LONG QUIZ

DRUGS FOR ENDOCRINOLOGIC DISORDERS

1. Parathyroid hormone increases the serum calcium level in all the following ways except:
a. it promotes bone resorption. c. it increases production of calcium in the long bones.
b. it increases the absorption of calcium from the intestine. d. it increases the reabsorption of calcium by the renal tubules.
2. Symptoms of thyroid storm include which of the following?
a. elevated temperature b. tachycardia c. congestive heart failure d. all of the above
3. All the following are true regarding the intravenous administration of calcium except:
a. heart rate and rhythm should be monitored, especially in the elderly.
b. the solution should be given by rapid infusion.
c. extravasation of infused calcium may cause tissue necrosis.
d. the solution should be warmed prior to administration.
4. An appropriate nursing diagnosis for the client taking thyroid medication is:
a. Risk for injury related to altered calcium levels. c. Excess fluid volume related to effects of deficiency of thyroid hormone.
b. Disturbed sleep pattern related to thyroid dysfunction. d. Pain related to ulcerogenic effects of thyroid hormone preparations.
5. The nurse should include which of the following when teaching the client about the proper procedure to administer lypressin (Diapid)
intranasally?
a. “This medication can be used during acute upper respiratory infections.” c. “This medication should not be inhaled.”
b. “Lie down while inserting this medication.” d. All of the above
6. Signs of hypocalcemia include all the following except:
a. nausea and vomiting. b. spasms of the hands and feet. c. cardiac irregularities. d. positive Chvostek’s sign.
7. What safety precautions need to be taken following administration of a tracer dose of I 131?
a. The client should be placed in a private room for 24 hours following administration of the dose.
b. The client’s bed linen and eating utensils must be cleaned separately from those of other clients.
c. The client should not be in close contact with children for about 1 week.
d. The client should be confined to her room for 48 hours.
8. What signs or symptoms associated with propylthiouracil (PTU) use should be reported promptly to the physician?
a. skin rash or sore throat b.nausea and dizziness c. gastrointestinal distress d. dry eyes and mouth
9. What factor might explain why a client would receive 100 mg of propylthiouracil (PTU) daily instead of the usual initial daily dose of
300 mg?
a. age c. estimated number of years the client has had the condition
b. the fact that hyperthyroidism is caused by a nodule, not hypertrophy d. all of the above
10. The drug that is most similar to propylthiouracil (PTU) is:
a. propranolol (Inderal). b. methimazole (Tapazole). c. liotrix (Euthroid). d. oxytocin (Pitocin).
11. When administering thyroid preparations to hypothyroid clients, the HCP should:
a. take radiation safety precautions. c. discontinue the medication if the client seems drowsy
b. check the client’s pulse rate before administration. d. administer the medication late in the evening.
12. Clients who are hypothyroid are very sensitive to:
a. vitamin and mineral preparations. b. antacids. c. sedatives and hypnotics d. antibiotics.
13. Which of the listed signs might indicate that a hypothyroid client receiving treatment is moving toward a euthyroid state?
a. loss of weight b. improved strength and endurance c. increase in pulse rate d. all of the above
14. The client with untreated diabetes insipidus:
a. gains weight b. exhibits excessive salivation c. produces large volumes of urine output.. d. develops hyponatremia.
15. Education for the client who is prescribed medication for hypothyroidism should be aware that:
a. many products will result in weight gain. c. it may take several weeks to become euthyroid.
b. the medication should only be taken when the resting pulse is >100 bpm. d. overmedication may be toxic to the thyroid gland.
16. When administering Lugol’s solution or a saturated solution of potassium iodide to a client, the HCP:
a. dilutes the medication in a small amount of liquid. c. gives the medication with an antacid.
b. checks the pulse rate before administering the drug. d. all of the above
17. Signs and symptoms of iodism include:
a. rapid pulse rate and pretibial edema. c. soreness of gums and excessive salivation.
b. sore throat and increase in body weight. d. increased appetite and difficulty sleeping.
18. Which of the statements is true about I 131 treatment for hyperthyroidism?
a. It is safe for use in pregnant women.
b. It may result in hypothyroidism as long as 10 years following treatment.
c. Clients must be isolated in a private room following treatment.
d. After treatment, clients pose a serious radiation hazard to other clients and to staff.
19. Clients taking oral anticoagulants who are then started on propylthiouracil (PTU) should:
a. have both drug dosages decreased. c. have the oral anticoagulant dose decreased.
b. get a lower propylthiouracil (PTU) dose than is usually given. d. have the oral anticoagulant dose increased.
20. The drug that is used during the treatment of thyroid storm to alleviate adrenergic problems is:
a. iodine. b. thyroid extract. c. methimazole (Tapazole). d. propranolol (Inderal).
21. Which statement applies to the use of antithyroid drugs?
a. They are safe for use in nursing mothers. c. They are unsafe for use during pregnancy and by nursing mothers
b. They are safe for use during pregnancy. d. They must be used during pregnancy to prevent thyroid abnormalities in the fetus
22. Which of the following is not true about the treatment of children with growth disturbances using a human growth hormone product?
a. Almost any growth deficiency can be treated successfully with these products.
b. It is important to relate to the child on the basis of age, not size.
c. Somatropin (Humatrope) must be given by injection. d. They are usually given with oxytocin to stimulate growth
23. Which of the following is true about corticotropin (ACTH)?
a. Diabetics taking ACTH may experience a need for an increase in their insulin dosage.
b. ACTH is frequently used for the treatment of many health problems.
c. ACTH can be given orally, intravenously, or intramuscularly. d. All of the above
24. Health Care assessment of clients taking vasopressin (Pitressin) should include daily determination of:
a. weight. b. intake and output. c. blood pressure. d. all of the above
25. Hyperthyroid clients generally exhibit which one of the following symptoms?
a. weight loss b. constipation c. bradycardia d. lowered body temperature
26. In monitoring clients on propylthiouracil (PTU), the nurse must be particularly watchful for:
a. cardiac arrest. b. hypertensive crisis. c. Hepatitis d. agranulocytosis

1
27. A reason for limiting the use of iodides in the treatment of hyperthyroidism is:
a. the instability of iodide products. c. the development of blood dyscrasias.
b. the danger of thyroid “escape.” d. they must be administered parenterally.
28. Propranolol (Inderal) is used in the treatment of hyperthyroidism to:
a. reduce the uptake of iodide by the thyroid. c. prolong the action of antithyroid drugs.
b. treat the cardiovascular effects of hyperthyroidism. d. prevent the chemical combination of iodine with tyrosine.
29. The thyroid hormone product most likely to cause hypersensitivity reactions is:
a. liotrix (Euthroid). c. desiccated thyroid (Thyroid USP).
b. levothyroxine sodium (T4). d. liothyronine sodium (T3) (Cytomel).
30. Which of the following statements is true?
a. T3 is partially converted to T4 in the body. c. Liotrix (Euthroid) is the least expensive form of thyroid therapy.
b. T4 has a longer duration of action than T3. d. All of the above
31. Which of the following is true of calcitonin?
a. It acts to increase serum calcium levels. c. Salmon calcitonin is more potent than human calcitonin.
b. It is usually administered orally. d. It is a hormone secreted by the pituitary gland.
32. Acromegaly is a glandular condition that:
a. is caused by hypopituitarism. c. occurs only in adults.
b. results in growth to an abnormal height. d. is identical to gigantism.
33. All the following statements are true regarding the use of U500 strength insulin except:
a. This strength insulin is reserved for clients who take large daily doses of insulin, usually 200 or more units per day.
b. This strength insulin is more likely to cause lipodystrophy.
c. This is the strength insulin used in insulin pumps. d. This insulin can only be purchased with a prescription.
34. Which of the following is the correct procedure for mixing two types of insulin in the same syringe?
a. Withdraw the regular insulin prior to any other type of insulin. c. Draw each insulin in a separate syringe then combine the two
b. Withdraw the regular insulin after other types of insulin. d. Two types of insulin should not be mixed in the same syringe.
35. Clients experiencing diabetic ketoacidosis need to be monitored closely for which electrolyte disturbance?
a. hypernatremia b. hyponatremia c. hypokalemia d. hyperkalemia
36. Advantages of using an insulin pump include:
a. that it provides less expensive management for diabetes. c. that it allows the client flexibility in when and what he or she eats
b. that the client experiences moderate weight gain. d. that required training is minimal
37. The mechanism of action of the glitazones, a new class of oral antidiabetic agents, is to:
a. block the breakdown of starches. c. stimulate insulin release in the pancreas.
b. sensitize the body to the insulin that is currently present. d. assist the pancreas in the production of insulin.
38. Which of the following is an example of an oral combination hypoglycemic agent?
a. Precose b. Prandin c. Avandia d. Glucovance
39. Which of the following is not a symptom usually associated with type 2 (NIDDM) diabetic clients?
a. polydipsia b. ketosis c. polyuria d. fatigue
40. Which of the following is not an action of insulin?
a. promotes conversion of glycogen to glucose c. enhances protein synthesis
b. decreases gastrointestinal absorption of dietary glucose d. inhibits lipolysis
41. An example of an intermediate-acting insulin is:
a. PZI. b. NPH. c. ultralente. d. semilente.
42. Insulin that may be given intravenously is:
a. regular. b. NPH. c. PZI. d. semilente.
43. A common name for isophane insulin suspension is:
a. lente. b. regular. c. NPH. d. ultralente.
44. The sulfonylurea oral hypoglycemic agent that has the longest duration of action is:
a. tolbutamide (Orinase). b. tolazamide (Tolinase). c. chlorpropamide (Diabinase). d. acetohexamide (Dymelor).
45. In most cases the major nursing goal in working with a diabetic client is to:
a. teach the client how to inject insulin. c. monitor the client’s diet.
b. help the client become independent in self-care. d. help the client avoid insulin reactions
46. Hypoglycemia in a type 1 diabetic client is most likely related to:
a. omission of meals b. lack of exercise. c. overeating. d. improper measurement of insulin dosage.
47. In order to minimize local skin reactions, insulin should be:
a. refrigerated. b. injected slowly. c. given in divided doses. d. brought to room temperature before injection.
48. Type 1 (IDDM) diabetics are:
a. insulin dependent. c. suffering from complications of diabetes.
b. not insulin dependent. d. usually diagnosed after age 40.
49. The condition that results from the administration of more insulin than is required to deal with a glucose load is called:
a. diabetic coma. b. diabetic ketoacidosis. c. insulin reaction. d. DKA.
50. If a diabetic is found unconscious, and the nurse does not know the reason, it is best to:
a. treat for ketoacidosis. c. wait until blood glucose test results have returned from the laboratory
b. treat for insulin reaction. d. delay treating the client until a physician can be summoned
51. An initial dose of glucagon given intramuscularly (IM) should be effective:
a. immediately. b. in 3-5 minutes. c. in 15-30 minutes. d. in 1 hour.
52. Clients taking oral hypoglycemic agents:
a. never become hypoglycemic enough to require treatment. c. need to learn self-care.
b. do not develop complications of diabetes. d. do not need to follow a special diet.
53. The form of insulin most similar to human insulin is:
a. pork insulin. b. beef insulin. c. beef/pork insulin combination. d. fish insulin.
54. Which of the following drugs is an example of a “second generation” sulfonylurea agent?
a. tolazamide (Tolinase). b. acetohexamide (Dymelor). c. tolbutamide (Orinase). d. glyburide (DiaBeta).
55. Clients using a sulfonylurea drug may develop a series of adverse effects if they also use:
a. antimicrobial agents. b. acetaminophen (Tylenol). c. alcohol. d. caffeine.
56. Exenatide (Byetta):
a. facilitates glucose production in type 2 diabetics.
b. is administered orally in conjunction with other hypoglycemic agents.
c. replaces regular insulin therapy for newly diagnosed type 2 diabetics.
d. causes insulin release from the pancreas only when serum glucose levels are high.

2
57. Clients who take metformin (Glucophage) should be aware that:
a. the drug should be withheld for at least 48 hours prior to use of IV contrast.
b. they may self-adjust the dosage of the drug as needed.
c. some clients develop metabolic acidosis as an adverse effect of this therapy.
d. the drug must be administered continually, even if the client cannot tolerate p.o. medications.
58. An oral contraceptive that provides a fixed dosage of estrogen and progestin throughout the cycle is termed:
a. monophasic. b. biphasic. c. triphasic. d. fixed.
59. Oral contraceptives containing progestin only are more likely to cause:
a. GI upset. b. breakthrough bleeding. c. weight gain. d. visual disturbances.
60. All of the following are true regarding depot-medroxyprogesterone acetate (Depo-Provera) except:
a. It is administered as an injection. c. It is administered once a year.
b. It is administered every 3 months. d. It is relatively inexpensive.
61. Norgestrel and ethinyl estradiol (Ovral) used as emergency postinfective contraception is administered:
a. the morning after unprotected intercourse.
b. as soon after unprotected intercourse as possible and repeated in 12 hours.
c. the morning after unprotected intercourse and repeated the next morning.
d. anytime within the first 2 days following unprotected intercourse.
62. Therapy with which of the following drugs allows a woman to have a menstrual cycle just once every 3 months?
a. levonorgestrel/ethinyl estradiol (Seasonale) c. medroxyprogesterone acetate (Prempro)
b. norelgestromin/ethinyl estradiol (Ortho Evra) d. mifepristone (Mifiprex)
63. Which of the following combinations is used to treat postpartum breast engorgement?
a. estrogens and progestins c. estrogens and androgens
b. progestins and androgens d. estrogens and anabolic steroids
64. What is the current belief about the relationship of the use of combination oral contraceptives and the development of thromboembolism?
a. There is little, if any, relationship between them.
b. There is an increased risk of thromboembolic disease in users of these oral contraceptives.
c. Only an easily identified group of oral contraceptive users are at risk of thromboembolic disease.
d. No one knows if there is a relationship between them.
65. Because of the tendency for medroxyprogesterone (Provera) to cause fluid retention, it must be used carefully in clients with:
a. asthma. b. migraine headaches. c. epilepsy. d. all of the above
66. Because of the fluid retention likely to occur with long-term estrogen therapy, the client is advised to:
a. eliminate fruit from her diet. c. have her blood pressure checked periodically.
b. decrease her daily water intake. d. discontinue estrogen if fluid retention occurs.
67. The primary action of estrogens in oral contraceptive products is to:
a. alter the viscosity of cervical mucus. c. suppress ovulation
b. suppress the release of luteinizing hormone from the pituitary. d. reduce the motility of the fallopian tubes
68. Which of the following hormones causes stimulation of the corpus luteum?
a. FSH b. progesterone c. estrogen d. LH
69. Which of the following is a progestin agent?
a. norethindrone (Norlutin) b. ethinyl estradiol (Estinyl) c. chlorotrianisene (Tace) d. diethylstilbestrol (DES)
70. The use of estrogens by females is frequently associated with which of the following adverse effects?
a. acne b. diuresis c. Nausea d. weight loss
71. Estrogens are not used therapeutically for the treatment of:
a. cryptorchidism. b. dysmenorrhea. c. menopausal symptoms. d. primary ovarian failure.
72. “MiniCell” oral contraceptive products contain:
a. only progestin. b. only estrogen. c. more estrogen than progestin. d. more progestin than estrogen.
73. Which of the following is not associated with the use of clomiphene citrate (Clomid, Serophene)?
a. ovarian cyst formation b. multiple fetuses c. weight gain d. blurred vision
74. Menotropins and urofollitropin are generally used in conjunction with:
a. estrogen. b. androgen. c. clomiphene citrate (Clomid). d. human chorionic gonadotropin (HCG).
75. Androgens would not generally be employed for the treatment of:
a. oligospermia. b. prostatic carcinoma. c. cryptorchidism. d. inoperable breast cancer.
76. Laboratory test results affected by estrogen therapy are:
a. hepatic and thyroid function tests. b. blood clotting tests. c. Pap smears. d. all of the above
77. If a woman taking an estrogen-progestin combination oral contraceptive forgets to take a dose, she should:
a. take it as soon as she remembers. c. immediately call her physician.
b. stop taking the rest of the tablets for the month. d. take two tablets instead of one each day for the rest of the month.
78. A decrease in the quantity of menstrual flow in women taking combination oral contraceptives is:
a. abnormal and should be reported immediately. c. abnormal and may require switching to another preparation.
b. abnormal and probably indicates pregnancy. d. normal and no cause for alarm.
79. Women who are taking progestins and believe they are pregnant should:
a. discontinue them and see their physician. c. delay any action until the end of their cycle to see if menstruation occurs.
b. continue them and see their physician. d. continue the pills and do nothing special.
80. Clients taking androgens for their metabolic effect:
a. are always males.
b. require nutritious foods in order to benefit from therapy.
c. are very likely to develop thromboembolic disease.
d. are given estrogens at the same time to control the androgen’s side effects.
81. A client taking clomiphene citrate (Clomid) should be instructed to call the physician immediately if she experiences:
a. nausea. b. pelvic discomfort. c. visual symptoms. d. menstrual changes.
82. A client taking menotropins and human chorionic gonadotropin who experiences indications of ovarian hyperstimulation syndrome
should be:
a. told to rest in bed. b. hospitalized. c. reassured that this is common. d. given uterine relaxants.
83. A drug used as a treatment for fibrocystic breast disease is:
a. testosterone cypionate (Depotestogen, Depo-Testadiol). c. danazol (Danocrine).
b. estradiol (Delestrogen). d. clomiphene citrate (Clomid).
84. Education of the client with erectile dysfunction must address caution about use of any of the erectile dysfunction medications if the
client also takes:
a. calcium channel blockers. b. beta blockers. c. lipid lowering agents. d. antidepressants.

3
 85. The advantage of tadalafil (Cialis) over other medications for erectile dysfunction is that it:
a. takes effect immediately. c. remains effective for a longer time.
b. works in response to sexual stimulation. d. does not cause significant hypotension.
86. Self-care instructions for the client discharged on terbutaline via pump include all the following except:
a. the pump is programmed to provide a basal rate and with the capability of bolus administration.
b. uterine contractions not controlled by two bolus doses within a 4-hour period should be reported.
c. bolus doses may be used as long as the pulse rate is less than 110 beats per minute.
d. the medication is delivered into an intravenous access site.
87. Which of the following explains why the action of oxytocin (Pitocin) increases during the last 9 weeks of pregnancy?
a. The mechanism of action is dependent on the presence of estrogen.
b. The mechanism of action is dependent on the presence of progestin.
c. The mechanism of action is dependent on the size of the fetus.
d. The mechanism of action is dependent on the size of the uterus.
88. A client scheduled for a late second trimester abortion is told of the possibility of delivering a live fetus. The client states she was
unaware of this possibility and is no longer sure she wants an abortion. The best response by the HCP is:
a. “Don’t worry, we won’t show you the fetus.”
b. “If you wait any longer, the possibility of a live fetus increases.”
c. “Would you like some time to talk this over.”
d. “It’s really not that common, so chances are it won’t happen to you.”
89. To evaluate a client’s ability to manage a terbutaline pump, the nurse will have the client:
a. demonstrate programming the pump. c. verbalize symptoms that need to be reported.
b. verbalize selection of injection sites. d. all of the above
90. The HCP understands that Rh0(D) immune globulin is administered:
a. to Rh negative mothers after delivery of an Rh positive infant.
b. to Rh positive mothers after delivery of an Rh negative infant.
c. to Rh positive mothers only following abortion of an Rh negative infant.
d. to Rh negative mothers only following abortion of an Rh positive infant.
91. Oxytocin (Pitocin) is not indicated for:
a. inducing first trimester abortion. c. increasing uterine tone during the postpartum period.
b. controlling postpartum hemorrhage. d. inducing milk letdown.
92. Ergot derivatives are not generally used for inducing labor because they:
a. only stimulate uterine contractions during the second trimester. c. tend to increase breast engorgement.
b. produce powerful uterine contractions. d. cause hypotension in many clients.
93. The most common adverse effect associated with the use of prostaglandins is:
a. cardiac stimulation. b. severe hypertension. c. hair loss. d. gastrointestinal distress.
94. Ritodrine HCl acts by:
a. interfering with prolactin activity. c. depressing the central nervous system.
b. inhibiting uterine contractility. d. preventing prolactin synthesis.
94. Bromocriptine mesylate (Parlodel) is most commonly used in obstetrics as a:
a. uterine stimulant. b. local anesthetic. c. uterine relaxant d. lactation suppressant..
96. Which of the following is not a sign of water intoxication associated with intravenous infusion of oxytocin (Pitocin)?
a. pounding maternal pulse c. moist respirations
b. increased maternal blood pressure d. bronchoconstriction
97. Adverse effects likely to be experienced by the client taking ritodrine include:
a. somnolence. b. lethargy. c. hypotension. d. nervousness.
98. The rate of infusion of oxytocin (Pitocin) should be decreased when:
a. blood pressure drops quickly. c. dilation of the pupils occurs.
b. depression of fetal heart tones occurs. d. dry mouth occurs.
99. Methylergonovine maleate (Methergine) and ergonovine maleate (Ergotrate) are most often used:
a. to induce labor. c. following delivery of the infant, but before delivery of the placenta.
b. during labor to regulate contractions. d. following delivery of the placenta
100. The local tingling feeling and general warm sensation that can accompany the injection of hypertonic saline to induce abortion are:
a. signs of hypernatremia. c. normal with use of this drug and are no cause for concern.
b. indications that intravascular injection has occurred. d. an indication of hypersensitivity
101. Which of the following is not true about the use of prostaglandins to induce abortion?
a. The fetus is always dead at delivery when prostaglandins are used.
b. Prostaglandins often produce gastrointestinal side effects.
c. Cervical trauma may occur at delivery if the cervix has not been sufficiently dilated.
d. Dinoprostone (Prostin E2) is an example of a prostaglandin.
102. Self-care instructions for the client discharged on ritodrine HCl include all of the following except:
a. avoidance of sexual intercourse. c. avoidance of breast massage.
b. good oral hygiene. d. modified bedrest.
103. A drug that can be used to stimulate the ejection of milk is:
a. oxytocin (Pitocin). c. dinoprostone (Prostin E2).
b. testosterone. d. diethylstilbestrol (DES).
104. Dinoprostone (Prostin E2) is generally administered as a(n):
a. IV infusion. b. oral tablet c. IM injection. d. suppository
105. To be effective, Rh™(D) immune globulin should be administered within what time period after delivery or abortion?
a. 10 minutes b. 60 minutes c. 24 hours d. 72 hours
106. Prostaglandins are most commonly used to:
a. induce labor. c. augment labor
b. terminate pregnancies between the 12th and 20th weeks. d. control postpartum bleeding