Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A client who has been taking a glucocorticoid for several months arrives in the clinic. The nurse notes the client's cheeks appear full, and a prominent hump of fat is present on the upper back. The nurse will ask the provider to order which of these laboratory tests?
A. Vitamin D levels
Vitamin D levels may be affected by long-term glucocorticoid use, but the described symptoms are more indicative of potential glucocorticoid-related side effects, such as Cushingoid features, which warrant liver function tests.
B. Liver function tests
Liver function tests are appropriate to assess the impact of long-term glucocorticoid use on the liver, as these medications can affect liver function.
C. Serum electrolytes
Serum electrolytes are important to monitor, but the specific symptoms mentioned (full cheeks, hump of fat) are not typically associated with electrolyte imbalances.
D. Tuberculin skin test
A tuberculin skin test is unrelated to the observed symptoms and is not typically ordered based on the physical features described.
This question is an excerpt from Nurse Dive's nursing test bank - Ramsussen Section 4 Module 11. Pharmocology For Professional Nursing Proctored Exam. Take the full exam now
Full Explanation
a) Vitamin D levels may be affected by long-term glucocorticoid use, but the described symptoms are more indicative of potential glucocorticoid-related side effects, such as Cushingoid features, which warrant liver function tests.
b) Liver function tests are appropriate to assess the impact of long-term glucocorticoid use on the liver, as these medications can affect liver function.
c) Serum electrolytes are important to monitor, but the specific symptoms mentioned (full cheeks, hump of fat) are not typically associated with electrolyte imbalances.
d) A tuberculin skin test is unrelated to the observed symptoms and is not typically ordered based on the physical features described.
Similar Questions
The nurse reinforces instructions regarding when to take levothyroxine and determines teaching was effective when the client states the medication should be taken in which manner?
A. 30 to 60 minutes before breakfast
Levothyroxine is usually recommended to be taken 30 to 60 minutes before breakfast to enhance absorption, but this is not the answer indicated by the client's statement.
B. At bedtime
Taking levothyroxine at bedtime is another acceptable option and may be more convenient for some individuals. Both options (morning or bedtime) are valid.
C. When they feel fatigued
Taking levothyroxine when feeling fatigued is not a specific guideline for medication administration.
D. With an antacid
Taking levothyroxine with an antacid may interfere with absorption and is not recommended.
Full Explanation
a) Levothyroxine is usually recommended to be taken 30 to 60 minutes before breakfast to enhance absorption, but this is not the answer indicated by the client's statement.
b) Taking levothyroxine at bedtime is another acceptable option and may be more convenient for some individuals. Both options (morning or bedtime) are valid.
c) Taking levothyroxine when feeling fatigued is not a specific guideline for medication administration.
d) Taking levothyroxine with an antacid may interfere with absorption and is not recommended.
The nurse is providing client education for a postmenopausal client; which risks associated with estrogen/progestin therapy should the nurse discuss with the client? (Select all that apply.)
A. Decreased bone density
This is not a risk of estrogen/progestin therapy. In fact, estrogen/progestin therapy can help prevent osteoporosis and fractures by increasing bone density and strength.
B. Ovarian cancer
This is a possible risk of estrogen/progestin therapy. Some studies have suggested that taking estrogen/progestin therapy for more than five years may increase the risk of ovarian cancer. However, other studies have not found this association
C. Stroke
This is a serious risk of estrogen/progestin therapy. Estrogen/progestin therapy can increase the risk of blood clots, which can lead to stroke or heart attack. The risk is higher for women who smoke, have high blood pressure, diabetes, or a history of cardiovascular disease.
D. Increased colon cancer
This is not a risk of estrogen/progestin therapy. In fact, some studies have suggested that estrogen/progestin therapy may reduce the risk of colon cancer by lowering inflammation and promoting regular bowel movements.
E. Deep vein thrombosis
This is another serious risk of estrogen/progestin therapy. Deep vein thrombosis (DVT) is a condition where a blood clot forms in a deep vein, usually in the leg. It can cause pain, swelling, and redness in the affected area. If the clot breaks off and travels to the lungs, it can cause a life threatening condition called pulmonary embolism (PE). Estrogen/progestin therapy can increase the risk of DVT and PE by making the blood more likely to clot
Full Explanation
A) This is not a risk of estrogen/progestin therapy. In fact, estrogen/progestin therapy can help prevent osteoporosis and fractures by increasing bone density and strength.
B) This is a possible risk of estrogen/progestin therapy. Some studies have suggested that taking estrogen/progestin therapy for more than five years may increase the risk of ovarian cancer. However, other studies have not found this association
C) This is a serious risk of estrogen/progestin therapy. Estrogen/progestin therapy can increase the risk of blood clots, which can lead to stroke or heart attack. The risk is higher for women who smoke, have high blood pressure, diabetes, or a history of cardiovascular disease.
D) This is not a risk of estrogen/progestin therapy. In fact, some studies have suggested that estrogen/progestin therapy may reduce the risk of colon cancer by lowering inflammation and promoting regular bowel movements.
E) This is another serious risk of estrogen/progestin therapy. Deep vein thrombosis (DVT) is a condition where a blood clot forms in a deep vein, usually in the leg. It can cause pain, swelling, and redness in the affected area. If the clot breaks off and travels to the lungs, it can cause a life threatening condition called pulmonary embolism (PE). Estrogen/progestin therapy can increase the risk of DVT and PE by making the blood more likely to clot
Which statement by a client indicates an understanding of self-care precautions when taking warfarin?
A. "My warfarin dose may need to be readjusted when I take a course of antibiotics."
Antibiotics can interact with warfarin, potentially affecting the INR, so dose adjustments may be necessary.
B. "I should expect pink urine due to metabolic bi-products of the dye used in this medication."
Pink urine is not an expected side effect of warfarin; this statement is inaccurate.
C. "I should eat spinach to increase my iron count if my INR goes below two."
Eating spinach to increase iron count is not a relevant action related to warfarin or INR levels.
D. "Herbal remedies are fine, but I shouldn't take aspirin without consulting my provider."
Warfarin interacts with many substances, including herbal remedies and aspirin. Notifying the provider before taking new medications or supplements is crucial for proper management.
Full Explanation
A) Antibiotics can interact with warfarin, potentially affecting the INR, so dose adjustments may be necessary.
B) Pink urine is not an expected side effect of warfarin; this statement is inaccurate.
C) Eating spinach to increase iron count is not a relevant action related to warfarin or INR levels.
D) Warfarin interacts with many substances, including herbal remedies and aspirin. Notifying the provider before taking new medications or supplements is crucial for proper management.