Nokea
A 72-year-old woman is diagnosed with diabetes. What does the nurse recognize about the management of diabetes in the older adult?
- A. It is more difficult to achieve strict glucose control than in younger patients.
- B. It usually is not treated unless the patient becomes severely hyperglycemic.
- C. It does not include treatment with insulin because of limited dexterity and vision.
- D. It usually requires that a younger family member be responsible for care of the patient
Correct Answer: A
Rationale: In older adults, achieving strict glucose control may be more difficult due to factors such as comorbidities, polypharmacy, and decreased physiological reserve.
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Ketoacidosis is most related to:
- A. adrenocortical insufficiency.
- B. Cushing syndrome.
- C. excess fatty acid catabolism.
- D. hyperglycemia.
Correct Answer: C
Rationale: Ketoacidosis is most related to excess fatty acid catabolism. During this process, the body breaks down fatty acids into ketones, leading to an accumulation of ketones in the blood and causing metabolic acidosis. Adrenocortical insufficiency (A) is related to cortisol deficiency, not ketoacidosis. Cushing syndrome (B) is associated with excess cortisol production, not ketoacidosis. Hyperglycemia (D) is high blood sugar levels and is not directly related to the mechanism of ketoacidosis.
Pilocarpine is used in the treatment of:
- A. Increased salivary secretion
- B. Glaucoma
- C. Intestinal colic
- D. Cardiac arrhythmias
Correct Answer: B
Rationale: The correct answer is B: Glaucoma. Pilocarpine is a cholinergic agonist that works by causing constriction of the pupil and increasing the outflow of aqueous humor in the eye, thereby reducing intraocular pressure in glaucoma. Increased salivary secretion (A) is a side effect of pilocarpine use. Pilocarpine is not indicated for treating intestinal colic (C) or cardiac arrhythmias (D).
Hyoscine is one of the most effective drugs for preventing motion sickness, but may cause photophobia or blurred vision. Which is the most similar prototype drug?
- A. A monoamine oxidase inhibitor
- B. Propranolol
- C. Atropine
- D. Bethanechol
Correct Answer: C
Rationale: Step 1: Hyoscine is an antimuscarinic drug used for motion sickness.
Step 2: Atropine is a similar prototype drug as it also belongs to the antimuscarinic class.
Step 3: Atropine, like hyoscine, can cause photophobia and blurred vision.
Step 4: Monoamine oxidase inhibitors (A) are not related to antimuscarinic drugs.
Step 5: Propranolol (B) is a beta-blocker and not an antimuscarinic drug.
Step 6: Bethanechol (D) is a muscarinic agonist, opposite in action to antimuscarinic drugs like hyoscine and atropine.
Which of the following is not a function of insulin?
- A. Lowering blood glucose levels
- B. Promoting protein synthesis
- C. Simulating hepatic gluconeogenesis
- D. Promoting fatty acid synthesis
Correct Answer: C
Rationale: The correct answer is C: Stimulating hepatic gluconeogenesis. Insulin's primary function is to lower blood glucose levels by promoting glucose uptake in cells and inhibiting gluconeogenesis in the liver. Choice A is correct as insulin helps lower blood glucose levels. Choice B is correct as insulin promotes protein synthesis. Choice D is correct as insulin promotes fatty acid synthesis to store excess glucose as fat. Therefore, choice C is incorrect as insulin actually inhibits hepatic gluconeogenesis rather than stimulating it.
Regarding parathyroid glands, All the following statements are true Except:
- A. They are four small yellowish brown ovoid glands
- B. They lie in relation to the posterior border of thyroid lobes
- C. Release of its hormones is controlled by pituitary gland
- D. Its hormone controls blood calcium level
Correct Answer: C
Rationale: The correct answer is C because the release of hormones by the parathyroid glands is actually controlled by the levels of calcium in the blood, not by the pituitary gland.
A: True - Parathyroid glands are four small yellowish brown ovoid glands.
B: True - They lie in relation to the posterior border of thyroid lobes.
D: True - The hormone produced by the parathyroid glands, parathyroid hormone (PTH), controls blood calcium levels by stimulating the release of calcium from bones and increasing the absorption of calcium from the intestines.