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Saunders Endocrine Pharmacology Questions with Answers

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Saunders Endocrine Pharmacology Questions with Answers The normal serum calcium level is 4.5 to 5.5 mEq/L or 9 to 11 mg/dL. Calcitonin, a thyroid hormone, decreases the plasma calcium level by increasing the incorporation of calcium into the bones thus keeping it out of the serum. In hypercalcemi...

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Saunders Endocrine Pharmacology
Questions with Answers

The normal serum calcium level is 4.5 to 5.5 mEq/L or 9 to 11 mg/dL. Calcitonin, a
thyroid hormone, decreases the plasma calcium level by increasing the incorporation of
calcium into the bones thus keeping it out of the serum. In hypercalcemia, large doses
of vitamin D should be avoided. Encourage high fluid intake (3000 to 4000 mL/day).
Furosemide (Lasix) may be given to promote the excretion of calcium in the urine.
Determine the patient's ability to perform self-care safely and provide help as needed.

A client informs the nurse that she has been taking acarbose as prescribed. The nurse
determines that a therapeutic effect of the medication has occurred if which laboratory
value is noted?

1.A serum lipase of 100 units/L
2.A sodium level of 140 mEq/L
3.A blood urea nitrogen (BUN) level of 15 mg/dL
4.A 2-hour postprandial serum glucose of 120 mg/dL - Answer-4. A 2-hour postprandial
serum glucose of 120 mg/dL

Acarbose is an oral antidiabetic medication used as an adjunct to diet to lower blood
glucose in clients with type 2 diabetes mellitus whose hyperglycemia cannot be
managed by diet alone. All of the laboratory values presented in the options are within a
normal value. Lipase level monitors pancreatic activity. Sodium is an electrolyte. The
BUN measures renal function. A 2-hour postprandial serum glucose of 120 mg/dL would
identify a therapeutic effect of the medication.

Metformin is prescribed for a client with type 2 diabetes mellitus. Which should the
nurse tell the client is a common side effect of the medication?

1.Weight gain
2.Hypoglycemia
3.Flushing and palpitations
4.Gastrointestinal (GI) disturbances - Answer-4. Gastrointestinal (GI) disturbances

The most common side effect of metformin is GI disturbances, including decreased
appetite, nausea, and diarrhea. These generally subside over time. This medication
does not cause weight gain; in fact, clients lose an average of 7 to 8 pounds because
the medication causes decreased appetite. Hypoglycemia may be an adverse effect.
Option 3 is not related to the use of this medication.

,When discussing the rationale for levothyroxine with a client with hypothyroidism, the
nurse should emphasize that the client can anticipate which primary expected outcome?

1.Alleviating depression
2.Increasing energy levels
3.Increasing blood glucose levels
4.Achieving normal thyroid hormone levels - Answer-4. Achieving normal thyroid
hormone levels

Laboratory determination of the serum thyroid-stimulating hormone level (TSH) is an
important means of evaluation of therapy with levothyroxine. Effective therapy will cause
the elevated TSH levels to decrease. These levels will begin their decline within hours
of the onset of therapy and will continue to drop as plasma levels of thyroid hormone
build up. If an adequate dosage is established, TSH levels will remain suppressed for
the duration of the therapy. Although energy levels are expected to increase, the
primary expected outcome is measured by thyroid hormone levels. Options 1 and 3 are
unrelated to this medication.

Insulin glargine is prescribed for a client with diabetes mellitus. The nurse tells the client
that which is the best time to take the insulin?

1.1 hour after each meal
2.Once daily at the same time each day
3.15 minutes before breakfast, lunch, and dinner
4.Before each meal on the basis of the blood glucose level - Answer-2.Once daily at the
same time each day

Insulin glargine is a long-acting recombinant DNA human insulin used to treat type 1
and type 2 diabetes mellitus. It has 24-hour duration of action and is administered once
a day at the same time each day.

Which instruction should the nurse reinforce to the client with diabetes mellitus receiving
acarbose? Select all that apply.

1."Take the medication at bedtime."
2."Take the medication with each meal."
3."Take the medication on an empty stomach."
4."Side effects include abdominal bloating and flatus."
5."Take some form of glucose if hypoglycemia occurs."
6."Report symptoms such as shortness of breath or tiredness." - Answer-2 ."Take the
medication with each meal."
4. "Side effects include abdominal bloating and flatus."
5. "Take some form of glucose if hypoglycemia occurs."
6. "Report symptoms such as shortness of breath or tiredness."

, The mechanism of action of acarbose is a delay in absorption of dietary carbohydrates,
thereby reducing the rise in blood glucose after a meal. To accomplish this, the
medication must be taken with each meal. Because of its bacterial fermentation of
unabsorbed carbohydrates in the colon, side effects such as borborygmus, cramps,
abdominal distention, and flatulence can occur. The medication also can affect
absorption of iron, leading to symptoms (shortness of breath, tiredness) of anemia.

A client diagnosed with hypothyroidism is taking levothyroxine. The client returns to the
clinic 1 week after beginning the medication and tells the nurse that the medication has
not helped. The appropriate nursing response to the client is based on which
information?

1.A higher dosage is required.
2.The medication may need to be changed.
3.Full therapeutic effect may take 1 to 3 weeks.
4.Full therapeutic effect may take up to 4 months. - Answer-Levothyroxine is used in the
treatment of hypothyroidism. Although therapy with levothyroxine may begin with small
doses that are gradually increased, the appropriate response is to inform the client that
full therapeutic effect may take 1 to 3 weeks. Options 1, 2, and 4 are inaccurate.

3.Full therapeutic effect may take 1 to 3 weeks.


The nurse preparing a client for surgery reviews the client's medication record. The
client is to receive nothing by mouth (NPO) after midnight. Which medication noted on
the client's record should the nurse question?
1.Allopurinol
2.Prednisone
3.Alendronate
4.Cyclobenzaprine - Answer-2. Prednisone

Prednisone is a corticosteroid that can cause adrenal atrophy, which reduces the body's
ability to withstand stress. Before and during surgery, dosages may be temporarily
increased. Cyclobenzaprine is a skeletal muscle relaxant. Alendronate is a bone-
resorption inhibitor. Allopurinol is an antigout medication.

The nurse is asked to prefill syringes containing NPH and regular insulin for a diabetic
client who lives at home alone and has difficulty with seeing and accurately preparing
dosages. Considering the stability of insulin, which number of prefilled syringes should
the nurse prepare for the client?
1.A 3-day supply
2.A 5-day supply
3.A 7-day supply
4.A 1-month supply - Answer-3. A 7-day supply

Mixtures of insulin in prefilled syringes should be stored in a refrigerator where they will
be stable for at least 1 week. The syringe should be stored vertically with the needle

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