Nokea
Which of the following hormones are secreted by the adrenal gland? Select all that apply.
- A. Growth hormone
- B. Mineralocorticoids
- C. Glucocorticoids
- D. Prolactin
- E. Oxytocin
Correct Answer: B,C
Rationale: Glucocorticoids and mineralocorticoids are secreted by the adrenal gland. Growth hormone, prolactin, and oxytocin are secreted by the pituitary gland.
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A client is receiving corticosteroids at a health care facility. The client is also receiving digoxin as treatment for heart failure. The nurse understands that which of the following is a possibility due to the interaction of these two drugs?
- A. Increased risk for toxicity
- B. Decreased muscle function
- C. Increased risk of hyperkalemia
- D. Decreased serum corticosteroid levels
Correct Answer: A
Rationale: The nurse should observe for an increased risk for digoxin toxicity when corticosteroids are given with digoxin. Decreased muscle function, hyperkalemia, and decreased serum corticosteroid levels are not associated with the interaction.
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 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.
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.
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.