1. Somatropin (Humatrope) is being given to a female patient with turner syndrome. Which of the following findings is associated with this medication?
- Decreases ALT and AST level.
- Mild hyperglycemia.
- Hypotension.
- Water intoxication.
2. A nurse provide instructions to a client regarding the administration of the prednisone and instructs the client that the best time to take the medication is during?
- Any time of the day.
- Early morning.
- Lunch.
- Before bedtime.
3. A client with diabetes insipidus is taking antidiuretic hormone. Which of the following symptoms would alert the need to decrease the dosage?
- Alopecia.
- Jaundice.
- Diarrhea.
- Drowsiness.
4. Which of the following medications decreases their action while taking thyroid hormone?
- Metformin.
- Warfarin.
- Zoloft.
- Epinephrine.
5. Prednisone is prescribed for a client with diabetes mellitus who is using Humulin 70/30 daily. Which of the following prescription changes does the nurse expect during the therapy with the prednisone?
- An addition of an oral hypoglycemic medication.
- Increased dosage of prednisone.
- Increased dosage of humulin 70/30.
- Decreased dosage of humulin 70/30.
6. A nurse is instructing a client regarding intranasal Vasopressin (Pitressin). The nurse tells the client that which of the following is a side effect specific to the medication?
- Runny nose.
- Headache.
- Flushing.
- Nausea.
7. A nurse is performing an assessment on a newly admit patient who is taking propylthiouracil (PTU) daily. The nurse suspects that the client has a history of?
- Addison’s disease.
- Cushing’s syndrome.
- Grave’s disease.
- Myxedema.
8. A nurse is giving discharge instructions a patient who is taking levothyroxine (Synthroid). The nurse instruct the client to notify the physician if which of the following occurs?
- Cold intolerance.
- Tremors.
- Coarse, dry hair.
- Muscle cramps.
9. A nurse is giving instructions a patient who is taking levothyroxine (Synthroid). The nurse tells the client that the best time to take this medication is?
- During bedtime.
- After lunch.
- Taken with food.
- Taken on an empty stomach.
10. Desmopressin acetate (DDAVP) is given to a patient with diabetes insipidus. Which of the following therapeutic response should you expect?
- Decreased blood pressure.
- Decreased attention span.
- Decreased urinary output.
- Decreased blood sugar.
11. A patient adrenal insufficiency is to be discharged and is given Prednisone as a home medication. The nurse instruct the patient the following, except?
- To avoid aspirin-containing products.
- To avoid foods rich in potassium.
- To avoid caffeinated drinks.
- To avoid individuals with respiratory infections.
12. Sildenafil (Viagra) is given to a patient with erectile dysfunction. Which of the following history is contraindicated with the medication?
- Blurred vision.
- Neuralgia.
- Use of vitamins.
- Use of nitroprusside.
13. Glipizide (Glucotrol) is prescribed to a patient with diabetes mellitus. The nurse instruct the patient to avoid which of the following?
- Soft drinks.
- Whole grain cereals.
- Alcohol.
- Organ meats.
14. A nurse is teaching a patient on how to mix regular insulin and NPH insulin in the same syringe. Which of the following actions, if performed by the patient , indicates the need for further teaching?
- Withdraws regular insulin first.
- Withdraws NPH insulin first.
- Injects an amount of air equivalent to the desired dose of insulin.
- Injects air into the NPH insulin first.
15. A patient is taking insulin glargine injection daily. The nurse instruct the client that the onset of action will likely happen?
- 2-4 hours after administration.
- 4-12 hours after administration.
- 6-12 hours after administration.
- 18-24 hours after administration.
16. A private nurse visits a client who is taking Humulin NPH insulin daily. The client asks the nurse on how is the storage of the unopened vials of insulin. The nurse tells the client to:
- Store it at room temperature.
- Store it in the freezer.
- Store it in the refrigerator.
- Keep the insulin in a sunlight, dry place.
17. A client with diabetes mellitus type I was prescribed with Exenatide (Bydureon). The nurse will take which of the following appropriate actions?
- Withdraw the insulin from the prefilled pen into an insulin syringe.
- Monitor for signs of nausea, vomiting, and gastric upset.
- Administer the medication twice a day during pre-meals.
- Hold the medication and call the physician to question the prescription.
18. Which of the following insulin cannot be mixed with any other type of insulin?
- Insulin glargine.
- Insulin aspart.
- Insulin isophane.
- Insulin lispro.
19. Which of the following medications causes hypoglycemia, except?
- Salicylates.
- Oral contraceptives.
- Sulfonamides.
- Anticoagulants.
20. A nurse is providing instruction to a client who is prescribed with Repaglinide (Prandin). All of which is true regarding this medication, except?
- Do not skip the dose when a meal is not taken.
- Dizziness may occur while taking it.
- Has quicker and shorter duration of action.
- Use to treat type II diabetes mellitus.
Answers and Rationale
1. Answer: B. Mild hyperglycemia. Somatropin (Humatrope) is a growth hormone. Excess growth hormone causes insulin resistance and hyperglycemia.
- Option A: Elevated AST and ALT is expected.
- Option C: Hypertension, not hypotension is a side effect.
- Option D is not related symptom to this medication.
2. Answer: B. Early morning. Prednisone is a corticosteroid (glucocorticoids) is administered early in the morning because it helps in reducing adrenal insufficiency and simulate the burst of glucocorticoids released naturally by the adrenal glands each morning.
3. Answer: D. Drowsiness. One of the side effects of taking antidiuretic hormone is water intoxication which is manifested by a headache, drowsiness, light-headedness, and shortness of breath. This could indicate the need to reduce the dosage.
- Options A, B, and C are not related signs to this medication.
4. Answer: A. Metformin. Metformin, an oral hypoglycemic drug when taken with a thyroid hormone decreases their action.
- Options B (anticoagulant), Option C (antidepressant) and Option D (sympathomimetic) increases their action when taken with a thyroid hormone.
5. Answer: C. Increased dosage of humulin 70/30. Prednisone a glucocorticoid increases blood glucose level hence people with diabetes needs to increase the dosage of their insulin.
- Options A, B, and D will not help the cause.
6. Answer: A. Runny nose. Vasopressin administered via intranasal route causes nasal congestion/Runny nose.
- Options B, C, and D are the side effects of the medication administered intravenously.
7. Answer: C. Grave’s disease. Propylthiouracil inhibits the synthesis of thyroid hormone and is used to treat Grave’s disease or hypothyroidism.
- Options A and B are disorders related to adrenal function.
- Option D indicates hypothyroidism.
8. Answer: B. Tremors. Excessive doses of levothyroxine can produce signs and symptoms of hyperthyroidism which includes heat tolerance, tremors, nervousness, tachycardia, chest pain, hyperthermia, and insomnia.
- Options A, C, and D are signs of hypothyroidism.
9. Answer: D. Taken on an empty stomach. Levothyroxine is taken on an empty stomach usually before breakfast to enhance the absorption.
10. Answer: C. Decreased urinary output. The therapeutic response of this medication is decreased urine output because it promotes renal conservation of water.
- Options A, B, and D are unrelated effect to this medication.
11. Answer: B. To avoid foods rich in potassium. One of the side effects of taking prednisone is hypokalemia so a potassium rich food should be included in the diet.
12. Answer: D. Use of nitroprusside. Sildenafil (Viagra) are contraindicated in patients taking nitrates, nitroprusside, and beta blockers.
- Options A and B are the side effects of this medication.
- Option C is not contraindicated with the use of sildenafil.
13. Answer: C. Alcohol. Alcohol when combined with glipizide, a disulfiram-like reaction (flushing, headache, and nausea) happens. In addition, large amounts of alcohol cause hypoglycemia.
- Options A, B, and D are not to be avoided.
14. Answer: B. Withdraws NPH insulin first. The regular insulin is drawn into the syringe first then the NPH, this will avoid contaminating the regular insulin vial with another type.
- Options A, C, and D are correct actions for preparing regular and NPH insulin.
15. Answer: A. 2-4 hours after administration. Insulin glargine is a long-acting insulin with an onset of 2-4 hours, no peak, and its duration of action is 24 hours.
16. Answer: C. Store it in the refrigerator. Unopened insulin is stored in the refrigerator until the expiry date.
- Option A: Only opened vials are stored at room temperature and it will only last for 28 days.
- Option B: It should never be stored in the freezer.
- Option D: Insulin are sensitive to light.
17. Answer: D. Hold the medication and call the physician to question the prescription. Exenatide (Bydureon) is only used to treat diabetes mellitus type 2 only. Therefore, holding the medication and calling the physician to question the order.
- Option A: A prefilled pens are ready for injection.
- Options B and C: Although are correct about the medication, it should not be administered in this kind of situation.
18. Answer: A. Insulin glargine. Only insulin glargine cannot be mixed with any other types of insulin.
19. Answer: B. Oral contraceptives. Medications such as thiazide diuretics, corticosteroids, oral contraceptives, estrogen, and sympathomimetics cause hyperglycemia.
20. Answer: A. Do not skip the dose when a meal is not taken.Repaglinide (Prandin) is a meglitinide type of antidiabetic which has a quick onset of action which allows a client to take the medication with meals and skip a dose when a meal is skipped.