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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.
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A physician has prescribed vasopressin to the client for regulating the reabsorption of water by the kidneys. Which of the following assessments should the nurse perform after the administration of vasopressin?
- A. Observe for and report any evidence of edema, such as dyspnea.
- B. Measure and record the client's abdominal girth every hour.
- C. Observe the client for blanching of the skin, abdominal cramps, and nausea.
- D. Weigh the client every day to obtain a baseline weight.
Correct Answer: C
Rationale: After vasopressin is administered to the client, the nurse should observe the client every 10 to 15 minutes for signs of an excessive dosage, which include blanching of the skin, abdominal cramps, and nausea. After corticotropin is administered to the client, the nurse needs to observe for and report any evidence of edema, such as weight gain, rales, increased pulse or dyspnea, or swollen extremities. If the client is receiving vasopressin for abdominal distention, the nurse needs to auscultate the abdomen every 15 to 30 minutes and measure abdominal girth hourly. The nurse needs to weigh the client to obtain a baseline weight for future comparison before administering vasopressin to the client.
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 client with diabetes insipidus has been prescribed vasopressin. The client's ambulatory status is limited. Which of the following would be most important for this client?
- A. Measuring the amount of fluid loss every 24 hours
- B. Refilling the water container at frequent intervals
- C. Giving four glasses of water immediately after the client takes the drug
- D. Examining the client's abdomen every 15 to 30 minutes
Correct Answer: B
Rationale: Clients with diabetes insipidus are continually thirsty, and in this case, the client also has limited ambulatory activities. Therefore, the nurse should be careful to refill the water container at frequent intervals to ensure the availability of enough drinking water at hand for the client. The nurse need not be careful to measure the amount of fluid loss every 24 hours, give four glasses of water immediately after the client takes the drug, or examine the client's abdomen every 15 to 30 minutes. The nurse instructs the client to measure the amount of urine excreted at each voiding and then total the amount for each 24-hour period. The nurse should instruct the client to drink one or two glasses of water immediately before taking the drug. The nurse need not auscultate the abdomen every 15 to 30 minutes in a client with diabetes insipidus. The nurse auscultates the abdomen every 15 to 30 minutes in a client with abdominal distention.
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.
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.