Nokea
A 46-year-old woman has hirsutism, hyperglycemia, obesity, muscle wasting, and increased ACTH. The most likely cause of her symptoms is
- A. primary adrenocortical insufficiency (Addison disease)
- B. pheochromocytoma
- C. primary overproduction of ACTH (Cushing disease)
- D. treatment with exogenous glucocorticoids
Correct Answer: C
Rationale: The correct answer is C: primary overproduction of ACTH (Cushing disease). In this case, the symptoms match those of Cushing syndrome, which is characterized by excess cortisol production. The increased ACTH levels are indicative of the pituitary gland overproducing ACTH, leading to excess cortisol. Choices A and B are incorrect as they do not match the symptoms presented. Choice D is incorrect because exogenous glucocorticoids would not lead to increased ACTH levels.
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In a patient with central diabetes insipidus, what will the administration of ADH during a water deprivation test result in?
- A. Decrease in body weight
- B. Decrease in blood pressure
- C. Increase in urinary output
- D. Increase in urine osmolality
Correct Answer: D
Rationale: In central diabetes insipidus, administering ADH during a water deprivation test will result in an increase in urine osmolality due to the kidneys' ability to concentrate urine in response to ADH.
Which row identifies the product at each electrode?
- A. bromide ions, lead ions
- B. bromine, lead
- C. lead ions, bromide ions
- D. lead, bromine
Correct Answer: D
Rationale: The correct answer is D because lead is the product at the cathode (negative electrode) during electrolysis, while bromine is the product at the anode (positive electrode). Lead is reduced at the cathode to form lead metal, and bromine is oxidized at the anode to form bromine gas. This is in line with the general rule that cations are attracted to the cathode and are reduced, while anions are attracted to the anode and are oxidized.
Choice A is incorrect as bromide ions are reduced at the cathode, not lead ions. Choice B is incorrect because bromine is produced at the anode, not lead. Choice C is incorrect because lead ions are reduced at the cathode, not bromide ions.
A patient is hospitalized with adrenocortical insufficiency. Which nursing activity should you delegate to the nursing assistant?
- A. Remind patient to change positions slowly.
- B. Check the patient for muscle weakness.
- C. Teach the patient how to collect 24-hour urine.
- D. Plan nursing interventions to promote fluid balance.
Correct Answer: A
Rationale: Reminding the patient to change positions slowly is a non-invasive task that is appropriate for delegation to a nursing assistant, as it helps prevent dizziness or hypotension due to adrenocortical insufficiency.
Hyperglycemic hyperosmolar nonketotic coma (HHNK) is one complication of diabetes. Symptoms include
- A. hypertension
- B. bradycardia
- C. polyuria
- D. Kussmaul respirations
Correct Answer: C
Rationale: Polyuria is a characteristic symptom of HHNK, along with hyperglycemia and severe dehydration.
Which of the following suppress(es) the secretion of ACTH?
- A. Elevated blood glucose levels
- B. Dietary iodine
- C. Corticotropin-releasing hormone (CRH)
- D. Elevated plasma cortisol levels
Correct Answer: D
Rationale: Elevated plasma cortisol levels suppress the secretion of ACTH through negative feedback. High cortisol levels signal the hypothalamus and pituitary to decrease the release of CRH and ACTH, respectively, to maintain homeostasis. This is a regulatory mechanism to prevent excessive cortisol production.
A: Elevated blood glucose levels do not directly suppress ACTH secretion.
B: Dietary iodine is not related to ACTH secretion.
C: CRH stimulates ACTH release, so it does not suppress its secretion.