Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A patient with type 1 diabetes was prescribed a glucocorticoid for COPD. Which will the nurse expect in this patient?
A. No change in blood sugar
Glucocorticoids can cause an increase in blood sugar by stimulating gluconeogenesis and inhibiting insulin action. Therefore, a patient with type 1 diabetes who is taking glucocorticoids will not have no change in blood sugar, but rather a rise in blood sugar.
B. A decrease in the blood pressure
Glucocorticoids can cause an increase in blood pressure by promoting sodium and water retention and increasing vascular reactivity. Therefore, a patient with type 1 diabetes who is taking glucocorticoids will not have a decrease in the blood pressure, but rather a possible increase in the blood pressure.
C. An increase in the blood sugar
Glucocorticoids can cause an increase in blood sugar by stimulating gluconeogenesis and inhibiting insulin action. Therefore, a patient with type 1 diabetes who is taking glucocorticoids will have an increase in blood sugar. This is the correct statement that describes the expected effect of glucocorticoids in this patient.
D. An increase in the need for carbohydrates
Glucocorticoids can cause an increase in blood sugar by stimulating gluconeogenesis and inhibiting insulin action. Therefore, a patient with type 1 diabetes who is taking glucocorticoids will not have an increase in the need for carbohydrates, but rather a need for more insulin to control the blood sugar.
This question is an excerpt from Nurse Dive's nursing test bank - South Merit college Patho-pharmacology Proctored Exam. Take the full exam now
Full Explanation
Choice A reason: Glucocorticoids can cause an increase in blood sugar by stimulating gluconeogenesis and inhibiting insulin action. Therefore, a patient with type 1 diabetes who is taking glucocorticoids will not have no change in blood sugar, but rather a rise in blood sugar.
Choice B reason: Glucocorticoids can cause an increase in blood pressure by promoting sodium and water retention and increasing vascular reactivity. Therefore, a patient with type 1 diabetes who is taking glucocorticoids will not have a decrease in the blood pressure, but rather a possible increase in the blood pressure.
Choice C reason: Glucocorticoids can cause an increase in blood sugar by stimulating gluconeogenesis and inhibiting insulin action. Therefore, a patient with type 1 diabetes who is taking glucocorticoids will have an increase in blood sugar. This is the correct statement that describes the expected effect of glucocorticoids in this patient.
Choice D reason: Glucocorticoids can cause an increase in blood sugar by stimulating gluconeogenesis and inhibiting insulin action. Therefore, a patient with type 1 diabetes who is taking glucocorticoids will not have an increase in the need for carbohydrates, but rather a need for more insulin to control the blood sugar.
Similar Questions
Which agent is preferred for the initial treatment of heart failure?
A. Vasodilators
Vasodilators are not the preferred agents for the initial treatment of heart failure. They are used as adjunctive therapy to reduce the afterload and preload on the heart. However, they do not address the fluid overload that is the main cause of heart failure symptoms.
B. Diuretics
Diuretics are the preferred agents for the initial treatment of heart failure. They help to reduce the fluid overload and congestion in the lungs and peripheral tissues. They also lower the blood pressure and improve the cardiac output and renal function.
C. Calcium channel blockers
Calcium channel blockers are not the preferred agents for the initial treatment of heart failure. They are contraindicated in most cases of heart failure because they can worsen the cardiac function and increase the mortality. They can also cause peripheral edema and hypotension.
D. Direct renin inhibitor
Direct renin inhibitors are not the preferred agents for the initial treatment of heart failure. They are a newer class of drugs that block the renin-angiotensin-aldosterone system (RAAS), which is involved in the pathophysiology of heart failure. However, they have not shown any significant benefit over the existing RAAS inhibitors, such as angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs). They can also cause hyperkalemia and renal impairment.
Full Explanation
Choice A reason: Vasodilators are not the preferred agents for the initial treatment of heart failure. They are used as adjunctive therapy to reduce the afterload and preload on the heart. However, they do not address the fluid overload that is the main cause of heart failure symptoms.
Choice B reason: Diuretics are the preferred agents for the initial treatment of heart failure. They help to reduce the fluid overload and congestion in the lungs and peripheral tissues. They also lower the blood pressure and improve the cardiac output and renal function.
Choice C reason: Calcium channel blockers are not the preferred agents for the initial treatment of heart failure. They are contraindicated in most cases of heart failure because they can worsen the cardiac function and increase the mortality. They can also cause peripheral edema and hypotension.
Choice D reason: Direct renin inhibitors are not the preferred agents for the initial treatment of heart failure. They are a newer class of drugs that block the renin-angiotensin-aldosterone system (RAAS), which is involved in the pathophysiology of heart failure. However, they have not shown any significant benefit over the existing RAAS inhibitors, such as angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs). They can also cause hyperkalemia and renal impairment.
Which nursing assessment confirms that the angiotensin II receptor blocker (ARB) that a patient is taking is effective?
A. LDL cholesterol levels have decreased
ARBs do not affect the LDL cholesterol levels. They lower the blood pressure by blocking the action of angiotensin II, which is a hormone that causes vasoconstriction and sodium retention. Statins are the drugs that lower the LDL cholesterol levels.
B. Weight loss of more than 2 pounds/week
ARBs do not cause weight loss of more than 2 pounds/week. They lower the blood pressure by blocking the action of angiotensin II, which is a hormone that causes vasoconstriction and sodium retention. Diuretics are the drugs that cause weight loss by increasing the urine output and reducing the fluid volume.
C. Urinary output is increased
ARBs do not increase the urinary output. They lower the blood pressure by blocking the action of angiotensin II, which is a hormone that causes vasoconstriction and sodium retention. Diuretics are the drugs that increase the urinary output by inhibiting the reabsorption of sodium and water in the kidneys.
D. Blood pressure has decreased
ARBs lower the blood pressure by blocking the action of angiotensin II, which is a hormone that causes vasoconstriction and sodium retention. Therefore, a nursing assessment that confirms that the ARB that a patient is taking is effective is a decrease in the blood pressure. This is the correct statement that describes the expected outcome of ARBs.
Full Explanation
Choice A reason: ARBs do not affect the LDL cholesterol levels. They lower the blood pressure by blocking the action of angiotensin II, which is a hormone that causes vasoconstriction and sodium retention. Statins are the drugs that lower the LDL cholesterol levels.
Choice B reason: ARBs do not cause weight loss of more than 2 pounds/week. They lower the blood pressure by blocking the action of angiotensin II, which is a hormone that causes vasoconstriction and sodium retention. Diuretics are the drugs that cause weight loss by increasing the urine output and reducing the fluid volume.
Choice C reason: ARBs do not increase the urinary output. They lower the blood pressure by blocking the action of angiotensin II, which is a hormone that causes vasoconstriction and sodium retention. Diuretics are the drugs that increase the urinary output by inhibiting the reabsorption of sodium and water in the kidneys.
Choice D reason: ARBs lower the blood pressure by blocking the action of angiotensin II, which is a hormone that causes vasoconstriction and sodium retention. Therefore, a nursing assessment that confirms that the ARB that a patient is taking is effective is a decrease in the blood pressure. This is the correct statement that describes the expected outcome of ARBs.
A patient with stable COPD receives prescriptions for an inhaled glucocorticoid and an inhaled beta2-adrenergic agonist. Which statement by the patient indicates understanding of this medication regimen?
A. I should use the glucocorticoid as needed when symptoms flare.
The patient should not use the glucocorticoid as needed when symptoms flare. The glucocorticoid is a long-term controller medication that reduces inflammation and prevents exacerbations of COPD. It should be used regularly as prescribed, not as a rescue medication.
B. I will need to use the beta2-adrenergic agonist drug daily even when I don't have any symptoms.
The patient does not need to use the beta2-adrenergic agonist drug daily even when they don't have any symptoms. The beta2-adrenergic agonist is a short-acting bronchodilator that relaxes the smooth muscles of the airways and improves airflow. It should be used as needed for relief of acute symptoms, not as a maintenance medication.
C. The beta2-adrenergic agonist suppresses the synthesis of inflammatory mediators.
The beta2-adrenergic agonist does not suppress the synthesis of inflammatory mediators. The beta2-adrenergic agonist is a bronchodilator that acts on the beta2 receptors of the airways and causes relaxation of the smooth muscles. It does not have any anti-inflammatory effects.
D. The glucocorticoid is used as prophylaxis to prevent exacerbations every day.
The glucocorticoid is used as prophylaxis to prevent exacerbations every day. This is the correct statement that indicates understanding of this medication regimen. The glucocorticoid is a long-term controller medication that reduces inflammation and prevents exacerbations of COPD. It should be used regularly as prescribed, along with the beta2-adrenergic agonist as needed for relief of acute symptoms.
Full Explanation
Choice A reason: The patient should not use the glucocorticoid as needed when symptoms flare. The glucocorticoid is a long-term controller medication that reduces inflammation and prevents exacerbations of COPD. It should be used regularly as prescribed, not as a rescue medication.
Choice B reason: The patient does not need to use the beta2-adrenergic agonist drug daily even when they don't have any symptoms. The beta2-adrenergic agonist is a short-acting bronchodilator that relaxes the smooth muscles of the airways and improves airflow. It should be used as needed for relief of acute symptoms, not as a maintenance medication.
Choice C reason: The beta2-adrenergic agonist does not suppress the synthesis of inflammatory mediators. The beta2-adrenergic agonist is a bronchodilator that acts on the beta2 receptors of the airways and causes relaxation of the smooth muscles. It does not have any anti-inflammatory effects.
Choice D reason: The glucocorticoid is used as prophylaxis to prevent exacerbations every day. This is the correct statement that indicates understanding of this medication regimen. The glucocorticoid is a long-term controller medication that reduces inflammation and prevents exacerbations of COPD. It should be used regularly as prescribed, along with the beta2-adrenergic agonist as needed for relief of acute symptoms.