Question 1

The nurse determines that a client is tolerating drug therapy with prednisone (Deltasone)by noting the absence of which of the following adverse effects?

Accepted Answer

Prednisone can cause gastrointestinal upset as a common adverse effect, so the absence of this symptom would indicate the client is tolerating the drug well.

Question 2

Which of the following statements about glucocorticoids as a drug class is most accurate?

Accepted Answer

Glucocorticoids as a drug class are influenced by circadian and ultradian rhythms. These rhythms refer to the natural patterns of hormone release that occur on a daily (circadian) and hourly (ultradian) basis. Glucocorticoids like cortisol are part of the body's natural stress response system and play a role in regulating energy metabolism, inflammation, and immune function. As such, their release is tightly regulated by these daily and hourly rhythms. When taken as a drug, the timing and dosing of glucocorticoids can have important implications for their effectiveness and potential side effects.

Question 3

A client has an order for hydrocortisone (Cortef).The nurse plans to schedule the ordered doses according to which commonly accepted pattern for this drug?

Accepted Answer

Hydrocortisone is a glucocorticoid with a short half-life. Therefore, it is usually prescribed in divided doses, with most of the dose given in the morning to mimic the body's natural cortisol secretion. The remaining one third of the dose is given in the evening to provide additional coverage during times of increased stress or activity. Therefore, the best choice is D, with two thirds of the dose in the morning and one third in the evening.

Question 4

Which statement indicates that the client needs more client teaching about steroid therapy?

Accepted Answer

The statement "Oh, I'm not worried about a little fever or cold" indicates that the client may not be aware of the increased susceptibility to infections while on steroid therapy and the need to report any signs of infection to the healthcare provider.

Question 5

The nurse would administer methylprednisolone (Solu-Medrol)carefully to a client with which of the following health problems because of adverse effects that could aggravate the condition?

Accepted Answer

Methylprednisolone can cause hyperglycemia and can worsen diabetes mellitus. Therefore, it should be administered carefully to clients with diabetes mellitus. It is safe to administer to clients with asthma, status post cranial surgery, and spinal cord injury.

Question 6

Which of the following actions is not true of glucocorticoids as a drug group?

Accepted Answer

Glucocorticoids do not have pulse and heart rate maintenance actions, so option B is not true. The other options are all true actions of glucocorticoids.

Question 7

The nurse is assigned to a client receiving corticosteroid therapy as part of treatment for shock.While in the hospital,the nurse anticipates that the dosage will be tapered down how frequently to avoid addisonian crisis?

Accepted Answer

Corticosteroid dosages are typically tapered every 4 days to prevent adrenal insufficiency or Addisonian crisis.

Question 8

The nurse would plan to administer ordered doses of a steroid cautiously to a client with a history of which of the following conditions?

Accepted Answer

Steroids can cause fluid retention and increase blood pressure, so they should be used cautiously in patients with hypertension.

Question 9

Which of the following would alert the nurse that steroids are problematic for a client with a history of chronic obstructive pulmonary disease,heart failure,and hypertension?

Accepted Answer

Steroids can cause fluid retention, leading to an increase in weight. This can be problematic for clients with a history of chronic obstructive pulmonary disease, heart failure, and hypertension as it can exacerbate their conditions. Increased specific gravity of urine and increase in mobility are not specific to the adverse effects of steroids in this client population. A decrease in weight may actually be desired in a client with these conditions, but it would not necessarily be a specific alert for steroids being problematic.

Question 10

What type of dietary considerations are necessary for the nurse to teach the client who is receiving fludrocortisone (Florinef)?

Accepted Answer

Fludrocortisone (Florinef) can cause potassium levels to drop, so a diet high in potassium is recommended to counteract this effect.

Question 11

The nurse plans to incorporate in client teaching about a newly ordered mineralocorticoid that it has which of the following pharmacologic actions?

Accepted Answer

Mineralocorticoids, such as aldosterone, act on the kidneys to stimulate reabsorption of sodium in the renal distal tubules. This helps maintain fluid and electrolyte balance and therefore blood pressure. Mineralocorticoids do not have antiinflammatory effects or affect metabolism.

Question 12

A client is being tapered from a systemic corticosteroid.The nurse would alert the physician that the client is not tolerated dosage tapering if which of the following symptoms is noted?

Accepted Answer

Lethargy is a symptom of adrenal insufficiency, which can occur if the client is not able to tolerate tapering of systemic corticosteroids. Hyperactivity, insomnia, and hyperglycemia are not necessarily indicative of adrenal insufficiency.

Question 13

The nurse would question an order for an antiadrenal medication such as aminoglutethimide (Cytadren)for which of the following clients?

Accepted Answer

The answer of The nurse would question an order for...

Question 14

The nurse planning drug therapy to coincide with natural rhythms in the body understands that plasma cortisol levels will be increased at which time of the day?

Accepted Answer

Plasma cortisol levels are typically highest in the early morning, so drug therapy should be planned accordingly.

Question 15

The nurse would assess for which of the following adverse effects in a client receiving prednisone (Deltasone)?

Accepted Answer

Mood changes are a common adverse effect of prednisone. Prednisone can cause mood swings, irritability, anxiety, and depression in some people. It is important for the nurse to monitor the client's emotional state and report any significant changes to the healthcare provider. While prednisone can also cause hypoglycemia, weight gain, and elevated blood pressure, it is not likely to cause declining blood pressure.

Question 16

In a teaching plan,the nurse should state that alcohol and aspirin should not be used while taking steroids because of which of the following associated effects?

Accepted Answer

Steroids can cause gastric irritation and alcohol and aspirin can exacerbate this effect, leading to worsening of gastric irritation and potentially even ulcer formation. Furthermore, aspirin can also increase the risk of bleeding while on steroids, and alcohol can potentially increase the risk of liver damage. There is no significant effect of alcohol or aspirin on the absorption or metabolism of steroids, and insomnia is not typically associated with these medications.

Question 17

Which of the following symptoms would not be part of the baseline of a client with Cushing's syndrome who is starting drug therapy with aminoglutethimide (Cytadren)?

Accepted Answer

Thickened skin is not a characteristic symptom of Cushing's syndrome and therefore would not be included in the baseline for drug therapy with aminoglutethimide. Buffalo hump, darkened pigmentation, and increased facial hair growth are all commonly seen in patients with Cushing's syndrome.

Question 18

The nurse expects that aldosterone,as a mineralocorticoid,will primarily affect the client's metabolism of which of the following?

Accepted Answer

Aldosterone, as a mineralocorticoid, primarily affects the client's metabolism of minerals and water as it regulates the reabsorption of sodium and water in the kidneys. It does not directly affect the metabolism of fat, carbohydrates, proteins, vitamins or minerals.

Question 19

The nurse who is reviewing a client's medication administration record notes that an ordered glucocorticoid is least likely to interact adversely with which of the following types of drugs?

Accepted Answer

Glucocorticoids can interact with a variety of drugs, but analgesics (pain relievers) generally have the least potential for adverse interactions with glucocorticoids compared to antacids (which can affect the stomach lining and how medications are absorbed), diuretics (which can affect electrolyte balance and increase the risk of hypokalemia), and oral antidiabetic agents (which can have their efficacy reduced by glucocorticoids, potentially leading to hyperglycemia).

Question 20

The nurse is teaching a client how to monitor for fluid retention at home while taking prednisone (Deltasone).The nurse explains that the client should measure which of the following each day as the best indicator of fluid status?

Accepted Answer

The best indicator of fluid retention is weight. Clients should monitor their weight daily and report any sudden weight gain to their healthcare provider immediately. While urine output, blood pressure, and pulse may also provide some information about fluid status, they are less reliable indicators than weight.

Quiz 48: Drugs Affecting the Adrenal Cortex

The nurse determines that a client is tolerating drug therapy with prednisone (Deltasone) by noting the absence of which of the following adverse effects?

Which of the following statements about glucocorticoids as a drug class is most accurate?

A client has an order for hydrocortisone (Cortef) .The nurse plans to schedule the ordered doses according to which commonly accepted pattern for this drug?

Which statement indicates that the client needs more client teaching about steroid therapy?

The nurse would administer methylprednisolone (Solu-Medrol) carefully to a client with which of the following health problems because of adverse effects that could aggravate the condition?

Which of the following actions is not true of glucocorticoids as a drug group?

The nurse is assigned to a client receiving corticosteroid therapy as part of treatment for shock.While in the hospital,the nurse anticipates that the dosage will be tapered down how frequently to avoid addisonian crisis?

The nurse would plan to administer ordered doses of a steroid cautiously to a client with a history of which of the following conditions?

Which of the following would alert the nurse that steroids are problematic for a client with a history of chronic obstructive pulmonary disease,heart failure,and hypertension?

What type of dietary considerations are necessary for the nurse to teach the client who is receiving fludrocortisone (Florinef) ?

The nurse plans to incorporate in client teaching about a newly ordered mineralocorticoid that it has which of the following pharmacologic actions?

A client is being tapered from a systemic corticosteroid.The nurse would alert the physician that the client is not tolerated dosage tapering if which of the following symptoms is noted?

The nurse would question an order for an antiadrenal medication such as aminoglutethimide (Cytadren) for which of the following clients?

The nurse planning drug therapy to coincide with natural rhythms in the body understands that plasma cortisol levels will be increased at which time of the day?

The nurse would assess for which of the following adverse effects in a client receiving prednisone (Deltasone) ?

In a teaching plan,the nurse should state that alcohol and aspirin should not be used while taking steroids because of which of the following associated effects?

Which of the following symptoms would not be part of the baseline of a client with Cushing's syndrome who is starting drug therapy with aminoglutethimide (Cytadren) ?

The nurse expects that aldosterone,as a mineralocorticoid,will primarily affect the client's metabolism of which of the following?

The nurse who is reviewing a client's medication administration record notes that an ordered glucocorticoid is least likely to interact adversely with which of the following types of drugs?

The nurse is teaching a client how to monitor for fluid retention at home while taking prednisone (Deltasone) .The nurse explains that the client should measure which of the following each day as the best indicator of fluid status?