Question

The nurse is developing a plan of care for an 84-year-old client who has been diagnosed with diabetes and is receiving oral hydrocortisone 40 mg daily for treatment of arthritis. What is the nurse's priority?

Answer 1

Correct Answers:

monitoring blood glucose levels frequently

Rationale :

🟣Hydrocortisone, a corticosteroid, increases glucose production by stimulating gluconeogenesis in the liver, which can lead to hyperglycemia, especially in clients with diabetes.

🟣Older adults, such as this 84-year-old client, have decreased physiologic reserves and are at higher risk for complications like hyperosmolar hyperglycemic states (HHS) when blood glucose levels are not well monitored.

🟣Frequent glucose monitoring allows for timely medication adjustment and dietary management to prevent severe fluctuations.

🟣Long-term corticosteroid use also reduces insulin sensitivity, increasing the risk for poor glycemic control.

🟣Therefore, the priority nursing action is to monitor blood glucose levels closely to detect and manage hyperglycemia early.

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Answer 2

Correct Answers:

spontaneous fractures

Rationale :

🔶Long-term glucocorticoid therapy causes calcium resorption from bones, leading to osteoporosis and increased fracture risk.

🔶These drugs decrease osteoblast activity and promote osteoclast activity, resulting in bone weakening over time.

🔶Older adults, like the 66-year-old client, are especially vulnerable because of age-related bone density loss.

🔶Regular bone mineral density assessments and adequate calcium and vitamin D supplementation should be part of care.

🔶Educating clients on fall prevention and weight-bearing exercises helps minimize risk for spontaneous fractures.

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Answer 3

Correct Answers:

impaired wound healing

Rationale :

💠Glucocorticoids suppress the inflammatory and immune responses, which are vital in the wound healing process.

💠They inhibit fibroblast proliferation and collagen synthesis, both essential for tissue repair.

💠Postoperative patients on long-term steroid therapy have delayed healing, increasing risk for infection or wound dehiscence.

💠Nurses should monitor surgical sites for signs of infection and collaborate with the provider on possible tapering or alternate therapy.

💠Maintaining good nutrition and aseptic wound care can help mitigate this adverse effect.

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Answer 4

Correct Answers:

"Take the medication before going to bed at night."

Rationale :

🟣Levothyroxine absorption is best on an empty stomach with a full glass of water to ensure complete dissolution and prevent esophageal irritation.

🟣The drug must be taken in the morning, 30–60 minutes before breakfast, as food interferes with absorption.

🟣Adequate water prevents tablet adherence to the esophagus, which can cause mucosal damage, especially in older adults.

🟣Consistency in administration timing promotes stable thyroid hormone levels and effective symptom control.

🟣Patient education on correct timing and method ensures optimal therapeutic outcomes for hypothyroidism.

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Answer 5

Correct Answers:

nervousness, tachycardia, tremors

Rationale :

🔷Overdose of levothyroxine results in hyperthyroidism symptoms due to excessive thyroid hormone activity.

🔷This increases metabolic rate, causing manifestations such as nervousness, anxiety, insomnia, and fine tremors.

🔷Tachycardia and palpitations occur due to the stimulatory effects of thyroid hormones on cardiac tissue.

🔷Severe toxicity may lead to thyrotoxic crisis, which can be life-threatening if untreated.

🔷Monitoring of heart rate and thyroid function tests (T3, T4, TSH) is crucial for safe dosage management.

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Answer 6

Correct Answers:

glucagon intravenous injection

Rationale :

♦ Glucagon rapidly increases blood glucose by stimulating hepatic glycogenolysis and gluconeogenesis.

♦ It is the drug of choice for severe hypoglycemia when oral intake or IV dextrose is not immediately possible.

♦ At a glucose level of 19 mg/dL, the brain is at risk for hypoglycemic coma, so immediate IV administration is critical.

♦ After glucagon, follow with IV glucose or oral carbohydrates once the patient regains consciousness to prevent recurrence.

♦ Continuous blood glucose monitoring ensures stabilization after emergency correction.

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Answer 7

Correct Answers:

insulin

Rationale :

🔵Insulin is the preferred agent for pregnancy-induced diabetes (gestational diabetes) because it does not cross the placental barrier, ensuring fetal safety.

🔵It provides tight glycemic control, which reduces the risk of macrosomia, neonatal hypoglycemia, and birth complications.

🔵Oral hypoglycemics may pose potential teratogenic effects or cross into fetal circulation.

🔵Insulin requirements often fluctuate during pregnancy; close monitoring prevents both hyper- and hypoglycemia.

🔵The nurse educates the client on proper injection technique, diet, and glucose monitoring for safe management.

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Answer 8

Correct Answers:

decreased urine output

Rationale :

🟢Desmopressin (DDAVP) is a synthetic analog of antidiuretic hormone (ADH) that promotes renal water reabsorption.

🟢The expected outcome in diabetes insipidus is a reduction in urine output and improved urine concentration.

🟢It acts on renal collecting ducts, reducing diuresis and preventing dehydration.

🟢Monitoring fluid balance and urine specific gravity helps evaluate treatment effectiveness.

🟢An overly large decrease in output or hyponatremia may indicate water intoxication, requiring dose adjustment.

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Answer 9

Correct Answers:

The time it takes for half of the drug dose to be eliminated from the body

Rationale :

⚪A drug’s half-life determines dosing intervals and duration of therapeutic effect.

⚪It represents the time required for 50% of the drug concentration to be metabolized or excreted.

⚪Drugs with longer half-lives are administered less frequently, while those with shorter half-lives need more frequent dosing.

⚪Understanding half-life ensures proper timing to maintain steady plasma concentration and avoid toxicity.

⚪It is also used in calculating withdrawal times and dosage adjustments in renal or hepatic impairment.

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Answer 10

Correct Answers:

Regular insulin

Rationale :

🟣 Regular insulin is the insulin of choice for emergency management of diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS).

🟣 It can be given intravenously, allowing for rapid onset and easy titration according to blood glucose levels.

🟣 A glucose level of 785 mg/dL indicates severe hyperglycemia requiring immediate reduction under close monitoring.

🟣 Insulin glargine and NPH are long-acting forms unsuitable for acute control.

🟣 Continuous IV infusion of regular insulin helps restore cellular glucose uptake and reduce ketone production safely.

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ADRN 114 Pharm M-S 3 Exam 1

No.

1 :
The nurse is developing a plan of care for an 84-year-old client who has been diagnosed with diabetes and is receiving oral hydrocortisone 40 mg daily for treatment of arthritis. What is the nurse's priority?

2 :
A 66-year-old client is on long-term oral glucocorticoid therapy to treat chronic obstructive pulmonary disease. When providing teaching about this medication, the nurse will inform this client that there is a particularly high risk for what to occur?

3 :
Nursing care for the postoperative client requiring long-term glucocorticoid drug therapy will be directed at overcoming what side effect of this medication?

4 :
The nurse is providing an older adult client teaching regarding the administration of levothyroxine. What is the nurse's priority teaching point?

5 :
What assessment findings would the nurse expect to see in a client who has overdosed on levothyroxine?

6 :
A client is brought to the emergency department with signs of hypoglycemia and a blood glucose level of 19 mg/dL. What drug should the nurse prepare to administer intravenously?

7 :
The nurse is caring for a client who has been diagnosed with pregnancy-induced diabetes. The nurse understands what antidiabetic agent is best suited for administration to this client?

8 :
The nurse administers desmopressin (DDAVP) to the client to treat diabetes insipidus. What assessment finding would indicate to the nurse that the desmopressin is producing the desired therapeutic effect?

9 :
What is the "half-life" of a drug?

10 :
A client is admitted to the emergency department with a blood glucose level of 785 mg/dL. The nurse anticipates that this type of insulin that will be ordered for this client:

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ADRN 114 Pharm M-S 3 Exam 1

No.

1 : The nurse is developing a plan of care for an 84-year-old client who has been diagnosed with diabetes and is receiving oral hydrocortisone 40 mg daily for treatment of arthritis. What is the nurse's priority?

2 : A 66-year-old client is on long-term oral glucocorticoid therapy to treat chronic obstructive pulmonary disease. When providing teaching about this medication, the nurse will inform this client that there is a particularly high risk for what to occur?

3 : Nursing care for the postoperative client requiring long-term glucocorticoid drug therapy will be directed at overcoming what side effect of this medication?

4 : The nurse is providing an older adult client teaching regarding the administration of levothyroxine. What is the nurse's priority teaching point?

5 : What assessment findings would the nurse expect to see in a client who has overdosed on levothyroxine?

6 : A client is brought to the emergency department with signs of hypoglycemia and a blood glucose level of 19 mg/dL. What drug should the nurse prepare to administer intravenously?

7 : The nurse is caring for a client who has been diagnosed with pregnancy-induced diabetes. The nurse understands what antidiabetic agent is best suited for administration to this client?

8 : The nurse administers desmopressin (DDAVP) to the client to treat diabetes insipidus. What assessment finding would indicate to the nurse that the desmopressin is producing the desired therapeutic effect?

9 : What is the "half-life" of a drug?

10 : A client is admitted to the emergency department with a blood glucose level of 785 mg/dL. The nurse anticipates that this type of insulin that will be ordered for this client:

1 :
The nurse is developing a plan of care for an 84-year-old client who has been diagnosed with diabetes and is receiving oral hydrocortisone 40 mg daily for treatment of arthritis. What is the nurse's priority?

2 :
A 66-year-old client is on long-term oral glucocorticoid therapy to treat chronic obstructive pulmonary disease. When providing teaching about this medication, the nurse will inform this client that there is a particularly high risk for what to occur?

3 :
Nursing care for the postoperative client requiring long-term glucocorticoid drug therapy will be directed at overcoming what side effect of this medication?

4 :
The nurse is providing an older adult client teaching regarding the administration of levothyroxine. What is the nurse's priority teaching point?

5 :
What assessment findings would the nurse expect to see in a client who has overdosed on levothyroxine?

6 :
A client is brought to the emergency department with signs of hypoglycemia and a blood glucose level of 19 mg/dL. What drug should the nurse prepare to administer intravenously?

7 :
The nurse is caring for a client who has been diagnosed with pregnancy-induced diabetes. The nurse understands what antidiabetic agent is best suited for administration to this client?

8 :
The nurse administers desmopressin (DDAVP) to the client to treat diabetes insipidus. What assessment finding would indicate to the nurse that the desmopressin is producing the desired therapeutic effect?

9 :
What is the "half-life" of a drug?

10 :
A client is admitted to the emergency department with a blood glucose level of 785 mg/dL. The nurse anticipates that this type of insulin that will be ordered for this client: