Nokea
A client with a history of hypertension is diagnosed with primary hyperaldosteronism. This diagnosis indicates that the client's hypertension is caused by excessive hormone secretion from which of the following glands?
- A. Adrenal cortex
- B. Adrenal medulla
- C. Pancreas
- D. none of the above
Correct Answer: A
Rationale: Primary hyperaldosteronism is a condition characterized by excessive production of aldosterone by the adrenal cortex. Aldosterone is a hormone produced by the adrenal glands that plays a key role in regulating blood pressure and electrolyte balance in the body. When there is an overproduction of aldosterone, it can lead to increased sodium retention and potassium excretion, resulting in hypertension. Therefore, in this case, the client's hypertension is caused by excessive hormone secretion from the adrenal cortex, making option A the correct answer.
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When caring for a client, whose being treated for hyperthyroidism, it's important to:
- A. Provide extra blankets and clothing to keep the client warm.
- B. Monitor the client for signs of restlessness, sweating and excessive weight loss during thyroid replacement therapy.
- C. Balance the client's periods of activity and rest.
- D. Encourage the client to be active to prevent constipation.
Correct Answer: B
Rationale: When caring for a client with hyperthyroidism, it is important to monitor the client for signs of restlessness, sweating, and excessive weight loss during thyroid replacement therapy. Treatment for hyperthyroidism often involves thyroid replacement therapy to restore the balance of thyroid hormones in the body. Monitoring for signs and symptoms of overmedication or undermedication is crucial to ensure the client's health and well-being. Restlessness, sweating, and weight loss can be indicators of an imbalance in thyroid hormone levels and may require adjustments in medication dosage. Regular monitoring and communication with healthcare providers are essential in managing the client's condition effectively.
A neonate has been diagnosed with caput succedaneum. Which statement is correct about this condition?
- A. It usually resolves in 3-6 weeks
- B. It doesn't cross the cranial suture line
- C. It's a collection of blood between the skull and the periosteum
- D. It involves swelling of tissue over the presenting part of the presenting head
Correct Answer: D
Rationale: Caput succedaneum is a condition characterized by the swelling of tissue over the presenting part of the infant's head during delivery. It is commonly a result of prolonged labor or vacuum extraction. Unlike cephalohematoma, caput succedaneum does cross the cranial suture lines. This condition typically resolves within a few days to a week after birth without intervention. It is important to monitor the infant for any complications or signs of infection during the resolution process.
Mrs. Zeno asks the nurse why the disease has occurred. The nurse bases the reply on the knowledge that there is:
- A. A genetic defect in the production of acetylcholine
- B. A reduced amount of neurotransmitter acetylcholine
- C. A decreased number of functioning acetyl-choline receptor sites
- D. An inhibition of the enzyme Ache leaving the end plates folded.
Correct Answer: C
Rationale: The disease mentioned in the question is likely myasthenia gravis. Myasthenia gravis is an autoimmune disorder where the body's immune system attacks acetylcholine receptors at the neuromuscular junction. Acetylcholine is a neurotransmitter responsible for transmitting nerve impulses to muscles. In myasthenia gravis, the immune system destroys or blocks the acetylcholine receptor sites on muscle cells, leading to a decrease in the number of functioning receptor sites. This results in muscle weakness and fatigue because the communication between nerves and muscles is impaired. This is why the nurse would base the reply on the knowledge that there is a decreased number of functioning acetyl-choline receptor sites as the underlying cause of the disease.
Low birth weight or premature infants are screened for anemia at birth and again at the age of
- A. 2 months
- B. 4 months
- C. 6 months
- D. 8 months
Correct Answer: C
Rationale: Anemia screening for low birth weight or premature infants is recommended at 6 months.
A client with ascites has a paracentesis, and 1500 ml of fluid is removed. Immediately following the procedure it is most important for the nurse to observe for:
- A. A rapid, thready pulse
- B. Decreased peristalsis .
- C. Respiratory congestion
- D. An increased in temperature
Correct Answer: C
Rationale: Following a paracentesis procedure where a large amount of ascitic fluid is removed, there is a risk of developing a fluid shift and a potential complication known as "paracentesis-induced circulatory dysfunction" (PICD). This may cause a sudden increase in central blood volume due to rapid re-distribution of fluid, leading to respiratory congestion, dyspnea, and hypoxemia. Therefore, it is crucial for the nurse to monitor the client closely for signs of respiratory distress or congestion immediately after the procedure to prevent any respiratory complications. A rapid, thready pulse (choice A) may indicate hypovolemia, but it is not the most important immediate concern in this case. Decreased peristalsis (choice B) and an increased temperature (choice D) are not typically associated with the immediate post-paracentesis period and are therefore lower priorities compared to monitoring for signs of respiratory congestion.