NURS 317 Unit 3 Chapter 35 Pharm Point Questions Flashcards
The nurse carefully monitors the client receiving an anterior pituitary hormone supplement who has what comorbidity? Select all that apply.
A) Severe renal dysfunction
B) Vascular disease
C) Asthma
D) Diabetes mellitus
E) Epilepsy
B) Vascular disease
C) Asthma
E) Epilepsy
Rationale:Caution should be used with any known vascular disease, epilepsy, asthma, and with hyponatremia. There is no contraindication with diabetes mellitus, and it is completely contraindicated in clients with severe renal dysfunction.
Hypopituitarism is often manifested as a growth hormone deficiency even before any signs and symptoms develop.
A) FALSE
B) TRUE
B) TRUE
Rationale:Hypopituitarism is often seen as GH deficiency before any other signs and symptoms occur. Hypopituitarism may occur as a result of developmental abnormalities or congenital defects of the pituitary, circulatory disturbances, acute or chronic inflammation of the pituitary, and pituitary tumors.
The nurse has been caring for a client who has been receiving ganirelix. What assessment finding best suggests that the drug is having the intended effect?
A) The client has had a positive home pregnancy test.
B) The client denies pain.
C) The client denies hot flashes or labile mood.
D) The client’s stature is within 2 standard deviations of the mean.
A) The client has had a positive home pregnancy test.
Rationale:Ganirelix is given to inhibit a premature luteinizing hormone surge in women undergoing controlled ovarian stimulation as part of a fertility program. A positive pregnancy test is consequently a desired outcome. This drug is not used to treat symptoms of menopause, growth disorders, or pain
Bromocriptine is a growth hormone agonist and a dopamine agonist.
A) FALSE
B) TRUE
A) FALSE
Rationale:Bromocriptine is a growth hormone antagonist as well as a dopamine agonist.
The nurse who provides care in an endocrinology clinic is working with a client who has been receiving somatropin on a regular basis for several months. What assessment should the nurse most likely prioritize when the client presents for follow-up?
A) Measure the length and width of the client’s hands and feet.
B) Review the client’s most recent fluid balance records.
C) Measure the client’s height and weight.
D) Assess the client’s menstrual patterns
C) Measure the client’s height and weight.
Rationale:While somatropin can be administered for a variety of health problems, the usual indication is growth hormone deficiency leading to growth failure in children. Consequently, the nurse should assess the client’s height and weight. Changes in the hands and feet do not occur with growth failure, and fluid balance is unlikely to be affected. Menstrual patterns would not likely exist yet
What assessment finding would indicate the need to stop somatropin administration in a child who has taken the drug for several years?
A) The child is 12 years old.
B) The child is in high school.
C) Closure of the epiphyseal plate.
D) Height of 5 ft has been reached.
C) Closure of the epiphyseal plate.
Rationale:Somatropin is contraindicated when the epiphyseal plate closes. Height, age, or year in school would not control when to stop administration.
Which client would be most likely to benefit from the administration of tesamorelin?
A) A client who has advanced prostate cancer
B) A client with stage III breast cancer
C) A client with human immunodeficiency syndrome
D) A 9-year-old client diagnosed with precocious puberty
C) A client with human immunodeficiency syndrome
Rationale:Tesamorelin is used for the reduction of excessive abdominal fat in HIV-infected patients with lipodystrophy. It is not indicated in the treatment of cancers or precocious puberty
A client has been prescribed desmopressin nasal spray, and the nurse is educating the client about self-administration. What should the nurse teach the client?
A) “Put the head of your bed at around 45 degrees before you take your nasal spray.”
B) “After you spray, tip your head back so that you don’t lose any of the medication.”
C) “Keep both of your nostrils open while you’re administering the spray.”
D) “Put the tip of the bottle about 1.5 cm into your nostril.”
D) “Put the tip of the bottle about 1.5 cm into your nostril.”
Rationale:The client should insert the tip of the spray bottle about 1.5 cm into the nostril while sitting upright. The opposite nostril should be covered with a finger, and the client should avoid leaning back after administration
Prior to a scheduled appointment, the nurse is reviewing the health record of a new client. The client’s medication regimen includes bromocriptine mesylate. The nurse should identify what likely implication of this?
A) The client has likely been treated for prostate cancer with minimal success.
B) The client likely has ambiguous sex characteristics.
C) The client likely has a much smaller-than-average stature.
D) The client likely has larger-than-average hands, feet, and face
D) The client likely has larger-than-average hands, feet, and face
Rationale:Bromocriptine mesylate is used to treat acromegaly, which often results in abnormal growth of a client’s hands, feet, and face. This drug is not used to treat cancer, GH deficiency, or unusual sex characteristics
The nurse suspects water intoxication in a client taking desmopressin as the result of what assessment finding?
A) Nasal irritation
B) Abdominal cramps
C) Calf pain
D) Drowsiness
D) Drowsiness
Rationale:Drowsiness is an indication of water intoxication. Abdominal cramps are an adverse effect of desmopressin but are not associated with water intoxication. Nasal irritation is an adverse effect of desmopressin nasal form but is not associated with water intoxication. Calf pain is not associated with water intoxication.
A client is to receive degarelix. The nurse would anticipate administering this drug by which route?
A) Subcutaneous
B) Intravenous
C) Oral
D) Intramuscular
A) Subcutaneous
Rationale:Degarelix is administered by subcutaneous injection.
The parents of a child receiving growth hormone replacement receive a new prescription for somatropin. What will the nurse teach this family about this delivery system?
A) There is no need to rotate injection sites.
B) The drug is administered as a fine mist.
C) The site does not require cleaning with an antibacterial agent.
D) Care should be taken to not touch the needle when removing the cap.
B) The drug is administered as a fine mist.
Rationale:Somatropin is a needleless delivery system that delivers the drug through the skin using a fine mist. Because it is needleless, the nurse would not need to warn parents about touching the needle. The site of administration should still be rotated to avoid disrupting skin integrity, and the site should still be cleaned with an antibacterial agent before administering to prevent introduction of bacteria
Which agent would the nurse expect to administer as an antineoplastic agent for a client with a hormone-specific cancer?
A) Somatropin
B) Ganirelix
C) Lanreotide
D) Goserelin
D) Goserelin
Rationale:Goserelin is used as an antineoplastic agent as treatment for specific hormone-stimulated cancers. Ganirelix is used to treat infertility. Somatropin is used to treat growth hormone deficiency. Lanreotide treats acromegaly.
By what routes could the nurse administer desmopressin? Select all that apply.
A) Oral
B) Subcutaneous
C) Intranasal
D) Transdermal
E) Intravenous
A) Oral
B) Subcutaneous
C) Intranasal
E) Intravenous
Rationale:Desmopressin is available for oral, IV, subcutaneous, and nasal administration. It is not available in a transdermal formula.
A client with short bowel syndrome has been prescribed somatropin rDNA origin 0.1 mg/kg subcutaneously. The client weighs 178 lbs. How many milligrams should the nurse administer? Provide your answer to one decimal place in mg
8.1mg
Rationale:The client’s weight must be converted from pounds to kilograms by dividing it by 2.2. This provides a weight of 80.91 kg. Multiplying by 0.1 mg/kg gives a dose of 8.091 mg, or 8.1 mg to one decimal place.
The nurse consults the provider regarding a client receiving pegvisomant and an opioid analgesic due to what anticipated interaction?
A) May require a lower dose of opioid
B) May require a higher dose of pegvisomant
C) May require a higher dose of opioid
D) May require a lower dose of pegvisomant
B) May require a higher dose of pegvisomant
Rationale:Clients receiving pegvisomant may require higher doses to receive adequate GH suppression if they are also taking opioids. The mechanism of action of this interaction is not understood.
A client is experiencing a prolonged labor and her contractions are ineffective. Which agent would the nurse expect to administer?
A) Degarelix
B) Oxytocin
C) Chorionic gonadotropin alfa
D) Desmopressin
B) Oxytocin
Rationale:Oxytocin is a posterior pituitary hormone that is used to promote uterine contractions. Degarelix is used to treat advanced prostate cancer. Desmopressin is used to treat diabetes insipidus. Chorionic gonadotropin alfa is a fertility agent.
Parents of children receiving growth hormone should report lack of growth, signs of glucose intolerance, and thyroid dysfunction.
A) TRUE
B) FALSE
A) TRUE
Rationale:When receiving GH, the child’s family will need instructions to report any lack of growth, as well as signs of glucose intolerance (thirst, hunger, voiding pattern changes) or thyroid dysfunction (fatigue, thinning hair, slow pulse, puffy skin, intolerance to the cold).
What medication should the nurse recognize as a hypothalamic antagonist?
A) Leuprolide
B) Ganirelix
C) Histrelin
D) Goserelin
B) Ganirelix
Rationale:Ganirelix is a hypothalamic antagonist. The other choices are hypothalamic agonists.
The nurse administers octreotide to a client and monitors for what common side effects? Select all that apply.
A) Flatulence
B) Postural hypotension
C) Acute abdominal pain
D) Drowsiness
E) Nausea
A) Flatulence
C) Acute abdominal pain
E) Nausea
Rationale:Flatulence and nausea are adverse effects of octreotide. Acute cholecystitis, manifested by acute abdominal pain, is an adverse effect of octreotide. Drowsiness is associated with bromocriptine therapy and not octreotide therapy. Postural hypotension is associated with bromocriptine therapy and not octreotide therapy.
After administering desmopressin to a client with diabetes insipidus, what assessment finding would indicate to the nurse that the drug has been effective?
A) Elevated blood glucose levels
B) Decreased reports of thirst
C) Decreased skin turgor
D) Increased urination
B) Decreased reports of thirst
Rationale:Thirst is associated with diabetes insipidus. A decrease in the symptom would indicate that the drug is working. Diabetes insipidus causes slightly higher than normal blood glucose levels, so further elevation would indicate the drug is not working. Diabetes insipidus causes polyuria, so a further increase would indicate that the drug was not working. Decreased skin turgor would suggest dehydration, which is a result of excessive fluid loss and should improve if the drug is working effectively.
A client is receiving leuprolide. The nurse should assess for what potential adverse effect?
A) Insomnia
B) Amenorrhea
C) Fluid retention
D) Fatigue
C) Fluid retention
Rationale:Hypothalamic agonists like leuprolide can cause ovarian overstimulation with resultant flushing, increased temperature and appetite, and fluid retention. Loss of energy, amenorrhea, and insomnia would be associated with hypothalamic antagonists and not with leuprolide.
Desmopressin is a synthetic form of aldosterone.
A) FALSE
B) TRUE
A) FALSE
Rationale:Desmopressin is a synthetic form of antidiuretic hormone.
The nurse is teaching a client about leuprolide and should inform the client about what common adverse effects? Select all that apply.
A) Dry skin
B) Hot flashes
C) Increased appetite
D) Hematuria
E) Constipation
B) Hot flashes
D) Hematuria
E) Constipation
Rationale:Hematuria, hot flashes, and constipation may occur with leuprolide, a hypothalamic antagonist. Anorexia is more likely than increased appetite. Increased sweating is more common than dry skin
After teaching a group of students about growth hormone agonists and antagonists, the instructor determines that additional teaching is needed when the students identify which agent as a growth hormone antagonist?
A) Octreotide
B) Somatropin
C) Pegvisomant
D) Bromocriptine
B) Somatropin
Rationale:Somatropin is a growth hormone agonist. Bromocriptine, octreotide, and pegvisomant are growth hormone antagonists.
The nurse is caring for a child taking somatropin who will require abdominal surgery. What order will the nurse anticipate receiving?
A) Increase dosage of somatropin.
B) Administer corticosteroid with somatropin.
C) Discontinue somatropin.
D) Reduce dosage of somatropin.
C) Discontinue somatropin
Rationale:Somatropin is contraindicated with abdominal surgery and acute illness secondary to complications of open-heart surgery because of potential problems with healing. Changing the dosage or administering corticosteroids with somatropin would not be effective as the drug needs to be stopped until the abdominal wound has healed.
A child is receiving growth hormone therapy. The nurse suspects possible thyroid dysfunction based on what assessment finding?
A) Cold intolerance
B) Increased urination
C) Hunger
D) Thirst
A) Cold intolerance
Rationale:Intolerance to cold is associated with thyroid dysfunction. The other answers are associated with glucose intolerance. All of these are potential adverse effects of GH therapy.
A client with acromegaly is to receive pegvisomant 40 mg as a loading dose. The nurse would expect to administer this agent by which route?
A) Oral
B) Intramuscular
C) Subcutaneous
D) Intravenous
C) Subcutaneous
Rationale:Pegvisomant is administered by subcutaneous injection.
Somatropin is a hypothalamic antagonist.
A) FALSE
B) TRUE
A) FALSE
Response:FALSE
Rationale:Somatropin is a synthetic growth hormone used as replacement for anterior pituitary hormone deficiency.
