Deck 72: Glucocorticoids in Nonendocrine Disorders

Question 1

A patient taking high doses of a glucocorticoid develops weakness in the muscles of the upper arms and in the legs. What will the nurse do?

A) Contact the provider to ask about reducing the dose.
B) Encourage the patient to restrict sodium intake.
C) Reassure the patient that this is an expected side effect.
D) Tell the patient to stop taking the drug.

Answer 1

Contact the provider to ask about reducing the dose.

Question 2

A patient who has been taking a glucocorticoid for several months arrives in the clinic. The nurse notes that the patient's cheeks appear full and that a prominent hump of fat is present on the upper back. The nurse will ask the provider to order which test(s)?

A) Liver function tests
B) Serum electrolytes
C) Tuberculin skin test
D) Vitamin D levels

Answer 2

Serum electrolytes

Question 3

A child is to begin long-term glucocorticoid therapy. The parents ask the nurse about the effects of this drug on the child's growth. Which response by the nurse is correct?

A) "A smaller dose may be indicated for your child."
B) "Ask your provider about every other day dosing."
C) "Long-acting glucocorticoid preparations should prevent growth suppression."
D) "Oral glucocorticoids rarely cause growth suppression."

Answer 3

"Ask your provider about every other day dosing."

Question 4

A patient taking a glucocorticoid for arthritis reports feeling bloated. The nurse notes edema of the patient's hands and feet. Which action by the nurse is correct?

A) Ask the patient about sodium intake.
B) Obtain a blood glucose level.
C) Suggest the patient limit potassium intake.
D) Tell the patient to stop taking the drug.

Question 5

A patient who has arthritis has been taking ibuprofen [Motrin] and a glucocorticoid medication. The patient reports having tarry stools but denies gastric pain. Which action by the nurse is correct?

A) Contact the provider to discuss ordering an antiulcer medication.
B) Counsel the patient to use over-the-counter antacids.
C) Reassure the patient not to worry unless there is gastric pain.
D) Tell the patient to stop taking the glucocorticoid immediately.

Question 6

A woman who is breastfeeding is prescribed a low pharmacologic dose of a glucocorticoid and asks the nurse about potential effects on her infant. What will the nurse tell her about this medication?

A) "At this dose, the concentration in your breast milk is safe."
B) "Contact your provider to discuss lowering the dose."
C) "There will be reversible side effects for your baby."
D) "This drug is likely to cause growth retardation in your baby."

Question 7

A patient is about to receive prednisone for tendonitis. The nurse reviewing the chart would be concerned about which of the following in the patient's medical history?

A) Asthma and allergic rhinitis
B) Gouty arthritis
C) Seborrheic dermatitis
D) Systemic fungal infection

Question 8

A nurse tells a nursing student that the glucocorticoids given for rheumatoid arthritis are nearly identical to substances produced naturally by the body. The student remarks that the drug must be very safe. Which response by the nurse is correct?

A) "As long as the drug is taken as prescribed, side effects usually do not occur."
B) "By interrupting the inflammatory process, these drugs inhibit side effects."
C) "Side effects can occur and are dependent on the dose and duration of treatment."
D) "The negative feedback loop prevents side effects."

Question 9

A nurse is discussing glucocorticoids with a group of nursing students. Which statement by a student indicates understanding of the teaching?

A) "Glucocorticoids have both endocrine and nonendocrine uses."
B) "Patients treated for adrenocortical insufficiency receive pharmacologic doses."
C) "Pharmacologic effects are achieved with low doses of glucocorticoids."
D) "Physiologic doses are used to treat inflammatory disorders."

Question 10

A clinic patient who has been taking a glucocorticoid for arthritis for several months remarks to the nurse, "It's a good thing my symptoms are better, because my mother has been quite ill, and I have to take care of her." The patient's blood pressure is 100/60 mm Hg. The nurse will report this to the provider and ask about:

A) reducing the patient's dose.
B) using every other day dosing.
C) increasing the patient's dose.
D) tapering the dose.

Question 11

Which disorders may be treated with glucocorticoids?

A) Allergic rhinitis
B) Anaphylaxis
C) Bronchiolitis
D) Gout
E) Ulcerative colitis

Question 12

A 60-year-old female patient is about to begin long-term therapy with a glucocorticoid. Which of the following will be important for minimizing the risk of osteoporosis?

A) Baseline vitamin D level
B) Calcium and vitamin D supplements
C) Estrogen therapy
D) Skeletal x-rays before treatment

Question 13

A patient who is a long-distance runner has been diagnosed with rheumatoid arthritis in both knees and will begin glucocorticoid therapy. When teaching the patient about the medication, the nurse will include what information?

A) "By reducing inflammation, this drug will slow the progression of your disease."
B) "Glucocorticoids are used as adjunctive therapy during acute flare-ups."
C) "Oral glucocorticoids cause less toxicity than intra-articular injections."
D) "You may resume running when the pain and swelling improve."

Question 14

A nurse is teaching a group of nursing students why glucocorticoids are preferred over nonsteroidal anti-inflammatory drugs in the treatment of inflammation. Which statement by a student indicates a need for further teaching?

A) "Glucocorticoids act by multiple mechanisms and have more anti-inflammatory effects than NSAIDs."
B) "Glucocorticoids have fewer side effects than nonsteroidal anti-inflammatory drugs."
C) "Glucocorticoids help avert damage to tissues from lysosomal enzymes."
D) "Glucocorticoids reduce the immune component of inflammation."

Question 15

The prescriber orders 20 mg of hydrocortisone orally once each day. The nurse will make sure the drug is scheduled to be administered at what time?

A) 8:00 AM
B) 12:00 PM
C) 4:00 PM
D) 9:00 PM

Question 16

A nurse is teaching a patient who has taken glucocorticoids for over a year about glucocorticoid withdrawal. Which statement by the patient indicates a need for further teaching?

A) "I should reduce the dose by half each day until I stop taking the drug."
B) "I will need to have cortisol levels monitored during the withdrawal process."
C) "The withdrawal schedule may take several months."
D) "If I have surgery, I may need to take the drug for a while, even after I have stopped."