Somatropin is a growth hormone made by recombinant DNA technology.
Correct Answer
True
True. Somatropin is produced in the laboratory using recombinant DNA and has the same structure as human growth hormone. It treats growth failure caused by growth hormone deficiency.
Category: Growth Hormone Replacement
Question 2
Somatropin is given orally as a daily tablet.
Correct Answer
False
False. Somatropin is a protein that would be digested in the stomach, so it is given by subcutaneous injection. Patients and families are taught injection technique and site rotation.
Category: Growth Hormone Replacement
Question 3
Somatropin is contraindicated in a patient with an active malignancy.
Correct Answer
True
True. Growth hormone promotes cell growth and could speed tumor growth, so active cancer is a contraindication. Critical illness and closed epiphyses in children also rule out its use for growth.
Category: Growth Hormone Replacement
Question 4
Somatropin can reveal or cause low thyroid function, so thyroid tests are monitored during therapy.
Correct Answer
True
True. Hypothyroidism can appear during growth hormone therapy and would limit the response to treatment. Thyroid function is checked and treated if it becomes low.
Category: Growth Hormone Replacement
Question 5
Lanreotide is a dopamine agonist used to treat acromegaly.
Correct Answer
False
False. Lanreotide is a somatostatin analog that inhibits growth hormone release. Bromocriptine is the dopamine agonist that can be used for acromegaly and high prolactin levels.
Category: Growth Hormone Suppressants
Question 6
Octreotide is used to treat growth hormone deficiency.
Correct Answer
False
False. Octreotide is a somatostatin analog that suppresses growth hormone, so it treats growth hormone excess such as acromegaly. Growth hormone deficiency is treated with somatropin.
Category: Growth Hormone Suppressants
Question 7
Desmopressin given as a nasal spray can irritate the nasal lining, so the nasal passages are checked during therapy.
Correct Answer
True
True. Intranasal antidiuretic hormone products can cause nasal irritation and ulceration. The nurse inspects the nasal passages and reports sores or congestion that may also reduce absorption.
Category: ADH Drugs
Question 8
Desmopressin is used to treat the syndrome of inappropriate antidiuretic hormone.
Correct Answer
False
False. Desmopressin acts like antidiuretic hormone, so it would worsen the water retention and hyponatremia of that syndrome. It treats diabetes insipidus, in which antidiuretic hormone is lacking or not working.
Category: ADH Drugs
Question 9
The syndrome of inappropriate antidiuretic hormone causes water retention and dilutional hyponatremia.
Correct Answer
True
True. Excess antidiuretic hormone makes the kidneys hold water, which dilutes the blood sodium. Severe hyponatremia can cause nausea, muscle cramps, confusion and seizures.
Category: ADH Antagonists
Question 10
Tolvaptan is safe to use in a patient with hypovolemic hyponatremia.
Correct Answer
False
False. Tolvaptan removes free water, so it is contraindicated when hyponatremia comes from low blood volume; that patient needs volume replacement instead. It is used for hyponatremia with normal or increased fluid volume.
Category: ADH Antagonists
Question 11
Tolvaptan can cause serious liver injury.
Correct Answer
True
True. Tolvaptan labeling warns of serious and potentially fatal liver injury, so liver tests are monitored. Patients report fatigue, loss of appetite, right upper abdominal pain, dark urine or jaundice.
Category: ADH Antagonists
Question 12
Strict fluid restriction is recommended while tolvaptan therapy is being started.
Correct Answer
False
False. Labeling advises against fluid restriction early in therapy, because combined with tolvaptan it can raise sodium too fast. Patients are allowed to drink in response to thirst.
Category: ADH Antagonists
Question 13
Untreated Addison disease commonly causes hyperkalemia because aldosterone is lacking.
Correct Answer
True
True. Aldosterone normally makes the kidneys excrete potassium and retain sodium. Without it, potassium rises while sodium and blood pressure fall.
Category: Adrenal Insufficiency
Question 14
Addisonian crisis typically causes high blood pressure.
Correct Answer
False
False. Adrenal crisis causes severe hypotension and shock from the loss of cortisol and aldosterone, along with weakness, confusion and abdominal pain. It is an emergency treated with IV hydrocortisone and fluids.
Category: Adrenal Insufficiency
Question 15
Hydrocortisone has both glucocorticoid and mineralocorticoid activity.
Correct Answer
True
True. Hydrocortisone is identical to cortisol and has salt-retaining as well as glucocorticoid effects, which makes it useful for replacement in adrenal insufficiency.
Category: Adrenal Insufficiency
Question 16
Patients with adrenal insufficiency should wear medical identification stating that they take steroid replacement.
Correct Answer
True
True. In an emergency, responders need to know the patient depends on replacement steroids and may need extra doses. A missed diagnosis of adrenal crisis can be fatal.
Category: Adrenal Insufficiency
Question 17
Hydrocortisone replacement for Addison disease can be stopped once the symptoms resolve.
Correct Answer
False
False. Addison disease is permanent loss of adrenal function, so replacement is lifelong. Stopping it can cause adrenal crisis.
Category: Adrenal Insufficiency
Question 18
Dexamethasone has strong salt-retaining activity, so it is used to replace aldosterone.
Correct Answer
False
False. Dexamethasone is a long-acting glucocorticoid with almost no mineralocorticoid activity. Fludrocortisone is the drug used to replace aldosterone.
Category: Glucocorticoid Therapy
Question 19
Alternate-day glucocorticoid therapy increases suppression of the hypothalamic-pituitary-adrenal axis compared with daily dosing.
Correct Answer
False
False. Giving the drug every other morning lets the axis recover on the off day, so it causes less suppression than daily dosing. It is used for some patients who need long-term therapy.
Category: Glucocorticoid Therapy
Question 20
Patients on long-term systemic glucocorticoids should avoid contact with people who have chickenpox or measles.
Correct Answer
True
True. Glucocorticoids suppress immunity, and these infections can become severe or fatal in an immunosuppressed patient. An exposure should be reported to the provider promptly.
Category: Glucocorticoid Therapy