Chapter 72: Glucocorticoids in Nonendocrine Disorders

Chapter 72: Glucocorticoids in Nonendocrine Disorders

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A nurse is discussing glucocorticoids with a group of nursing students. Which statement by a student indicates understanding of the teaching?

a.	“Glucocorticoids have both endocrine and nonendocrine uses.”
b.	“Patients treated for adrenocortical insufficiency receive pharmacologic doses.”
c.	“Pharmacologic effects are achieved with low doses of glucocorticoids.”
d.	“Physiologic doses are used to treat inflammatory disorders.”

 

 

ANS:  A

Glucocorticoids have applications for both endocrine and nonendocrine disorders. Adrenocortical insufficiency requires physiologic, or low-dose, treatment. Pharmacologic doses are used when large doses are required, such as to suppress inflammation. Physiologic doses are used to treat endocrine disorders.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 869

TOP:   Nursing Process: Implementation

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

 

2. A nurse tells a nursing student that the glucocorticoids given for rheumatoid arthritis are nearly identical to substances produced naturally by the body. The student remarks that the drug must be very safe. Which response by the nurse is correct?

a.	“As long as the drug is taken as prescribed, side effects usually do not occur.”
b.	“By interrupting the inflammatory process, these drugs inhibit side effects.”
c.	“Side effects can occur and are dependent on the dose and duration of treatment.”
d.	“The negative feedback loop prevents side effects.”

 

 

ANS:  C

When taken in pharmacologic doses, as for inflammatory disorders, glucocorticoids can cause an array of serious adverse effects. When glucocorticoids are given in pharmacologic doses, side effects can occur even when the drugs are taken as prescribed. Interruption of the inflammatory process causes some of the adverse effects. The negative feedback loop does not inhibit side effects.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   pp. 869-870

TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs Category: Pharmacologic and Parenteral Therapies

 

3. A clinic patient who has been taking a glucocorticoid for arthritis for several months remarks to the nurse, “It’s a good thing my symptoms are better, because my mother has been quite ill, and I have to take care of her.” The patient’s blood pressure is 100/60 mm Hg. The nurse will report this to the provider and ask about:

a.	reducing the patient’s dose.
b.	using every other day dosing.
c.	increasing the patient’s dose.
d.	tapering the dose.

 

 

ANS:  C

Because of their adrenal suppression, patients taking glucocorticoids long term require increased doses at times of stress and even for a time after stopping the drug until adrenal function returns. This patient’s lower blood pressure is an indication that glucocorticoid levels may be depleted. Reducing the dose would only exacerbate the patient’s problems. Every other day dosing is used early in glucocorticoid therapy to reduce adrenal suppression, but it would not be useful now. Tapering of doses is used to allow adrenal function to recover as the drug is discontinued.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 874

TOP:   Nursing Process: Diagnosis

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

 

4. A nurse is teaching a group of nursing students why glucocorticoids are preferred over nonsteroidal anti-inflammatory drugs in the treatment of inflammation. Which statement by a student indicates a need for further teaching?

a.	“Glucocorticoids act by multiple mechanisms and have more anti-inflammatory effects than NSAIDs.”
b.	“Glucocorticoids have fewer side effects than nonsteroidal anti-inflammatory drugs.”
c.	“Glucocorticoids help avert damage to tissues from lysosomal enzymes.”
d.	“Glucocorticoids reduce the immune component of inflammation.”

 

 

ANS:  B

Glucocorticoids have many side effects. They are used because of their multiple mechanisms of action, including their ability to limit tissue damage caused by the inflammatory process and suppression of the immune component of inflammation.

 

PTS:   1                    DIF:    Cognitive Level: Analysis                REF:   pp. 871-872

TOP:   Nursing Process: Implementation

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