Nokea
A client has been prescribed glucocorticoids for the treatment of congenital adrenal hyperplasia. Which of the following assessments should the nurse perform for the client?
- A. Take and record vital signs every 4 to 8 hours.
- B. Test the serum electrolyte levels.
- C. Auscultate the abdomen and record the findings.
- D. Observe for signs of blanching of the skin.
Correct Answer: A
Rationale: When glucocorticoids are administered to the client, the nurse should take and record vital signs every 4 to 8 hours. The nurse need not perform assessments related to serum electrolyte levels, abdominal auscultation, or skin blanching. These are appropriate for a client receiving vasopressin therapy.
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A nurse is reviewing the medical history report of a client who is to receive gonadotropins. In which of the following conditions would the use of gonadotropins be contraindicated?
- A. Sensitivity to benzyl alcohol
- B. Epiphyseal closure
- C. Adrenal dysfunction
- D. Epilepsy
Correct Answer: C
Rationale: While reviewing the medical history of the client, the nurse should identify that gonadotropins are contraindicated in clients with adrenal dysfunction, high gonadotropin levels, thyroid dysfunction, liver disease, abnormal bleeding, ovarian cysts, sex-hormone-dependent tumors, or organic intracranial lesions (pituitary tumors). Gonadotropins should be used cautiously in clients with epilepsy. Somatropin growth hormones are contraindicated in clients with sensitivity to benzyl alcohol, epiphyseal closure, and underlying cranial lesions.
A nurse would administer vasopressin (Pressyn) cautiously to a client with which of the following? Select all that apply.
- A. Sleep apnea
- B. Migraine headaches
- C. Asthma
- D. Seizure disorders
- E. Angina
Correct Answer: B,C,D,E
Rationale: Vasopressin (Pressyn) is used cautiously in clients with a history of seizure disorder, migraine headaches, asthma, congestive heart failure, or vascular disease (angina and myocardial infarction).
A physician has ordered a client to receive growth hormone subcutaneously. Which of the following tests would the nurse anticipate as required at different intervals during the treatment?
- A. Carbohydrate tolerance
- B. Serum electrolyte levels
- C. Glucose tolerance
- D. pH level of the blood
Correct Answer: C
Rationale: Periodic testing of growth hormone levels, glucose tolerance, and thyroid functioning are required during growth hormone treatment for the client. The pH level of blood and carbohydrate tolerance testing are not required. Testing serum electrolyte levels is needed when a client is undergoing vasopressin therapy.
Which of the following adrenocortical hormone drugs influence or regulate functions such as the immune response; glucose, fat, and protein metabolism; and the anti-inflammatory response? Select all that apply.
- A. Betamethasone (Celestone)
- B. Fludrocortisone (Florinef)
- C. Budesonide (Entocort EC)
- D. Hydrocortisone (Cortef)
- E. Dexamethasone (Decadron)
Correct Answer: A,C,D,E
Rationale: Glucocorticoids, like betamethasone (Celestone), budesonide (Entocort EC), hydrocortisone (Cortef), and dexamethasone (Decadron), influence or regulate functions such as the immune response; glucose, fat, and protein metabolism; and the anti-inflammatory response.
A nurse is educating a client and his family about vasopressin (DDAVP) for the treatment of diabetes insipidus. In addition to administration instructions, which of the following should the nurse discuss with the client and family? Select all that apply.
- A. Wearing a medical alert bracelet
- B. Monitoring the daily intake of fluids
- C. Avoiding sun exposure while using the drug
- D. Carrying extra doses with the client at all times
- E. Carrying liquids with the client at all times
Correct Answer: A,B,D,E
Rationale: In addition to administration instructions, the nurse should include the following: wear a medical alert bracelet, monitor the daily intake and output of fluids, avoid the use of alcohol, and carry extra doses and liquids with the client at all times.