Chap 33 (exam 3)

Question 1

A 50 year old man has been taking prednisone (Deltasone) as part of treatment for bronchitis. He notices that the dosage of the medication decreases. During a follow up office visit, he asks the nurse why he must continue the medication and why he cannot just stop taking it now that he feels better. What is the rationale begind the tapering dosages?
Sudden discontinuation of this medication may result in adrenal insufficiency
The patient would experience withdrawal symptoms if the drug were discontinued abruptly
Cushing’s syndrome may develop as a reaction to a sudden drop in serum cortisone levels
Once the symptoms have started to disappear, lower dosages are needed

Answer 1

Sudden discontinuation of this medication may result in adrenal insufficiency

Question 2

The nurse is reviewing the use of oral glucocorticoids. Which os these is the preferred oral glucocorticoid for antiinflammatory or immunosuppressant purposes?
Fludrocortisone (Florinef)
Dexamethasone (Generic)
Prednisone (Deltasone)
Hydrocortison (Solu-Cortef)

Answer 2

Prednisone (Deltasone)

Question 3

When monitoring a patient who is taking corticosteroids, the nurse observes for which adverse effects? Select all that apply: 
Fragile skin
Hyperglycemia
Nervousness
Hypotension
Weight loss
Drowsiness

Answer 3

Fragile skin
Hyperglycemia
Nervousness

Question 4

A patient has Cushing's syndrome. The nurse expects which drug to be used to inhibit the function of the adrenal cortex in the treatment of this syndrome?
Dexamethasone (Generic)
Aminoglutethimide (Cytadren)
Hydrocortisone (Solu-Cortef)
Fludrocortisone (Florinef)

Answer 4

Aminoglutethimide (Cytadren)

Question 5

A patient who has been taking corticosteroids has developed a “moon face” and facial redness, and has many bruises on her arms. Which of these is the most appropriate nursing diagnosis?
Risk for infection
Imbalanced nutrition: less than body requirements
Deficient fluid volume
Disturbed body image

Answer 5

Disturbed body image

Question 6

Because corticosteroids may cause sodium retention, the nurse will closely monitor patients with which condition when administering corticosteroids?
Diabetes mellitus
Seizure disorders
Heart failure
Hyperthyroidism

Answer 6

Heart failure

Question 7

The nurse is administering aminoglutethimide to a patient, and will monitor for which adverse effects? Select all that apply:
Constipation
Dizziness
Anorexia
Hypertension
Lethargy

Answer 7

Dizziness
Anorexia
Lethargy