Chapter 33: Adrenal Drugs

Chapter 33: Adrenal Drugs

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The nurse is administering adrenal drugs to a patient. Which action by the nurse is appropriate for this patient?

a.	Administering oral drugs on an empty stomach to maximize absorption
b.	Rinsing the oral cavity after using corticosteroid inhalers
c.	Administering the corticosteroids before bedtime to minimize adrenal suppression
d.	Discontinuing the medication immediately if weight gain of 5 pounds or more in 1 week occurs

 

 

ANS:  B

After the patient has used the corticosteroid inhalers, cleaning the oral cavity helps to prevent possible oral fungal infections from developing. Adrenal drugs need be taken with meals to minimize gastrointestinal upset and in the mornings to minimize adrenal suppression, and they need to be discontinued by weaning, not abruptly.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   p. 530

TOP:   NURSING PROCESS: Implementation

MSC:  NCLEX: Safe and Effective Care Environment: Management of Care

 

2. A patient will be starting therapy with a corticosteroid. The nurse reviews the patient’s orders and notes that an interaction may occur if the corticosteroid is taken with which of these drug classes?

a.	Nonsteroidal anti-inflammatory drugs
b.	Antibiotics
c.	Opioid analgesics
d.	Antidepressants

 

 

ANS:  A

The use of corticosteroids with aspirin, other NSAIDs, and other ulcerogenic drugs produces additive gastrointestinal effects and an increased chance for the development of gastric ulcers. The other options are incorrect.

 

DIF:    COGNITIVE LEVEL: Understanding (Comprehension)    REF:   p. 526

TOP:   NURSING PROCESS: Assessment

MSC:  NCLEX: Safe and Effective Care Environment: Management of Care

 

3. A patient is concerned about the body changes that have resulted from long-term prednisone therapy for the treatment of asthma. Which effect of this drug therapy would be present to support the nursing diagnosis of disturbed body image?

a.	Weight loss
b.	Weight gain
c.	Pale skin color
d.	Hair loss

 

 

ANS:  B

Facial erythema, weight gain, hirsutism, and “moon face” (characteristic of Cushing’s syndrome) are possible body changes that may occur with long-term prednisone therapy.

 

DIF:    COGNITIVE LEVEL: Analyzing (Analysis)                     REF:   p. 527

TOP:   NURSING PROCESS: Nursing Diagnosis

MSC:  NCLEX: Psychosocial Integrity

 

4. A patient is taking fludrocortisone (Florinef) for Addison’s disease, and his wife is concerned about all of the problems that may occur with this therapy. When teaching them about therapy with this drug, the nurse will include which information?

a.	It may cause severe postural hypotension.
b.	It needs to be taken with food or milk to minimize gastrointestinal upset.
c.	The medication needs to be stopped immediately if nausea or vomiting occurs.
d.	Weight gain of 5 pounds or more in 1 week is an expected adverse effect.

 

 

ANS:  B

Patients receiving fludrocortisone need to take it with food or milk to minimize gastrointestinal upset; weight gain of 5 pounds or more in 1 week needs to be reported to the physician; abrupt withdrawal is not recommended because it may precipitate an adrenal crisis. Adverse effects are related to the fluid retention and may include heart failure and hypertension.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   p. 531

TOP:   NURSING PROCESS: Implementation

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies