CU 9 Drugs Affecting the Body System and Nursing Considerations: Endocrine

1. After a blood glucose reading, it is determined that the patient should receive 4 units of
Lispro and 8 units of NPH. Which action will the nurse take to administer these medications?
a. Draw up each insulin in separate syringes and administer two injections.
b. Draw up the NPH first and then the Lispro using the same syringe.
c. Administer the Lispro before the meal and the NPH after the meal.
d. Draw up the Lispro first and then the NPH using the same syringe.

2. A patient with type 2 diabetes mellitus, which was previously controlled with an oral
antidiabetic agent, is hospitalized for treatment of a leg ulcer. The health care provider has
ordered sliding scale insulin coverage with regular insulin for hyperglycemia. The nurse
brings the injection into the room, and the patient becomes upset, stating I do not want to
start taking that drug! I will need it the rest of my life. What is the nurse’s best response?
a. This is the same drug as the oral medication you were taking. It’s a stronger dose while you
are in the hospital.
b. Don’t worry. You shouldn’t need this too often. As you feel better, your blood glucose level
will drop.
c. Your body is under stress right now, which raises your blood glucose level. This does not
mean you will be on this drug permanently. Once you’re feeling better, your provider will
determine if your oral medication is all you will need.
d. Your disease is progressing and your pancreas is producing less insulin. I know this is a hard
time for you. Do you want to talk about it

3. What test determines glycemic control over the previous 8 to 10 weeks?

a. 24 hour glucose clearance test (GTT)
b. Fructosamine test
c. Fasting blood sugar (FBS)
d. A1c test

4. When is the best time for the nurse to administer Lispro?

a. After the patient has started eating
b. Within 10 to 15 minutes of eating
c. 30 minutes before a meal
d. 45 to 60 minutes before a meal

5. Which is the most important for the successful management of diabetes mellitus?
a. A network of community resources
b. The level of self – management
c. Preventative education
d. Frequent follow up with the health care provider
6. Which medication is used to treat hyperthyroidism?
 a. Levothyroxine (Synthroid)
b. Liotrix (Thyrolar)
c. Propylthiouracil (Propacil)
d. Liothyronine (Cytomel)

7. A patient with a history of heart failure has been diagnosed with hypothyroidism. The drug
interaction with glycosides and thyroid replacement therapy will most likely require which
change in therapy?
a. Decrease in the daily digoxin dosage
b. Gradual increase in the daily glycoside dosage
c. Inability to begin thyroid replacement therapy because of the underlying heart condition
d. Increased thyroid replacement dosage

8. Which nursing diagnosis may be identified for a patient with hyperthyroidism?

a. Imbalanced nutrition: more than body requirements
b. Constipation
c. Disturbed sleep pattern
d. Ineffective airway clearance

9. A patient with type 1 diabetes was prescribed a glucocorticoid for chronic obstructive
pulmonary disease. Which will the nurse expect in the treatment plan?
a. A decrease in the amount of insulin needed
b. No change in the amount of insulin needed
c. An increase in the need for carbohydrates
d. An increase in the insulin needed

10. Which condition would require mineralocorticoid replacement?

a. Addisons disease
b. Diabetes insipidus
c. Myxedema
d. Glomerulonephritis