Chapter 59: Drugs Related to Hypothalamic and Pituitary Function

Chapter 59: Drugs Related to Hypothalamic and Pituitary Function

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A child with Prader-Willi syndrome (PWS) has short stature, and the provider is considering treatment with growth hormone. Which aspect of this child’s history should the nurse report to the provider?

a.	Behavior problems
b.	Low muscle tone
c.	Mental impairment
d.	Sleep apnea

 

 

ANS:  D

Growth hormone must be avoided in patients with PWS who are severely obese, who have a history of upper airway obstruction or sleep apnea, or who have severe respiratory impairment because of a risk of sudden death associated with these disorders. Behavior problems, low muscle tone, and mental impairment are commonly associated with PWS and are not contraindications to treatment with growth hormone.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 718

TOP:   Nursing Process: Assessment

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential

 

2. A nurse is providing teaching for a nondiabetic adult who develops growth hormone deficiency and who will begin treatment with somatropin [Humatrope]. Which statement by the patient indicates understanding of the teaching?

a.	“Intramuscular dosing is more effective than subcutaneous dosing.”
b.	“I will have increased muscle mass and strength as well as increased height.”
c.	“I will need to monitor my blood pressure frequently while taking this drug.”
d.	“I will need to take insulin while using this, because it causes hyperglycemia.”

 

 

ANS:  C

Growth hormone in adults causes an increase in systolic blood pressure, so patients should be taught to monitor blood pressure while taking the drug. Subcutaneous dosing is as effective as IM dosing and is preferred, because it is less painful. Although muscle mass will increase, strength and height will not. Growth hormone is diabetogenic but causes significant problems in patients with preexisting diabetes.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 718

TOP:   Nursing Process: Planning

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

 

3. A 7-year-old child who is otherwise healthy is receiving mecasermin [Increlex] replacement therapy to treat severe primary deficiency of insulin-like growth factor-1 (IGF-1). The child develops tonsillar hypertrophy. The nurse anticipates that the provider will recommend:

a.	antibiotics.
b.	reducing the dose of mecasermin.
c.	discontinuing the mecasermin.
d.	tonsillectomy.

 

 

ANS:  D

Mecasermin can cause hypertrophy of the tonsils, which can be managed by tonsillectomy if needed. Antibiotics are not indicated, because the tonsil enlargement is not caused by infection. Neither reducing the dose of mecasermin nor discontinuing the drug is indicated.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   pp. 718-719

TOP:   Nursing Process: Evaluation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

 

4. A nurse is preparing to administer a dose of growth hormone and reconstitutes the medication. After adding the diluent, the nurse notices that the preparation is cloudy. What will the nurse do?

a.	Administer the drug as ordered.
b.	Discard the drug and prepare another dose.
c.	Notify the prescriber.
d.	Shake the drug to dissipate the particles.

 

 

ANS:  B

The medication should not be injected if the preparation is cloudy or contains particulate matter. The drug should be discarded and another dose drawn up and administered. There is no need to notify the prescriber. The preparation should never be shaken.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 723

TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies