Nokea
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.
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A client is receiving corticosteroid therapy. Which nursing diagnosis would the nurse be least likely to identify for this client?
- A. Risk for Infection
- B. Disturbed Body Image
- C. Risk for Injury
- D. Deficient Fluid Volume
Correct Answer: D
Rationale: A client who is receiving corticosteroid therapy would be least likely to have a nursing diagnosis of Deficient Fluid Volume. Rather, Excess Fluid Volume would be more appropriate. Risk for Infection related to immunosuppression, Disturbed Body Image related to cushingoid effects, and Risk for Injury related to muscle atrophy and osteoporosis would be appropriate.
A client is receiving treatment with adrenocorticotropic hormone. The nurse would instruct the client to avoid receiving which vaccine? Select all that apply.
- A. Zostavax (shingles)
- B. Meruvax (rubella)
- C. Td (tetanus and diphtheria)
- D. Fluzone (influenza)
- E. Attenuvax (measles)
Correct Answer: A,B,E
Rationale: Clients taking ACTH should avoid any vaccination with live virus including Zostavax, Meruvax, and Attenuvax.
A group of nursing students demonstrate understanding of a class discussion on pituitary hormones when they identify which of the following hormones as secreted by the posterior pituitary gland? Select all that apply.
- A. Growth hormone
- B. Adrenocorticotropic hormone
- C. Vasopressin
- D. Prolactin
- E. Oxytocin
Correct Answer: C,E
Rationale: Vasopressin and oxytocin are secreted by the posterior pituitary gland. Growth hormone, adrenocorticotropic hormone, and prolactin are secreted by the anterior pituitary gland, not the posterior.
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.
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.