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Pharmacotherapeutics for Advanced Practice Nurse Prescribers 5th Edition Woo Robinson Test Bank Chapter 19. Drugs Affecting the Endocrine System: Pituitary, Thyroid, and Adrenal Drugs£6.24
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Pharmacotherapeutics for Advanced Practice Nurse Prescribers 5th Edition Woo Robinson Test Bank Chapter 19. Drugs Affecting the Endocrine System: Pituitary, Thyroid, and Adrenal Drugs
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Pharmacotherapeutics
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Pharmacotherapeutics
Pharmacotherapeutics for Advanced
Practice Nurse Prescribers 5th Edition Woo
Robinson Test Bank
Chapter 19. Drugs Affecting the Endocrine System: Pituitary, Thyroid, and Adrenal Drugs
pharmacotherapeutics for advanced practice nurse prescribers 5th edition woo robinson test bank chapter 19 drugs affecting the endocrine system pituitary
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Pharmacotherapeutics for Advanced
Practice Nurse Prescribers 5th Edition Woo
Robinson Test Bank
Chapter 19. Drugs Affecting the Endocrine System: Pituitary, Thyroid, and Adrenal Drugs
1. The nurse is teaching the patient, newly diagnosed with Gravess disease, about the normal
functioning of the thyroid gland. What hormone will the nurse tell the patient controls
production and release of thyroid hormones?
A) Thyrotropin-releasing hormone (TRH)
B) Thyroid-stimulating hormone (TSH)
C) Tetraiodothyronine
D) Triiodothyronine
Ans: B
Feedback:
Thyroid hormone production and release are regulated by the anterior pituitary hormone called
thyroid-stimulating hormone (TSH). The secretion of TSH is regulated by thyrotropin-
releasing hormone (TRH), a hypothalamic regulating factor.
Tetraiodothyronine and triiodothyronine are thyroid hormones produced by the thyroid gland
because of TSH stimulation.
2. A child is diagnosed with hypothyroidism. The nurse anticipates an order for the drug of choice
when treating children, which is what?
A) Liothyronine (Cytomel)
B) Liotrix (Thyrolar)
C) Levothyroxine (Synthroid)
D) Methimazole (Tapazole)
Ans: C
Feedback:
Levothyroxine is the drug of choice in children because of its predictable bioavailability and
reliability. Liothyronine and liotrix tend to have more adverse effects and, although they
, can be used in children, are not the drugs of choice. Methimazole is an antithyroid drug and
is used to treat hyperthyroidism.
3. A patient is at risk for thrombosis formation and is taking an oral anticoagulant. The patient
has been newly diagnosed with hypothyroidism and placed on levothyroxine (Synthroid).
What will the nurse monitor the patient for?
A) Tachycardia
B) Elevated body temperature
C) Increased time spent sleeping
D) Increased bruising and bleeding
Ans: D
Feedback:
The effectiveness of an oral anticoagulant is increased if it is used in combination with a
thyroid hormone. This may lead to increased bleeding and the need to decrease the dosage
of the oral anticoagulant. Tachycardia would be found with hyperthyroidism and the
effect of levothyroxine is not increased with the drug combination. Increased time spent
sleeping would indicate lowering of thyroid function and the treatment should increase
thyroid function. Increased body temperature is associated with hyperthyroidism.
4. The nurse is providing patient teaching regarding the administration of levothyroxine
(Synthroid). What is the nurses priority teaching point? A) Take the medication
after breakfast.
B) Take the medication with a full glass of water.
C) Remain in the upright position for 30 minutes after administering.
D) Take the medication before going to bed at night.
Ans: B
Feedback:
The patient should be instructed to take the medication with a full glass of water to help
prevent difficulty swallowing and esophageal atresia. The medication should be taken on an
empty stomach before breakfast. There is no need to maintain an upright position. The
medication should be taken as a single daily dose before breakfast each day to ensure
consistent therapeutic levels.
5. The nurse instructs the patient with a new prescription to treat hyperthyroidism and includes
the importance of regular lab studies to monitor for bone marrow suppression, which can be
an adverse effect of this drug. What drug is the nurse teaching the patient about?
A) Methimazole (Tapazole)
B) Propylthiouracil (PTU)
, C) Sodium iodide I131 (Generic)
D) Potassium iodide (Thyro-Block)
Ans: A
Feedback:
Methimazole is associated with bone marrow suppression, so the patient using this drug
must have frequent blood tests to monitor for this effect. Propylthiouracil is associated with
GI effects. The most common adverse effect of sodium iodide I131 and potassium iodide is
hypothyroidism. Other effects of these two drugs include metallic taste and burning in the
mouth, sore teeth and gums, diarrhea, cold symptoms, stomach upset, stained teeth, rash,
and the development of goiter.
6. A patient is seen in the clinic and diagnosed with hyperthyroidism. Potassium iodide is
prescribed. The nurse reviews the patients medical record before administering the drug. What
assessment finding would cause the nurse to alter the plan of care?
A) A daily walk of 3 miles a day
B) A low fat, low sodium diet
C) A bowel movement every 2 to 3 days
D) Digoxin 0.125 mg daily
Ans: D
Feedback:
Potassium iodide will cause the patient to move from hyperthyroidism to hypothyroidism,
thus altering the patients metabolism. Digoxin has a small margin of safety that could be
altered by a change in thyroid function. The patient will need to be monitored carefully for
an alteration in digoxin effects that may include an increased heart rate, arrhythmia, or
reduced cardiac output. A daily walk of 3 miles, a low fat, low sodium diet, and a bowel
movement every 2 to 3 days are important for maintenance of a healthy lifestyle but
would not alter the plan of care.
7. A patient with Pagets disease calls the clinic and tells the nurse that she is experiencing flushing
of the face and hands and a rash. The patient states that she is taking calcitonin, salmon
(Calcimar) for her Pagets disease. What is the nurses best response?
A) We expected this to happen. Just ignore it and please do not worry about it.
B) You will need to see the doctor immediately. Come in as soon as possible.
C) This is a common adverse effect of your medication that will lessen with time.
D) This is a serious adverse effect. Stop taking the drug and see the doctor today.
Ans: C
Feedback:
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