Mastery EAQ Ch. 33

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Question #1

The nurse is caring for a patient who has recently undergone an adrenalectomy. During preparation for discharge, the nurse teaches the patient’s family members about care to be given at home. Which instruction would the nurse include in the teaching?

A “Report fat deposition at the abdomen.”

B “Do mild to moderate exercises regularly.”

C “Maintain a regular diabetic diet.”

D “Immediately report any wound infection.”

Question #2

The nurse teaches a patient receiving long-term corticosteroid drug therapy about the dosage regimen. Which response by the patient indicates the need for further teaching?

A “I will stop taking this medication if I have any adverse effects.”

B “I will take this medication with food or milk regularly.”

C “I will not touch or interact with people who have infections.”

D “I will report to you immediately if I have fever or a sore throat.”

Question #3

A nursing student is caring for an older adult patient with Addison’s disease. The nursing instructor asks the student about the characteristics that can be observed in patients with Addison’s disease. What is the best answer given by the student?

A “The patient has weight gain because of the deposition of excess fat in the body.”

B “The patient has hypokalemia because of a decrease in blood potassium concentrations.”

C “The patient has dehydration because of a decrease in blood aldosterone concentrations.”

D “The patient has muscle weakness because of increased carbohydrate metabolism.”

Question #4

Which information would the nurse obtain prior to giving glucocorticoids to a 10-year-old patient?

A Visual acuity

B Bone density

C Blood glucose

D Height and weight

Question #5

The nurse is caring for a patient with Addison’s disease who has been prescribed a combination of oral prednisone and fludrocortisone. After a few days the patient reports severe gastrointestinal upset. Which treatment does the nurse expect to be prescribed for the patient?

A Extra oral adrenal medication

B Decreased dose of fludrocortisone

C Proton pump inhibitor medication

D Decreased dose of prednisone

Question #6

A nursing student is caring for an elderly patient who has Cushing’s syndrome. The nursing instructor asks the student about the characteristics that can be observed in patients with Cushing’s syndrome. Which response by the student is correct?

A “The patient has hypokalemia because of a decrease in blood potassium concentrations.”

B “The patient has redistribution of body fat from the face, shoulders, trunk, and abdomen to the arms and legs.”

C “The patient has muscle weakness because of increased carbohydrate metabolism.”

D “The patient has dehydration because of a decrease in blood aldosterone concentrations.”

Question #7

The nurse is caring for a patient who has Addison’s disease who takes a loop diuretic medication. Which other medication would the nurse likely find in the patient’s prescription to provide effective treatment?

A Sodium supplements, Vitamin supplements

B Iron supplements, Sodium supplements

C Calcium supplements, Potassium supplements

D Vitamin supplements, Iron supplements

Question #8

The nurse administers fludrocortisone to a patient who has acute primary adrenocortical insufficiency. Which adverse effect of the therapy is a priority for the nurse to prevent?

A Gastric erosion

B Hypertension

C Peptic ulcers

D Pulmonary edema

Question #9

A patient is being treated for secondary adrenocortical insufficiency. If the patient’s adrenal glands are still intact, which medication used in the treatment of primary adrenocortical insufficiency would the nurse avoid?

A Fludrocortisone

B Prednisone

C Cosyntropin

D Glargine insulin

Question #10

A patient is receiving long-term prednisone therapy. During the follow-up visit, the nurse finds that the patient has gained weight and has low levels of adrenal hormone. Which action by the patient would have led to an alteration in the adrenal hormone level?

A The patient took the medication after meals.

B The patient included high-protein food in the diet.

C The patient took the medication with milk.

D The patient took the medication at night.

Question #11

The nurse is performing a follow-up assessment of a patient who is being treated with glucocorticoids for an exacerbation of chronic obstructive pulmonary disease (COPD). Which assessment finding indicates that the treatment is effective?

A Random blood glucose concentration of 150 mg/dL, Temperature of 100.6°F (38.1°C), Weight gain of 4.4 lb (2 kg) over a week

B Oxygen saturation of 95%, Temperature of 100.6°F (38.1°C), Weight gain of 4.4 lb (2 kg) over a week

C Temperature of 100.6°F (38.1°C), Respiratory rate of 16 breaths/min, Weight gain of 4.4 lb (2 kg) over a week

D Respiratory rate of 16 breaths/min, Oxygen saturation of 95%, Random blood glucose concentration of 150 mg/dL

Question #12

The nurse is caring for a patient with Addison’s disease who has been prescribed corticosteroids. Prior to administering the medication, which condition would the nurse assess for in the patient?

A Septicemia, Liver disorder, Ulcerative colitis

B Liver disorder, Glaucoma, Ulcerative colitis

C Glaucoma, Septicemia, Diabetes mellitus

D Diabetes mellitus, Liver disorder, Ulcerative colitis

Question #13

A patient is diagnosed with hypersecretion of adrenocorticoid hormones, leading to symptoms of weight gain and hypertension. Which subjective finding would the nurse expect in this patient?

A History of diabetes mellitus, Rapid, deep breathing

B Rapid, deep breathing, Consumption of a protein-rich diet

C Consumption of a protein-rich diet, History of diabetes mellitus

D Frequent use of corticosteroids, Easy bruising

Question #14

Which medication would the nurse expect to administer to a patient with adrenal insufficiency if the patient is unable to produce it endogenously?

A Hydrocortisone

B Prednisone

C Epinephrine

D Regular insulin

Question #15

The nurse is caring for a patient with an adrenal tumor. The health care provider has prescribed an antiadrenal drug to the patient. Which therapeutic response will the nurse assess in this patient?

A Decrease in adrenal suppression, Decrease in inflammation

B Decrease in lymphocyte count, Decrease in adrenal suppression

C Decrease in the tumor size, Decrease in Cushing’s syndrome symptoms

D Decrease in inflammation, Decrease in lymphocyte count

Question #16

A patient is receiving dexamethasone to prevent cerebral edema caused by a motor vehicle accident. Which nursing intervention will help to prevent complications of the pharmacotherapy?

A Requesting a prescription for a proton pump inhibitor

B Requesting a prescription for aluminum hydroxide

C Performing frequent oral suctioning

D Elevating the head of the bed 30°

Question #17

The nurse is assessing an older adult who has a dermatologic disorder and has been prescribed methylprednisolone. During the assessment, the nurse learns that the patient has myasthenia gravis and is taking anticholinesterase medications. Which adverse effect would the nurse expect if methylprednisolone is administered to this patient?

A Memory loss

B Inflammation of the joints

C Muscle weakness

D Impaired hearing ability

Question #18

The nurse is caring for a patient who has hypertension and is on continuous corticosteroid therapy to treat adrenal insufficiency. The electrocardiograph shows a steady slowing of the patient’s heart beat. The patient’s blood pressure is 140/96 mm Hg. Which medication may contribute to the patient’s symptoms?

A Loop diuretics

B Hydantoins

C Barbiturates

D Cholinergics

Question #19

Upon reviewing the laboratory reports of a patient with hypoglycemia, the nurse expects that the patient would be prescribed a combination of fludrocortisone and prednisone. Which findings did the nurse observe in the patient’s laboratory reports to suggest such a conclusion?

A Hypernatremia

B Hyperlipidemia

C Hypercalcemia

D Hyperkalemia

Question #20

Which condition can be treated with glucocorticoid drugs?

A Glaucoma, Systemic lupus erythematous, Varicella infection

B Chronic obstructive pulmonary disease, Septicemia, Varicella infection

C Glaucoma, Septicemia, Varicella infection

D Cerebral edema, Systemic lupus erythematous, Chronic obstructive pulmonary disease

Question #21

A patient with diabetes mellitus has recently undergone pancreas transplantation. According to the prescription, the nurse administers a long-acting depot formulation of methylprednisolone. The next day, the patient’s blood glucose concentration and blood pressure are higher than the normal levels. Which factor may be the reason for the high blood glucose concentration?

A Release of excess drug from the depot formulation

B Presence of benzyl alcohol in the depot formulation

C Complete elimination of the drug from the body

D Failure of the pancreas transplantation

Question #22

The nurse is caring for a patient who has salt-losing adrenogenital syndrome. Which prescription would the nurse expect to find in the patient’s treatment regimen?

A 0.1 mg of oral fludrocortisone

B 0.2 mg of intravenous prednisone

C 0.5 mg of intravenous methylprednisolone

D 0.75 mg of oral betamethasone

Question #23

Which condition is a contraindication to the use of fludrocortisone?

A Hyperkalemia

B Adrenogenital syndrome

C Addison’s disease

D Candidiasis

Question #24

The nurse is assessing a patient who is experiencing pain, muscle weakness, and edema. The patient’s laboratory reports indicate the patient has increased concentrations of sodium. Which condition do these findings suggest?

A Primary hypotension

B Type 1 diabetes mellitus

C Primary aldosteronism

D Addison’s disease

Question #25

A patient with Addison’s disease is prescribed corticosteroids. During the follow-up visit the nurse finds that the patient is taking oral contraceptives and has severe insomnia and osteoporosis. Which is a possible reason for insomnia and osteoporosis in the patient?

A Presence of corticosteroids in the blood for longer lengths of time

B Rapid elimination of corticosteroids from the blood

C Completely stopping corticosteroid administration

D Irregular administration of corticosteroids

Question #26

While assessing a patient who has hypoglycemia, a nursing student finds that the patient has severe weight loss. The patient’s laboratory reports suggest that there is a decrease in the sodium concentration and increase in potassium concentration. Which condition does the nursing student suspect?

A Insulin resistance

B Addison’s disease

C Hypothyroidism

D Cushing’s syndrome

Question #27

When assessing for potential side effects of fludrocortisone, which assessment is a priority for the nurse to monitor?

A Serum calcium levels for hypercalcemia

B Intake and output for potential fluid volume deficit

C Serum sodium levels for potential hyponatremia

D Serum potassium levels for hypokalemia

Question #28

The nurse is caring for a patient who has Addison’s disease. The primary health care provider prescribes fludrocortisone. For which adverse effect will the nurse monitor this patient?

A Hypoglycemia

B Hypocalcemia

C Hypokalemia

D Hyponatremia

Question #29

Which laboratory value would the nurse assess when giving loop diuretics to a patient taking corticosteroids?

A Magnesium

B Potassium

C Sodium

D Chloride

Question #30

Which laboratory value would the nurse monitor in a patient receiving methylprednisolone?

A Magnesium

B Carbon dioxide (CO2)

C Sodium

D Blood glucose

Question #31

Which symptom would the nurse assess for in a patient taking prednisone that suggests adrenal crisis?

A Edema

B Hypoglycemia

C Increased appetite

D Hypotension

Question #32

Which dermatological change would the nurse monitor for in a patient receiving long-term corticosteroid therapy?

A Bruising

B Jaundice

C Cyanosis

D Cysts

Question #33

Which would the nurse include in patient education on the side effects of inhaled glucocorticoids?

A Measure blood glucose.

B Rinse out mouth after use.

C Assess for edema.

D Obtain daily weights.

Question #34

A nurse is preparing to administer an intraarticular injection of a glucocorticoid medication. Which action by the nurse is correct?

A Instruct the patient to rest the area for 8 hours.

B Apply a pressure bandage to the injection site.

C Place a cold pack over the injection site to minimize pain.

D Monitor the patient’s vital signs every 30 minutes for 4 hours.

Question #35

A patient is undergoing glucocorticoid therapy. Which medication would the nurse administer to the patient for mild pain management?

A Naproxen sodium

B Aspirin

C Acetaminophen

D Ibuprofen

Question #36

A patient has been prescribed corticosteroids for adrenal suppression. Which behavior process may be observed in the patient because of this?

A Memory loss

B Hallucinations

C Impaired thinking

D Impaired stress response

Question #37

Which statement about glucocorticoids is correct?

A They stimulate defense mechanisms to produce immunity.

B They influence carbohydrate, fat, and protein metabolism.

C They are not produced during stressful situations.

D They decrease serum sodium and glucose concentrations.

Question #38

What role does the release of cortisol play in the stress response?

A Provides more fuel for cells

B Decreases oxygen delivery

C Decreases coagulability of blood

D Reduces blood flow to vital organs

Question #39

Which corticosteroid drug is safe to use during pregnancy?

A Fludrocortisone

B Prednisone

C Methylprednisolone

D Betamethasone

Question #40

A patient has been prescribed a beclomethasone inhaler. When teaching the patient about the use of inhalers, the nurse instructs the patient to rinse the mouth with warm water after using the inhaler. Which side effect is the nurse trying to prevent?

A Fungal infection

B Addison’s disease

C Cushing’s syndrome

D Adrenal crisis

Question #41

Which condition would a nurse expect in a patient who abruptly withdraws from a glucocorticoid medication?

A Osteoporosis

B Cushing’s syndrome

C Cataracts

D Addison’s disease

Question #42

Which hormone is affected by renal failure?

A Norepinephrine

B Corticotropin

C Aldosterone

D Epinephrine

Question #43

For which condition would daily fludrocortisone be prescribed?

A Addison’s disease

B Rheumatoid arthritis

C Organ transplant

D Chronic obstructive pulmonary disease (COPD)

Question #44

Which medication would be prescribed for a patient experiencing an exacerbation of chronic obstructive pulmonary disease (COPD)?

A Methylprednisolone

B Aldosterone

C Betamethasone

D Fludrocortisone

Question #45

Which side effect of long-term treatment with corticosteroids requires patients to undergo an annual bone density exam?

A Chronic obstructive pulmonary disease (COPD)

B Osteoporosis

C Addison’s disease

D Type 1 diabetes mellitus

Question #46

Which pregnancy category is methylprednisolone classified as?

A C

B X

C B

D D

Question #47

Which period represents the elimination half-life of prednisolone?

A 0.5 hour

B 1 to 2 hours

C 3 to 4 hours

D 2 to 3 hours

Question #48

Which corticosteroid drug is indicated for Addison disease?

A Florinef

B Sterapred

C Deltasone

D Solu-medrol

Question #49

The interaction of systemically administered corticosteroids with which drug produces severe hypocalcemia and hypokalemia?

A Thyroid hormones

B Barbiturates

C Thiazides

D Hydantoins

Question #50

Which drug is the preferred choice for women in premature labor to accelerate fetal lung maturation?

A Betamethasone

B Prednisone

C Methylprednisolone

D Dexamethasone

Question #51

Which biologic function does a glucocorticoid affect?

A Carbohydrate and protein metabolism

B Maintenance of pH levels in the blood

C Sodium and water resorption

D Maintenance of serum potassium levels

Question #52

When assessing for potential adverse effects of fludrocortisone, which electrolyte imbalance would the nurse monitor for?

A Hyperkalemia

B Hyponatremia

C Hypercalcemia

D Hypokalemia

Question #53

Which statement about glucocorticoids is accurate?

A They are produced in decreased amounts during times of stress.

B They decrease serum sodium and glucose concentrations.

C They stimulate defense mechanisms to produce immunity.

D They influence carbohydrate, lipid, and protein metabolism.

Question #54

Which corticosteroid has exclusive mineralocorticoid activity?

A Alclometasone

B Beclomethasone

C Fludrocortisone

D Aminoglutethimide

Question #55

The adrenal cortex is essential for survival through the secretion of which substance?

A Corticotrophins

B Aldosterone

C Epinephrine

D Glucocorticoids

Question #56

What is the function of aldosterone?

A Stimulation of the erythroid cells

B Production of glycogen in the liver

C Fluid and water retention

D Inhibition of inflammatory and immune responses

Question #57

Which assessment will the nurse perform for a patient with a history of heart failure who is prescribed corticosteroids?

A Capillary refill

B Bowel sounds

C Breath sounds

D Peripheral pulses

Question #58

Which adverse effect is produced by the interaction of fludrocortisone with digoxin?

A Increased risk for dysrhythmias

B Enhanced anticoagulant activity

C Hypokalemia

D Reduced efficacy

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