine |
| 3. | Oxytocin |
| 4. | Clomiphene |
ANS: 3
Oxytocin is the drug of choice to induce labor in many areas of the country.
DIF: Cognitive Level: Application REF: Page 341 OBJ: 2
TOP: Pregnancy Drugs KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
- When using drugs for labor induction, contractions should not be over:
| 1. | 50 mm Hg. |
| 2. | 20 mm Hg. |
| 3. | 80 mm Hg. |
| 4. | 10 mm Hg. |
ANS: 1
The contractions should not be over 50 mm Hg.
DIF: Cognitive Level: Knowledge REF: Page 342 OBJ: 2
TOP: Pregnancy Drugs KEY: Nursing Process Step: Evaluation
MSC: NCLEX: Physiological Integrity
- A type 2 diabetic patient is learning to control his condition with diet and exercise. The patient was started on Januvia, a new incretin. The nurse expects the dose adjustment to be based on what lab values?
| 1. | CBC |
| 2. | TSH |
| 3. | Creatinine clearance |
| 4. | BUN |
ANS: 3
The dose of medication is adjusted based on the creatinine clearance and kidney function.
DIF: Cognitive Level: Application REF: Page 336, Table 20-2
OBJ: 4 TOP: Incretins KEY: Nursing Process Step: Evaluation
MSC: NCLEX: Physiological Integrity
MULTIPLE RESPONSE
- On a cool day, a patient complains of tachycardia, diaphoresis, and being warm. The patient has no known health problems. The health care provider will assess the patient for which of the following conditions: (Select all that apply.)
| 1. | Diabetes |
| 2. | Thyroid disease |
| 3. | Posterior pituitary hormone deficiency |
| 4. | Hypertension |
ANS: 1, 2, 3
If some part of the hormonal system does not work properly, failure in one organ system may then cause changes in another part of the hormonal system. Tachycardia, diaphoresis, and increased body temperature may be related to diabetes, thyroid disease, or posterior pituitary hormone deficiency.
DIF: Cognitive Level: Application REF: Page 339 OBJ: 5
TOP: Hormones KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
- Drugs of choice for the induction of labor include: (Select all that apply.)
| 1. | oxytocin |
| 2. | ergonovine |
| 3. | Decadron |
| 4. | prostaglandins |
ANS: 1, 4
Oxytocin and prostaglandins are the drugs of choice to induce labor.
DIF: Cognitive Level: Knowledge REF: Page 341 OBJ: 2
TOP: Pregnancy Drugs KEY: Nursing Process Step: N/A
MSC: NCLEX: Physiological Integrity: Reduction of risk potential
- Which of the following methods should be used to stop steroid therapy? (Select all that apply.)
| 1. | Therapy is stopped immediately. |
| 2. | The medication is tapered gradually. |
| 3. | After shorter courses, the dosage may be reduced by 50% each day. |
| 4. | The dosage may be reduced at consistent intervals. |
ANS: 2, 3, 4
Corticosteroid therapy must not be stopped abruptly.
DIF: Cognitive Level: Comprehension REF: Page 346 OBJ: 4
TOP: Steroids KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
- Insulin needs may increase due to which insulin antagonists below? (Select all that apply.)
| 1. | Corticosteroids |
| 2. | Epinephrine |
| 3. | Alcohol |
| 4. | Thyroid hormone |
ANS: 1, 2, 3
Insulin needs may be increased by insulin antagonists such as corticosteroids, epinephrine, and preparations used for thyroid hormone replacement therapy.
DIF: Cognitive Level: Comprehension REF: Page 333 OBJ: 4
TOP: Insulin KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
