Nokea
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.
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Which of the following should be included in the nurse's preadministration assessment of a client receiving desmopressin (DDAVP) for relief of abdominal distention? Select all that apply.
- A. Abdominal girth
- B. Weight
- C. Pulse
- D. Respiratory rate
- E. Blood glucose
Correct Answer: A,C,D
Rationale: Blood pressure, pulse, respiratory rate, and abdominal girth should be included in the nurse's preadministration assessment of a client receiving desmopressin (DDAVP) for relief of abdominal distention.
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 nurse completing discharge counseling should advise a client taking vasopressin (Pressyn) to notify the physician if which of the following occur? Select all that apply.
- A. Changes in urine output
- B. Abdominal cramps
- C. Skin blanching
- D. Diarrhea
- E. Cough
Correct Answer: A,B,C
Rationale: A nurse completing discharge counseling should advise a client taking vasopressin (Pressyn) to notify the physician if any of the following occur: a significant increase or decrease in urine output, abdominal cramps, skin blanching, nausea, confusion, headache, drowsiness, or signs of inflammation or infection at the injection sites.
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 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.