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Mount St. Marys College - NURSING 30

Chapter 46: Pituitary, Thyroid, Parathyroid, and Adrenal Disorders

MULTIPLE CHOICE

1)The parents of an 11-year-old boy ask about growth hormone therapy for their child, who is shorter than his 10-year-old sister. The nurse will tell the parents that growth hormone

1. 1. does not affect other hormones when given.
   2. is available as an oral tablet to be taken once daily.
   3. is given after tests prove that it is necessary.
   4. may be given until the child’s desired height is reached.
2. The nurse is caring for a patient who is receiving growth hormone. Which assessment will the nurse monitor daily?
   1. Complete blood count
   2. Height and weight
   3. Renal function
   4. Serum glucose
3. The parents of a 16-year-old boy who plays football want their child to receive growth hormone to improve muscle strength. What will the nurse tell the parents?
   1. “Growth hormone may be used to improve strength in young athletes.”
   2. “If the epiphyses are not fused, growth hormone may be an option.”
   3. “Small doses of growth hormone may be used indefinitely for this purpose.”
   4. “Using growth hormone to build muscle mass is not recommended.”
4. Which would be a contraindication for hormone therapy with somatropin (Genotropin) in a school-age child?

1. Asthma
2. Dwarfism
3. Enuresis
4. Prader-Willi syndrome

5. A child exhibits acromegaly caused by a tumor that cannot be destroyed with radiation.

Which medication will most likely be used to treat this child?

5. 1. Bromocriptine mesylate (Parlodel)
   2. Octreotide acetate (Sandostatin)
   3. Somatrem (Protropin)
   4. Somatropin (Genotropin)
6. The nurse is caring for a patient who has hypothyroidism. To assist in differentiating between primary and secondary hypothyroidism, the nurse will expect the provider to order which drug?
   1. Liothyronine sodium (Cytomel)
   2. Liotrix (Thyrolar)
   3. Methimazole (Tapazole)
   4. Thyrotropin (Thytropar)
7. The nurse administers intravenous corticotropin (Acthar) to a patient. A serum cortisol level drawn 60 min later shows no change in serum cortisol levels from prior to the dose. What is the nurse’s first action?
   1. Notify the provider to discuss a possible non-functioning adrenal gland.
   2. Recognize the need for an increased dose to treat pituitary insufficiency.
   3. Request an order for a second dose of corticotropin to treat cortisone deficiency.
   4. Request an order to repeat the serum cortisol level in 1–2 h.
8. The nurse provides teaching for a patient who is receiving corticotropin. The nurse will instruct the patient to contact the provider if which condition occurs?
   1. Bruising
   2. Constipation
   3. Myalgia
   4. Nausea
9. The nurse is caring for a patient who has experienced head trauma in a motor vehicle accident. The patient is having excessive output of dilute urine. The nurse will notify the provider and will anticipate administering which medication?
   1. Calcifediol (Calderol)
   2. Corticotropin (Acthar)
   3. Prednisolone (AK-Pred)
   4. Vasopressin (Pitressin)
10. The nurse is preparing to administer piperacillin to a patient to treat an infection caused by pseudomonas. The nurse learns that the patient receives corticotropin to treat multiple sclerosis. The nurse will request an order for
    1. a different antibiotic.
    2. blood glucose monitoring.
    3. cardiac monitoring.
    4. serum electrolytes.
11. The nurse is caring for a patient who is receiving desmopressin acetate (DDAVP). Which assessments are important while caring for this patient?
    1. Blood pressure and serum potassium
    2. Heart rate and serum calcium
    3. Lung sounds and serum magnesium
    4. Urine output and serum sodium
12. A 35-year-old woman reports lethargy, difficulty remembering things, facial edema, dry skin, and cessation of menses. The nurse notes a heart rate of 60 beats per minute and a weight increase of 5 pounds from a previous visit. The nurse will notify the provider of which possible condition?
    1. Cretinism
    2. Early menopause
    3. Hyperthyroidism
    4. Myxedema
13. A patient is admitted to the hospital to treat hypothyroidism. For rapid improvement in symptoms, the nurse will expect to administer which medication?
    1. Levothyroxine sodium (Synthroid)
    2. Liothyronine (Cytomel)
    3. Liotrix (Thyrolar)
    4. Thyroid desiccated (Armour Thyroid)
14. A patient who takes warfarin (Coumadin) and digoxin (Lanoxin) develops hypothyroidism and will begin taking levothyroxine (Synthroid). The nurse anticipates which potential adjustments in dosing for this patient?
    1. Decreased digoxin and decreased warfarin
    2. Decreased digoxin and increased warfarin
    3. Increased digoxin and decreased warfarin
    4. Increased digoxin and increased warfarin
15. A patient who takes the oral antidiabetic agent metformin (Glucophage) will begin taking levothyroxine (Synthroid). The nurse will teach this patient to monitor for
    1. hyperglycemia.
    2. hypoglycemia.
    3. hyperkalemia.
    4. hypokalemia.
16. A patient who has hyperthyroidism will begin treatment with an antithyroid medication. The patient asks the nurse about dietary requirements. The nurse will counsel the patient to avoid which food(s)?
    1. Fava beans
    2. Foods high in purine
    3. Grapefruit
    4. Shellfish
17. The nurse is caring for a patient who is being treated for hypothyroidism. The patient reports insomnia, nervousness, and flushing of the skin. Before notifying the provider, the nurse will perform which action?
    1. Assess serum glucose to evaluate possible hypoglycemia.
    2. Check the patient’s heart rate to assess for tachycardia.
    3. Perform an assessment of hydration status.
    4. Take the patient’s temperature to evaluate for infection.
18. A patient with Graves disease exhibits tachycardia, heat intolerance, and exophthalmos. Prior to surgery, which drug is used to alter thyroid hormone levels?
    1. Liotrix (Thyrolar)
    2. Propranolol (Inderal)
    3. Propylthiouracil (PTU)
    4. Thyroid (Thyro-Tab)
19. A patient has hypocalcemia caused by parathyroid hormone deficiency. Which medication will the nurse anticipate giving to this patient?
    1. Calcitonin
    2. Calcitriol
    3. Calcium
    4. Vitamin D
20. A patient is receiving a glucocorticoid medication to treat an inflammatory condition, and the provider has ordered a slow taper in order to discontinue this medication. The nurse explains to the patient that this is done to prevent which condition?
    1. Acromegaly
    2. Adrenocortical insufficiency
    3. Hypertensive crisis
    4. Thyroid storm