Chapter 37: Corticosteroids

Chapter 37: Corticosteroids

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A patient has been on high-dose corticosteroid therapy for the treatment of lupus erythematosus. In addition to monitoring electrolyte levels, which laboratory studies will the nurse monitor?

ANS:  D

Corticosteroid therapy may induce hyperglycemia, particularly in prediabetic or diabetic patients. All patients must be monitored for the development of hyperglycemia, particularly during the early weeks of therapy. Steroids do not affect blood count, bleeding time, or liver function.

DIF:    Cognitive Level: Application           REF:   Page 581        OBJ:   3

TOP:   Nursing Process Step: Assessment

MSC:  NCLEX Client Needs Category: Physiological Integrity

NOT:  CONCEPT(S): Clinical Judgment; Hormonal Regulation; Glucose Regulation

2. A patient who has been taking glucocorticoids over the past 3 months for Crohn’s disease comes in for a follow-up visit. On assessment, the nurse notes facial edema, thinning extremities, and a fatty deposition (buffalo hump) on the scapular area. The patient reports the symptoms of the Crohn’s disease are “somewhat better.” What will the nurse expect the treatment to be?

ANS:  C

Glucocorticoids are primarily used as anti-inflammatory agents. Because the symptoms are improving, the physician will most likely maintain the steroid dosage. Adverse effects are anticipated with corticosteroid therapy. Decreasing the dose will not help the condition. Increasing the dose will exacerbate the adverse effects, and the condition is improving with the current dosage. Stopping the dosage will not help the condition or the adverse effects.

DIF:    Cognitive Level: Application           REF:   Page 586        OBJ:   4

TOP:   Nursing Process Step: Evaluation

MSC:  NCLEX Client Needs Category: Health Promotion and Maintenance

NOT:  CONCEPT(S): Clinical Judgment; Hormonal Regulation; Safety

3. What is the rationale for administering glucocorticoid therapy as an adjunct to chemotherapeutic agents?

ANS:  C

Glucocorticoids have an anti-inflammatory and antiallergenic action. Suppression of inflammation resulting from cancer enhances the effectiveness of the chemotherapeutic agents. Glucocorticoids do not have an analgesic effect. Glucocorticoids increase blood glucose, but it is an adverse effect, not a primary effect. Glucocorticoids do not reduce mucositis.

DIF:    Cognitive Level: Comprehension     REF:   Page 584        OBJ:   4

TOP:   Nursing Process Step: Evaluation

MSC:  NCLEX Client Needs Category: Health Promotion and Maintenance

NOT:  CONCEPT(S): Clinical Judgment; Hormonal Regulation; Safety

4. A patient with type 1 diabetes was prescribed a glucocorticoid for chronic obstructive pulmonary disease. Which will the nurse expect in the treatment plan?

ANS:  D

Glucocorticoids may elevate blood glucose levels and induce hyperglycemia, particularly in prediabetic or diabetic patients. Insulin needs increase with an increase in blood glucose levels. Carbohydrate needs will not increase.

DIF:    Cognitive Level: Application           REF:   Page 586        OBJ:   4

TOP:   Nursing Process Step: Evaluation

MSC:  NCLEX Client Needs Category: Health Promotion and Maintenance

NOT:  CONCEPT(S): Clinical Judgment; Hormonal Regulation; Glucose Regulation; Safety