NG. Endocrine Pharmacology Exam

John, a 58-year-old male with a BMI of 31, was recently diagnosed with type 2 diabetes mellitus. His HbA1c level is 8.5%. He's been started on metformin 500mg twice daily. He comes to the clinic for a follow-up and asks about the medication's specifics.

Which of the following statements would be the most appropriate education for John regarding metformin?

John, a 65-year-old male with a history of Parkinson's disease, has been prescribed bromocriptine. He's also been experiencing increased headaches recently.

Which of the following are three known indications or uses of bromocriptine? Management of Parkinson's disease and:

Emily, a 28-year-old female with a 10-year history of type 1 diabetes, is an avid swimmer training for an upcoming championship. She has noticed areas of thickened skin at her insulin injection sites and is concerned about how this might affect her training and diabetes management.

Considering Emily's athletic pursuits and the described skin changes, which of the following nursing considerations and interventions would be most appropriate for her situation? Select all that apply:

Maya, a 49-year-old travel blogger with type 2 diabetes, was recently prescribed canagliflozin to help manage her blood sugar levels during her extended travels across various continents.
She's particularly concerned about how changing diets, climates, and activities might interplay with potential side effects of the drug.
Given her active lifestyle and exposure to different environments, she reaches out to her healthcare provider to understand the side effects she should be particularly wary of during her trips.

For each side effect below, click if the adverse effects are consistent with the use of canagliflozin.

The nurse is assessing a child who has been receiving levothyroxine for hypothyroidism. The nurse is concerned that the child’s levothyroxine dose may be too high based on recent observations.

Which findings should indicate to the nurse that the child’s levothyroxine dose is too high? Select all that apply.

Tom, a 50-year-old male, is scheduled for a cosyntropin stimulation test to evaluate his adrenal function. The healthcare team needs to ensure Tom is adequately prepared for the test.
Which of the following instructions and precautions are essential for Tom before undergoing the cosyntropin test? Select all that apply

Linda is a 30-year-old female who was recently diagnosed with pregnancy during her first trimester (8 weeks gestation). She has a history of hyperthyroidism, which has been managed for the past 5 years. Before her pregnancy, she was treated with methimazole, which effectively controlled her symptoms.

Given her new pregnancy, Linda is concerned about the safety of continuing her anti-thyroid treatment for both her and the baby.
Which of the following anti-thyroid drugs would be most appropriate to consider during Linda’s first trimester of pregnancy, keeping in mind both maternal and fetal well-being?

Sarah Jenkins, a 42-year-old woman, was admitted to the Endocrinology Department due to persistent symptoms over the past 3 months. Sarah reports decreased physical and mental activity, weight gain of 10 pounds, hair thinning and loss, irregular menstrual periods, and spontaneous galactorrhea.
She also mentions feeling cold most of the time, despite mild weather.
Which two nursing considerations are most important to keep in mind when advising Sarah about her current prescription?

Aria, a 29-year-old female, has been diagnosed with generalized lipodystrophy. Given her persistently low leptin levels and associated complications, her endocrinologist has prescribed metreleptin.
Aria, being health-conscious, wants to understand the drug's nuances and how it might impact her daily activities.
Which of the following nursing considerations or patient education pointers are crucial for Aria when starting metreleptin? Select all that apply

Ella is a 32-year-old female who has been prescribed inhaled dexamethasone, for the treatment of a chronic respiratory obstructive condition.

The nurse is preparing to administer the medication and must consider several precautions to ensure safe and effective treatment.
Which three precautions should the nurse consider when administering dexamethasone to Ella?

Hannah, a 45-year-old female with type 1 diabetes mellitus, comes to the clinic complaining of recurrent episodes of dizziness and shakiness around mid-morning. 
According to her history, which type of insulin is most probable that Hanna uses? 

A child diagnosed with congenital adrenal hyperplasia (CAH) has been prescribed glucocorticoids to manage the condition. The nurse is assessing the child to determine whether the therapy is effective.

Which nursing assessment finding indicates that the therapy is successful?

Leah, a 35-year-old woman diagnosed with gestational diabetes
Given Leah's specific circumstances, which of the two following statements regarding the storage of her insulin pen is correct?

Maria, a 50-year-old female with type 2 diabetes, HCP is considering adding exenatide to her regimen. 
Which nursing considerations are correct when discussing adding exenatide with Maria? Select all that apply

Michael, a 68-year-old male diagnosed with non-metastatic castration-resistant prostate cancer, recently started treatment with darolutamide. During a follow-up visit, he mentioned experiencing several new symptoms.

Which of the following are three potential side effects of darolutamide?

A 58-year-old male, Mr. Williams, presents to the outpatient clinic for a follow-up after being diagnosed with chronic kidney disease stage 4. He reports a history of hypertension, diabetes mellitus type 2, and secondary hyperparathyroidism. He was recently prescribed calcitriol.

During patient education, Mr. Williams makes the following statements:

Which statement by Mr. Williams requires the nurse to intervene? Select all that apply

Anthony, a 27-year-old male bodybuilder, admits to using various anabolic steroids, including fluoxymesterone, for muscle gain. He presents with fatigue and abdominal discomfort.
Which of the following complications are associated with the use of fluoxymesterone? Select all that apply

Emily, a 38-year-old female, has been diagnosed with Cushing's syndrome and has been started on levoketoconazole. As a nurse, you are reviewing her medications and preparing for patient education.

What nursing implication is crucial for patients on levoketoconazole?

Deborah is a 52-year-old obese woman who has been scheduled by her doctor to undergo a contrast angiogram due to emerging angina pectoris, which she has been suffering from for 2 months.
Before the procedure, the nurse must check her medical record to ensure that all her documents and authorizations are signed, as well as the list of potential medications that she will need to temporarily discontinue.

Complete the diagram by dragging from the choices below to specify what possible drug is important to check and stop in this case from the list, two actions the nurse would take when caring for the client receiving this drug, and two parameters the nurse would monitor before performing the client’s procedure

An infant diagnosed with congenital hypothyroidism has been prescribed levothyroxine sodium. The nurse is responsible for assessing the effectiveness of the medication during follow-up visits.

Which assessments would assist the nurse in evaluating the effectiveness of levothyroxine sodium? Select all that apply

George, a 62-year-old male with type 2 diabetes and a history of mild cognitive impairment, has been prescribed both NPH and regular insulin. He recalls some instructions from his diabetes education class but is confused about specific steps in the mixing process. He's worried about potential mistakes, especially since he's had previous episodes of hypoglycemia with insulin. Today, he brought his insulin vials and syringes to the clinic and asked the nurse for a demonstration.

Which sequence of steps best represents the correct technique for mixing the two types of insulin?

Liam, a 38-year-old professional athlete recently diagnosed with type 1 diabetes, has been meticulous about understanding the nuances of different insulin types. Given the demands of his profession and his frequent international travels, he's looking for insulins that offer flexibility without compromising control.
A fellow athlete friend suggested insulin glargine as a potential fit. Liam has done some reading but seems to have misconceptions intermingled with facts.
Which of the following three statements made by Liam is correct regarding insulin glargine?

45-year-old Laura has been diagnosed with autosomal dominant polycystic kidney disease (ADPKD) and recently began treatment with tolvaptan. The healthcare team is keen on monitoring her response to the medication.
Which of the following measures will be crucial in evaluating Laura's outcomes with the use of tolvaptan? Select all that apply

The medications for treating type 1 DM are changed for the Native American 12-year-old from NPH and rapid-acting insulin to a basal-bolus insulin regimen of glargine and insulin aspart.
To achieve tight glucose control and prevent complications due to DM, which instructions should the nurse provide to the child and parent? Select all that apply.

A 47-year-old female, Mrs. Smith, with a 15-year history of type 1 diabetes mellitus presents for a routine checkup. She has been struggling with postprandial hyperglycemia and was recently started on pramlintide to help manage her blood sugar levels in addition to her insulin regimen.
She reports being unsure about how to adjust her insulin and diet since starting the new medication and the nurse begin to educate her.
Which statement by Mrs. Smith indicates the need for further teaching?

The parents of a 7-year-old child with type 1 diabetes mellitus (DM) are planning a road trip to the beach, driving 1,200 miles. They are concerned about how to store the child’s insulin during the trip and ask the nurse for advice. The nurse provides information on safe insulin storage and travel considerations.

Which response by the nurse is most accurate?

Robert, a 50-year-old male with a complex medical history, including hypertension and irritable bowel syndrome, has recently been prescribed insulin therapy to manage his type 2 diabetes. He is on multiple medications for his other conditions.
Since starting on insulin, he's observed a variety of new symptoms and is concerned about drug interactions, adverse reactions, or even potential mismanagement of his conditions.
Given his medical background and current symptoms, which of the following three might be adverse reactions specifically attributed to his insulin therapy?

A 4-year-old child with type 1 diabetes mellitus (DM) consumed breakfast, which included one-half cup of oatmeal, 60 mL of orange juice, and 60 mL of milk. The child's blood glucose was 150 mg/dL before the meal, and no insulin was given before breakfast.
The nurse is now reviewing the meal and blood glucose levels to determine the appropriate management of insulin.

Which conclusions by the nurse are correct? Select all that apply.

The nurse is providing discharge instructions to the parents of a child diagnosed with Addison’s disease. The focus is on ensuring that the parents understand how to manage the child’s condition, particularly during times of illness or stress.

Which instructions should be included by the nurse? Select all that apply.

Mark, a 55-year-old male, presents with symptoms of testosterone deficiency. His recent labs confirm a low testosterone level. His endocrinologist prescribes Depo-testosterone (testosterone cypionate), and he comes to the nursing clinic for his first injection.

Which of the following nursing implications should be considered when administering Depo-testosterone? Select all that apply: