Patho/Pharm: Endocrine System Saunder's ?'s: MEDICATIONS
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1. The nurse is teaching a client Correct answer: 1
how to mix regular insulin and
NPH insulin in the same syringe. Rationale: When preparing a mixture of short-acting insulin,
Which action, if performed by such as regular insulin, with another insulin preparation,
the client, indicates the need for the short-acting insulin is drawn into the syringe first. This
further teaching? sequence will avoid contaminating the vial of short-acting
insulin with insulin of another type. Options 2, 3, and 4
1. Withdraws the NPH insulin identify correct actions for preparing NPH and short-acting
first insulin.
2. Withdraws the regular insulin
first
3. Injects air into NPH insulin vial
first
4.Injects an amount of air equal
to the desired dose of insulin
into each vial
2. The home care nurse visits a Correct answer: 2
client recently diagnosed with
diabetes mellitus who is taking Rationale: Insulin in unopened vials should be stored under
Humulin NPH insulin daily. The refrigeration until needed. Vials should not be frozen. When
client asks the nurse how to stored unopened under refrigeration, insulin can be used
store the unopened vials of in- up to the expiration date on the vial. Options 1, 3, and 4 are
sulin. The nurse should tell the incorrect.
client to take which action?
1. Freeze the insulin.
2. Refrigerate the insulin.
3. Store the insulin in a dark, dry
place.
4. Keep the insulin at room tem-
perature.
, Patho/Pharm: Endocrine System Saunder's ?'s: MEDICATIONS
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3. Glimepiride is prescribed for a Correct answer: 2, 3, 5
client with diabetes mellitus.
The nurse instructs the client Rationale: When alcohol is combined with glimepiride {Oral
that which food items are most Hpoglycemic med}, a disulfiram-like reaction may occur.
acceptable to consume while This syndrome includes flushing, palpitations, and nausea.
taking this medication? Select all Alcohol can also potentiate the hypoglycemic effects of the
that apply. medication. Clients need to be instructed to avoid alco-
hol consumption while taking this medication. Low-calorie
1. Alcohol desserts should also be avoided. Even though the calorie
2. Red meats content may be low, carbohydrate content is most likely high
3. Whole-grain cereals and can affect the blood glucose. The items in options 2, 3,
4. Low-calorie desserts and 5 are acceptable to consume.
5. Carbonated beverages
4. The nurse is providing discharge Correct answer: 2
teaching for a client newly diag-
nosed with type 2 diabetes mel- Rationale: Metformin is classified as a biguanide and is the
litus who has been prescribed most commonly used medication for type 2 diabetes melli-
metformin. Which client state- tus initially. It is also often used as a preventive medication
ment indicates the need for fur- for those at high risk for developing diabetes mellitus. When
ther teaching? used alone, metformin lowers the blood sugar after meal in-
take as well as fasting blood glucose levels. Metformin does
1. "It is okay if I skip meals now not stimulate insulin release and therefore poses little risk
and then." for hypoglycemia. For this reason, metformin is well suited
2. "I need to constantly watch for for clients who skip meals. Unusual somnolence, as well as
signs of low blood sugar." hyperventilation, myalgia, and malaise, are early signs of
3. "I need to let my health care lactic acidosis, a toxic effect associated with metformin. If any
provider know if I get unusually of these signs or symptoms occur, the client should inform
tired." the health care provider immediately. While it is best to avoid
4. "I will be sure to not drink al- consumption of alcohol, it is not always realistic or feasible
for clients to quit drinking altogether; for this reason, clients
, Patho/Pharm: Endocrine System Saunder's ?'s: MEDICATIONS
Study online at https://quizlet.com/_b86vqm
cohol excessively while on this should be informed that excessive alcohol intake can cause
medication." an adverse reaction with metformin.
5. A client is taking Humulin NPH Correct answer: 1, 3
insulin and regular insulin every
morning. The nurse should pro- Rationale: Humulin NPH is an intermediate-acting insulin.
vide which instructions to the The onset of action is 60 to 120 minutes, it peaks in 6 to 14
client? Select all that apply. hours, and its duration of action is 16 to 24 hours. Regular
insulin is a short-acting insulin. Depending on the type, the
1. Hypoglycemia may be experi- onset of action is 30 to 60 minutes, it peaks in 1 to 5 hours,
enced before dinnertime. and its duration is 6 to 10 hours. Hypoglycemic reactions
2. The insulin dose should be de- most likely occur during peak time. Insulin should be at
creased if illness occurs. room temperature when administered. Clients may need
3. The insulin should be admin- their insulin dosages increased during times of illness. In-
istered at room temperature. sulin vials should never be shaken vigorously. Regular insulin
4. The insulin vial needs to be is always drawn up before NPH.
shaken vigorously to break up
the precipitates.
5. The NPH insulin should be
drawn into the syringe first, then
the regular insulin.
6. A client with hyperthyroidism Correct answer: 1, 3, 4
has been given methimazole.
Which nursing considerations Rationale: Common side effects of methimazole include
are associated with this medica- nausea, vomiting, and diarrhea. To address these side ef-
tion? Select all that apply. fects, this medication should be taken with food. Because of
the increase in metabolism that occurs in hyperthyroidism,
1. Administer methimazole with the client should consume a high-calorie diet. Antithyroid
food. medications can cause agranulocytosis with leukopenia and
2. Place the client on a low-calo- thrombocytopenia. Sore throat, fever, headache, or bleeding
rie, low-protein diet. may indicate agranulocytosis and the health care provider
, Patho/Pharm: Endocrine System Saunder's ?'s: MEDICATIONS
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3. Assess the client for unex- should be notified immediately. Methimazole is not radioac-
plained bruising or bleeding. tive and should not be stopped abruptly, due to the risk of
4. Instruct the client to re- thyroid storm.
port side and adverse effects
such as sore throat, fever, or
headaches.
5. Use special radioactive pre-
cautions when handling the
client's urine for the first 24
hours following initial adminis-
tration.
7. The nurse is monitoring a client Correct answer: 1, 2, 5
receiving levothyroxine sodium
for hypothyroidism. Which find- Rationale: Insomnia, weight loss, and mild heat intolerance
ings indicate the presence of a are side effects of levothyroxine sodium. Bradycardia and
side effect associated with this constipation are not side effects associated with this medica-
medication? Select all that ap- tion, and rather are associated with hypothyroidism, which
ply. is the disorder that this medication is prescribed to treat.
1. Insomnia
2. Weight loss
3. Bradycardia
4. Constipation
5. Mild heat intolerance
8. The nurse provides instructions Correct answer: 3
to a client who is taking levothy-
roxine. The nurse should tell the Rationale: Oral doses of levothyroxine should be taken on an
client to take the medication in empty stomach to enhance absorption. Dosing should be
which way? done in the morning before breakfast.
Study online at https://quizlet.com/_b86vqm
1. The nurse is teaching a client Correct answer: 1
how to mix regular insulin and
NPH insulin in the same syringe. Rationale: When preparing a mixture of short-acting insulin,
Which action, if performed by such as regular insulin, with another insulin preparation,
the client, indicates the need for the short-acting insulin is drawn into the syringe first. This
further teaching? sequence will avoid contaminating the vial of short-acting
insulin with insulin of another type. Options 2, 3, and 4
1. Withdraws the NPH insulin identify correct actions for preparing NPH and short-acting
first insulin.
2. Withdraws the regular insulin
first
3. Injects air into NPH insulin vial
first
4.Injects an amount of air equal
to the desired dose of insulin
into each vial
2. The home care nurse visits a Correct answer: 2
client recently diagnosed with
diabetes mellitus who is taking Rationale: Insulin in unopened vials should be stored under
Humulin NPH insulin daily. The refrigeration until needed. Vials should not be frozen. When
client asks the nurse how to stored unopened under refrigeration, insulin can be used
store the unopened vials of in- up to the expiration date on the vial. Options 1, 3, and 4 are
sulin. The nurse should tell the incorrect.
client to take which action?
1. Freeze the insulin.
2. Refrigerate the insulin.
3. Store the insulin in a dark, dry
place.
4. Keep the insulin at room tem-
perature.
, Patho/Pharm: Endocrine System Saunder's ?'s: MEDICATIONS
Study online at https://quizlet.com/_b86vqm
3. Glimepiride is prescribed for a Correct answer: 2, 3, 5
client with diabetes mellitus.
The nurse instructs the client Rationale: When alcohol is combined with glimepiride {Oral
that which food items are most Hpoglycemic med}, a disulfiram-like reaction may occur.
acceptable to consume while This syndrome includes flushing, palpitations, and nausea.
taking this medication? Select all Alcohol can also potentiate the hypoglycemic effects of the
that apply. medication. Clients need to be instructed to avoid alco-
hol consumption while taking this medication. Low-calorie
1. Alcohol desserts should also be avoided. Even though the calorie
2. Red meats content may be low, carbohydrate content is most likely high
3. Whole-grain cereals and can affect the blood glucose. The items in options 2, 3,
4. Low-calorie desserts and 5 are acceptable to consume.
5. Carbonated beverages
4. The nurse is providing discharge Correct answer: 2
teaching for a client newly diag-
nosed with type 2 diabetes mel- Rationale: Metformin is classified as a biguanide and is the
litus who has been prescribed most commonly used medication for type 2 diabetes melli-
metformin. Which client state- tus initially. It is also often used as a preventive medication
ment indicates the need for fur- for those at high risk for developing diabetes mellitus. When
ther teaching? used alone, metformin lowers the blood sugar after meal in-
take as well as fasting blood glucose levels. Metformin does
1. "It is okay if I skip meals now not stimulate insulin release and therefore poses little risk
and then." for hypoglycemia. For this reason, metformin is well suited
2. "I need to constantly watch for for clients who skip meals. Unusual somnolence, as well as
signs of low blood sugar." hyperventilation, myalgia, and malaise, are early signs of
3. "I need to let my health care lactic acidosis, a toxic effect associated with metformin. If any
provider know if I get unusually of these signs or symptoms occur, the client should inform
tired." the health care provider immediately. While it is best to avoid
4. "I will be sure to not drink al- consumption of alcohol, it is not always realistic or feasible
for clients to quit drinking altogether; for this reason, clients
, Patho/Pharm: Endocrine System Saunder's ?'s: MEDICATIONS
Study online at https://quizlet.com/_b86vqm
cohol excessively while on this should be informed that excessive alcohol intake can cause
medication." an adverse reaction with metformin.
5. A client is taking Humulin NPH Correct answer: 1, 3
insulin and regular insulin every
morning. The nurse should pro- Rationale: Humulin NPH is an intermediate-acting insulin.
vide which instructions to the The onset of action is 60 to 120 minutes, it peaks in 6 to 14
client? Select all that apply. hours, and its duration of action is 16 to 24 hours. Regular
insulin is a short-acting insulin. Depending on the type, the
1. Hypoglycemia may be experi- onset of action is 30 to 60 minutes, it peaks in 1 to 5 hours,
enced before dinnertime. and its duration is 6 to 10 hours. Hypoglycemic reactions
2. The insulin dose should be de- most likely occur during peak time. Insulin should be at
creased if illness occurs. room temperature when administered. Clients may need
3. The insulin should be admin- their insulin dosages increased during times of illness. In-
istered at room temperature. sulin vials should never be shaken vigorously. Regular insulin
4. The insulin vial needs to be is always drawn up before NPH.
shaken vigorously to break up
the precipitates.
5. The NPH insulin should be
drawn into the syringe first, then
the regular insulin.
6. A client with hyperthyroidism Correct answer: 1, 3, 4
has been given methimazole.
Which nursing considerations Rationale: Common side effects of methimazole include
are associated with this medica- nausea, vomiting, and diarrhea. To address these side ef-
tion? Select all that apply. fects, this medication should be taken with food. Because of
the increase in metabolism that occurs in hyperthyroidism,
1. Administer methimazole with the client should consume a high-calorie diet. Antithyroid
food. medications can cause agranulocytosis with leukopenia and
2. Place the client on a low-calo- thrombocytopenia. Sore throat, fever, headache, or bleeding
rie, low-protein diet. may indicate agranulocytosis and the health care provider
, Patho/Pharm: Endocrine System Saunder's ?'s: MEDICATIONS
Study online at https://quizlet.com/_b86vqm
3. Assess the client for unex- should be notified immediately. Methimazole is not radioac-
plained bruising or bleeding. tive and should not be stopped abruptly, due to the risk of
4. Instruct the client to re- thyroid storm.
port side and adverse effects
such as sore throat, fever, or
headaches.
5. Use special radioactive pre-
cautions when handling the
client's urine for the first 24
hours following initial adminis-
tration.
7. The nurse is monitoring a client Correct answer: 1, 2, 5
receiving levothyroxine sodium
for hypothyroidism. Which find- Rationale: Insomnia, weight loss, and mild heat intolerance
ings indicate the presence of a are side effects of levothyroxine sodium. Bradycardia and
side effect associated with this constipation are not side effects associated with this medica-
medication? Select all that ap- tion, and rather are associated with hypothyroidism, which
ply. is the disorder that this medication is prescribed to treat.
1. Insomnia
2. Weight loss
3. Bradycardia
4. Constipation
5. Mild heat intolerance
8. The nurse provides instructions Correct answer: 3
to a client who is taking levothy-
roxine. The nurse should tell the Rationale: Oral doses of levothyroxine should be taken on an
client to take the medication in empty stomach to enhance absorption. Dosing should be
which way? done in the morning before breakfast.
