Nokea
A 16-year-old boy who is taking somatropin comes into the office because he had an asthma attack during a race at school. Because of this new development, the nurse expects which intervention to occur next?
- A. He will need to stop participating in school physical education classes.
- B. The somatropin must be discontinued immediately.
- C. The somatropin dosage may be adjusted.
- D. His growth will be documented and monitored for changes.
Correct Answer: C
Rationale: Somatropin should be used cautiously in patients with acute or chronic illnesses like asthma, often requiring dosage adjustments to balance risks and benefits. Immediate discontinuation is not necessary, and growth monitoring is routine but not the primary intervention.
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A patient is about to receive a dose of octreotide. The nurse will assess for which contraindications or cautions? (Select all that apply.)
- A. Carcinoid crisis
- B. Diarrhea
- C. Type 1 diabetes mellitus
- D. Gallbladder disease
- E. Chronic renal failure
- F. Esophageal varices
Correct Answer: C,D,E
Rationale: Octreotide requires caution in patients with type 1 or 2 diabetes, gallbladder disease, or chronic renal failure due to potential effects on glucose metabolism, gallbladder function, and renal clearance. Carcinoid crisis, diarrhea, and esophageal varices are indications for octreotide use.
A patient's medication order indicates that he is to receive a dose of cosyntropin. The nurse is aware that this drug is used to diagnose which condition?
- A. Adrenocortical insufficiency
- B. Diabetes insipidus
- C. Myasthenia gravis
- D. Pituitary dwarfism
Correct Answer: A
Rationale: Cosyntropin is a synthetic ACTH used to diagnose adrenocortical insufficiency by stimulating cortisol production. It is not used for diagnosing diabetes insipidus, myasthenia gravis, or pituitary dwarfism.
A patient is to receive vasopressin 5 units SUBQ twice a day. The medication is available in a vial that contains 20 units/mL. Identify how many milliliters the nurse will draw up for this dose. (record answer using two decimal places)
Correct Answer: 0.25 mL
Rationale: To calculate: 20 units/1 mL = 5 units/x mL. Cross-multiply: (20 * x) = (1 * 5); 20x = 5; x = 5/20 = 0.25 mL.
Which of these hormones are secreted by the anterior pituitary gland? (Select all that apply.)
- A. Antidiuretic hormone
- B. Thyroid-stimulating hormone
- C. Oxytocin
- D. Growth hormone
- E. Adrenocorticotropic hormone
Correct Answer: B,D,E
Rationale: The anterior pituitary secretes thyroid-stimulating hormone, growth hormone, and adrenocorticotropic hormone. Antidiuretic hormone and oxytocin are secreted by the posterior pituitary gland.
A patient who has been on somatropin has been hospitalized for an acute asthma exacerbation, and is receiving intravenous doses of glucocorticoids. The nurse recognizes that which effect may occur if these drugs are given together?
- A. Reduction of growth effects
- B. Hyperkalemia
- C. Increased urine output
- D. Diarrhea
Correct Answer: A
Rationale: Glucocorticoids can reduce the growth-promoting effects of somatropin by counteracting its anabolic actions, though the benefits of glucocorticoids for asthma may outweigh this risk. Hyperkalemia, increased urine output, and diarrhea are not expected interactions.