NURS 167 - Exam 3 Review Questions
and Correct Answers
A nurse is monitoring a client receiving desmopressin acetate (DDAVP) for diabetes
insipidus. Which of the following indicates the presence of an adverse effect?
1. Insomnia
2. Drowsiness
3. Weight loss
4. Increased urination ✅2. Drowsiness Rationale: Water intoxication (overhydration) or
hyponatremia is an adverse effect to desmopressin. Early signs include drowsiness,
listlessness, and headache. Decreased urination, rapid weight gain, confusion,
seizures, and coma also may occur in overhydration.
A patient with diabetes insipidus is taking Vasopressin . He is complaining of
drowsiness, lightheadedness, and headache. What does the nurse suspect that he is
experiencing?
A. An allergic reaction
B. Dehydration
C. Depression
D. Water intoxication ✅D. Water intoxication
A nurse reinforces instructions to a client who is taking levothyroxine (Synthroid). The
nurse tells the client to take the medication:
1. With food
2. At lunchtime
3. On an empty stomach
4. At bedtime with a snack ✅On an empty stomach Rationale:Oral doses of
levothyroxine (Synthroid) should be taken on an empty stomach to enhance absorption.
Dosing should be done in the morning before breakfast. *Note that options 1, 2, and 4
are comparable or alike in that these options address administering the medication with
food.*
A nurse reinforces medication instructions to a client who is taking levothyroxine
(Synthroid). The nurse instructs the client to notify the health care provider (HCP) if
which of the following occurs?
1. Fatigue
2. Tremors
3. Cold intolerance
4. Excessively dry skin ✅Tremors
Rationale: Excessive doses of levothyroxine (Synthroid) can produce signs and
symptoms of hyperthyroidism. These include tachycardia, chest pain, tremors,
nervousness, insomnia, hyperthermia, heat intolerance, and sweating. The client should
,be instructed to notify the HCP if these occur. Options 1, 3, and 4 are signs of
hypothyroidism.
A nurse is caring for a client with hyperparathyroidism and notes that the client's serum
calcium level is 13 mg/dL. Which medication should the nurse prepare to administer as
prescribed to the client?
1. Calcium chloride
2. Calcium gluconate
3. Calcitonin (Miacalcin)
4. Large doses of vitamin D ✅3. Calcitonin (Miacalcin)
Rationale: The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is
experiencing hypercalcemia. Calcium gluconate and calcium chloride are medications
used for the treatment of tetany, which occurs as a result of acute hypocalcemia. In
hypercalcemia, large doses of vitamin D need to be avoided. Calcitonin, a thyroid
hormone, decreases the plasma calcium level by inhibiting bone resorption and
lowering the serum calcium concentration.
A nurse is caring for a client after thyroidectomy and notes that calcium gluconate is
prescribed for the client. The nurse determines that this medication has been prescribed
to:
1. Treat thyroid storm.
2. Prevent cardiac irritability.
3. Treat hypocalcemic tetany.
4. Stimulate the release of parathyroid hormone. ✅Treat hypocalcemic tetany.
Rationale:Hypocalcemia can develop after thyroidectomy if the parathyroid glands are
accidentally removed or injured during surgery. Manifestations develop 1 to 7 days after
surgery. If the client develops numbness and tingling around the mouth, fingertips, or
toes or muscle spasms or twitching, the health care provider is notified immediately.
Calcium gluconate should be kept at the bedside.
The nurse admitting a patient with acromegaly anticipates administering which
medication?
desmopressin (DDAVP)
corticotropin (Acthar)
somatropin (Nutropin)
octreotide (Sandostatin) ✅octreotide (Sandostatin)
The nurse would question an order for steroids in a patient with which condition?
Uncontrolled diabetes mellitus
Rheumatoid arthritis
Septic shock
,Exacerbation of chronic obstructive pulmonary disease (COPD) ✅Uncontrolled
diabetes mellitus
The nurse is providing care to a patient following a non-accidental traumatic brain injury.
The patient has developed diabetes insipidus due to the injury. What medication is most
often used in the management of diabetes insipidus?
desmopressin (DDAVP)
corticotrophin (Acthar)
octreotide (Sandostatin)
somatropin (Humatrope) ✅desmopressin (DDAVP)
A patient is receiving vasopressin. Which symptoms warrant immediate notification of
the primary health care provider? Select all that apply.
1 Diarrhea
2 Pale skin
3 Yellow eyes
4 Hypertension
5 Abdominal cramping ✅1 Diarrhea
4 Hypertension
5 Abdominal cramping
Which drug is used to treat pulseless cardiac arrest according to the Advanced Cardiac
Life Support (ACLS) guidelines?
1 Somatropin
2 Vasopressin
3 Desmopressin
4 Luteinizing hormone ✅2 Vasopressin
Which medication, when given with desmopressin, causes increased water retention?
1 Thioridazine
2 Carbamazepine
3 Acetaminophen
4 Norepinephrine ✅2 Carbamazepine
Which effect results from drug therapy for growth hormone deficiency in children?
Select all that apply.
1 Lower plasma albumin levels
2 Increased lipid mobilization
3 Retention of potassium levels
4 Increased retention of sodium
5 Improved tissue-building processes ✅2 Increased lipid mobilization
4 Increased retention of sodium
5 Improved tissue-building processes
, The drugs that mimic growth hormone (GH) are somatropin and somatrem. These
drugs promote growth by stimulating various anabolic (tissue-building) processes, liver
glycogenolysis (to raise blood sugar levels), lipid mobilization from body fat stores, and
retention of sodium, potassium, and phosphorus. These drugs do not cause lower
plasma albumin levels or retention of potassium levels, however. Both drugs promote
linear growth in children who lack normal amounts of the endogenous hormone.
A patient who has a VIPoma tumor reports severe watery diarrhea and sudden
reddening of the face. The primary health care provider instructs the nurse to administer
octreotide. Which form of octreotide dosage is preferred?
1 Oral tablet
2 Capsule dosage
3 Injection (IV/IM)
4 Depot suspension ✅4 Depot suspension
The patient should receive octreotide depot suspension to treat symptoms produced by
excessive substances that are produced by tumors. Oral dosage forms, such as tablets
and capsules, are not manufactured. The nurse would not confuse the depot form of
dosage with octreotide injection, as the latter formulation mimics the actions of
somatostatin.
Which drug is used to diagnose adrenocortical insufficiency?
1 Octreotide
2 Somatropin
3 Cosyntropin
4 Desmopressin ✅3 Cosyntropin
Cosyntropin is used for the diagnosis of adrenocortical insufficiency. The test involves
injecting a small amount of the drug, after which the cortisol levels are measured in
response to the drug. Octreotide is useful in alleviating symptoms of carcinoid tumors.
Somatropin is used in the treatment of growth hormone deficiency. Desmopressin is
useful in the treatment of hemophilia A and type I von Willebrand disease.
A patient is prescribed cosyntropin. Which side effect will the nurse expect?
1 Edema
2 Hypotension
3 Inflammation
4 Scar formation ✅1 Edema
Cosyntropin travels to the adrenal cortex of the kidney and promotes renal retention,
which results in edema. This action is followed by an increase in blood pressure or
hypertension, not hypotension. The process is associated with an antiinflammatory
action. Scar formation in the tissue is also reduced.
A patient with carcinoid crisis has severe diarrhea, flushing, and life-threatening
hypotension. Which drug will be ordered to manage the patient's condition?
