TEST BANK FOR MEDICAL SURGICAL NURSING 7TH EDITION Chapter 37: CorticosteroidsClayton/Willihnganz: Basic Pharmacology for Nurses, 17th Edition

1. A patient has been on high-dose corticosteroid therapy for the treatment of lupus erythematosus. In addition to monitoring electrolyte levels, which laboratory studies will the nurse monitor? a. Complete blood count b. Partial thromboplastin time c. Liver function panel d. Blood glucose levels ANS: D Corticosteroid therapy may induce hyperglycemia, particularly in prediabetic or diabetic patients. All patients must be monitored for the development of hyperglycemia, particularly during the early weeks of therapy. Steroids do not affect blood count, bleeding time, or liver function. DIF: Cognitive Level: Application REF: Page 581 OBJ: 3 TOP: Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity NOT: CONCEPT(S): Clinical Judgment; Hormonal Regulation; Glucose Regulation 2. A patient who has been taking glucocorticoids over the past 3 months for Crohn’s disease comes in for a follow-up visit. On assessment, the nurse notes facial edema, thinning extremities, and a fatty deposition (buffalo hump) on the scapular area. The patient reports the symptoms of the Crohn’s disease are “somewhat better.” What will the nurse expect the treatment to be? a. Decrease the steroid dosage by one half. b. Increase the steroid dosage. c. Maintain the steroid dosage. d. Immediately stop the steroid dosage. ANS: C Glucocorticoids are primarily used as anti-inflammatory agents. Because the symptoms are improving, the physician will most likely maintain the steroid dosage. Adverse effects are anticipated with corticosteroid therapy. Decreasing the dose will not help the condition. Increasing the dose will exacerbate the adverse effects, and the condition is improving with the current dosage. Stopping the dosage will not help the condition or the adverse effects. DIF: Cognitive Level: Application REF: Page 586 OBJ: 4 TOP: Nursing Process Step: Evaluation MSC: NCLEX Client Needs Category: Health Promotion and Maintenance NOT: CONCEP