Nokea
A nurse is caring for a client who has been undergoing glucocorticoid therapy at a health care facility and is getting discharged. Which of the following instructions should the nurse include in the teaching plan for the client and family?
- A. Report any symptoms of sore throat or fever immediately.
- B. Notify the PHCP if glucose appears in the urine.
- C. Measure the amount of fluids taken each day.
- D. Take the oral drug with meals or snacks.
Correct Answer: D
Rationale: The nurse should instruct the client to take the oral drug with meals or snacks to decrease the gastrointestinal effects and upsets in the teaching plan for the client and family. Reporting any symptoms of sore throat or fever immediately and notifying the primary health care provider if glucose appears in the urine should be included in the teaching plan for a client undergoing adrenocorticotropic hormone (ACTH) therapy. The nurse should instruct the client to measure the amount of fluids taken each day in the teaching plan for the client receiving vasopressin.
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The nurse should educate a client receiving adrenocorticotropic hormone (ACTH) to report which of the following to the health care provider? Select all that apply.
- A. Malaise
- B. Sores that don't heal
- C. Otic irritation
- D. Fever
- E. Diarrhea
Correct Answer: A,B,D
Rationale: The nurse instructs a client receiving adrenocorticotropic hormone (ACTH) to report any of the following adverse reactions to the physician: sore throat, cough, fever, malaise, sores that don't heal, or redness or irritation of the eyes.
A nurse is caring for a client with nocturnal enuresis. A physician has prescribed desmopressin acetate to the client. The nurse would assess the client for which of the following as a possible adverse reaction?
- A. Nasal congestion
- B. Breast tenderness
- C. Fluid retention
- D. Gynecomastia
Correct Answer: A
Rationale: The nurse should monitor for nasal congestion, abdominal cramps, headache, and nausea in the client as the adverse reactions to desmopressin acetate. When the client is administered gonadotropin, the nurse needs to monitor for fluid retention and gynecomastia as the adverse reactions to the drug. When choriogonadotropin alfa is administered to the client, the nurse should monitor for breast tenderness, ovarian overstimulation, and vasomotor flushes as the adverse reactions to the drug.
Which of the following hormones would the instructor include as being secreted by the anterior pituitary gland? Select all that apply.
- A. Growth hormone
- B. Adrenocorticotropic hormone
- C. Vasopressin
- D. Prolactin
- E. Oxytocin
Correct Answer: A,B,D
Rationale: Prolactin, adrenocorticotropic hormone, growth hormone, luteinizing hormone, follicle-stimulating hormone, and thyroid-stimulating hormone are secreted by the anterior pituitary gland. Vasopressin and oxytocin are secreted by the posterior pituitary gland.
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.
A nurse suspects that a client taking short-term high-dose methylprednisolone (Medrol) is developing Cushing's syndrome based on assessment of which of the following? Select all that apply.
- A. Weight loss
- B. Moon face
- C. Buffalo hump
- D. Dry skin
- E. Hypotension
Correct Answer: B,C
Rationale: A nurse should monitor a client taking short-term high-dose methylprednisolone (Medrol) for signs and symptoms of Cushing's syndrome, which include buffalo hump, moon face, oily skin, acne, osteoporosis, purple striae on the abdomen and hips, altered skin pigmentation, and weight gain.