Question 1

Which of the following is an expected assessment finding for a patient recently placed on fludrocortisone (Florinef)?

Accepted Answer

Fludrocortisone is a mineralocorticoid that can cause sodium retention, leading to an increase in blood pressure.

Question 2

Which of the following vital signs would be associated with a patient requiring mineralocorticoid replacement therapy?

Accepted Answer

Mineralocorticoids, like aldosterone, play a crucial role in regulating sodium and water balance, which directly affects blood pressure. A low blood pressure (78/58) could indicate a deficiency in mineralocorticoids, necessitating replacement therapy.

Question 3

A patient has been prescribed hydrocortisone replacement therapy.Which of the following patient education information is incorrect?

Accepted Answer

Hydrocortisone is a corticosteroid, and taking aspirin (a nonsteroidal anti-inflammatory drug) can increase the risk of gastrointestinal bleeding, especially when combined with corticosteroids. Therefore, recommending aspirin for a fever without consulting a healthcare provider is incorrect.

Question 4

A nurse posts a sign, limiting visitors, outside of the door of a patient receiving high-dose intravenous corticosteroids.When the family inquires why visitors are limited, the nurse best responds:

Accepted Answer

High-dose intravenous corticosteroids can suppress the immune system, making the patient more susceptible to infections from others. Limiting visitors helps reduce the risk of the patient being exposed to potential infections.

Question 5

You are caring for a 24-year-old female patient diagnosed with Cushing's disease.Prior to prescribing mifepristone (Mifeprex), which of the following questions should be asked?

Accepted Answer

Mifepristone is used in the management of Cushing's disease but is also known as an abortifacient. Asking about the last menstrual period is crucial to rule out an existing pregnancy before prescribing this medication.

Question 6

A nurse is planning care for a patient taking long-term hydrocortisone replacement therapy.Which of the following findings is indicative of a masked infection?

Accepted Answer

Hydrocortisone, a corticosteroid, can suppress the immune system and mask signs of infection. A low-grade oral temperature in a patient taking long-term hydrocortisone could indicate a masked infection, as the usual inflammatory response (including fever) may be diminished.

Question 7

Which of the following patients should not receive mineralocorticoid replacement therapy?

Accepted Answer

Patients with Conn's syndrome, which is characterized by hyperaldosteronism (excessive production of aldosterone), should not receive mineralocorticoid replacement therapy as it would exacerbate their condition by further increasing aldosterone levels.

Question 8

Describe the rationale for the use of mineralocorticoid replacement therapy for a patient with Addison's disease.

Accepted Answer

Mineralocorticoid replacement therapy is used in patients with Addison's disease because their adrenal glands do not produce enough aldosterone. Aldosterone is a type of mineralocorticoid that helps regulate sodium and potassium levels in the body, and its deficiency is a hallmark of Addison's disease.

Question 9

A nurse is caring for a patient admitted to rule out Cushing's disease.Identify which of the following agents is used for diagnostic purposes:

Accepted Answer

Metyrapone (Metopirone) is used in the diagnostic testing of Cushing's disease. It inhibits cortisol synthesis, allowing healthcare providers to assess the pituitary gland's ability to increase ACTH production in response to decreased cortisol levels.

Question 10

The treatment of choice for a patient with Addison's disease is:

Accepted Answer

Hydrocortisone is the treatment of choice for Addison's disease as it replaces the deficient cortisol in patients with this condition.

Question 11

A nurse is planning care for a diabetic patient who is about to begin taking lifelong therapy for adrenal insufficiency.Which of the following advice should not be given to this patient?

Accepted Answer

The answer of A nurse is planning care for a...

Question 12

A patient diagnosed with Cushing's syndrome is ordered to take ketoconazole (Nizoral).The patient asks why she is being prescribed an antifungal drug.The nurse's best response is:

Accepted Answer

Ketoconazole, while primarily an antifungal medication, can inhibit adrenal steroid synthesis, which is beneficial in managing the high cortisol levels associated with Cushing's syndrome.

Question 13

A patient is on lifelong replacement therapy with hydrocortisone.The patient is scheduled for surgery.The nurse anticipates that prior to surgery, the patient's hydrocortisone dose will:

Accepted Answer

Patients on lifelong hydrocortisone therapy require an increased dose prior to surgery to mimic the body's natural stress response and prevent adrenal insufficiency.

Question 14

Identify the rationale for administering corticosteroids to a patient for transplant rejection prophylaxis.

Accepted Answer

Corticosteroids are administered to suppress the patient's immune response, thereby preventing the immune system from attacking and rejecting the transplanted organ.

Question 15

A patient with inflammatory bowel disease is prescribed budesonide (Entocort-EC).He asks why this drug is ordered.The nurse correctly explains:

Accepted Answer

Budesonide (Entocort-EC) is a corticosteroid that is designed to act locally in the intestine to reduce inflammation associated with conditions like inflammatory bowel disease. It has limited systemic absorption, which minimizes the risk of systemic corticosteroid side effects.

Question 16

A nurse is performing patient teaching regarding the initiation of fludrocortisone (Florinef).The nurse determines that more education is required when the patient states:

Accepted Answer

Fludrocortisone (Florinef) is a synthetic corticosteroid that is used to treat conditions where the body does not produce enough of its own steroids, such as Addison's disease. It has mineralocorticoid properties, which means it helps the body retain sodium and water, and can lead to an increase in blood pressure, not a decrease. Therefore, the statement about the drug lowering blood pressure indicates a misunderstanding.

Question 17

A nurse would question an order for corticosteroids in a patient diagnosed with which of the following?

Accepted Answer

Corticosteroids suppress the immune system, which can exacerbate infections like active tuberculosis, making it potentially dangerous to administer corticosteroids to patients with this condition.

Question 18

Mineralocorticoid replacement therapy should be used judiciously in patients with:

Accepted Answer

Mineralocorticoid replacement therapy can exacerbate fluid retention and worsen heart failure, so it should be used cautiously in these patients.

Question 19

A patient receiving lifelong therapy with corticosteroids should immediately report which of the following to the health care provider?

Accepted Answer

Corticosteroids can cause increased appetite, insomnia, and weight gain as side effects. These symptoms can indicate that the patient's dose may need adjustment.

Quiz 69: Corticosteroids and Drugs Affecting the Adrenal Cortex

Which of the following is an expected assessment finding for a patient recently placed on fludrocortisone (Florinef) ?