Nokea
A nursing health history of a client suspected of having Cushing syndrome must include assessment of
- A. increased pigmentation
- B. decreased urinary output
- C. changes in body structure and weight
- D. increased thickening and coarsening of skin
Correct Answer: C
Rationale: Changes in body structure and weight, such as fat redistribution and weight gain, are key signs of Cushing syndrome.
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Intravenous administration of epinephrine to a patient results in a severe decrease in diastolic pressure and an increase in cardiac output. Which of the following drugs might the patient have previously taken that could account for this unexpected effect?
- A. Propranolol
- B. Atropine
- C. Phenylephrine
- D. Prazosin
Correct Answer: D
Rationale: The correct answer is D: Prazosin. Prazosin is an alpha-1 adrenergic receptor antagonist, which blocks the vasoconstrictor effect of catecholamines like epinephrine, leading to vasodilation and a decrease in diastolic pressure. The unexpected effect of a decrease in diastolic pressure and an increase in cardiac output after epinephrine administration suggests that the patient might have taken a drug that blocks alpha-1 receptors. Propranolol (A) is a beta-blocker, which would not cause this effect. Atropine (B) is a muscarinic receptor antagonist and would not explain the observed effects. Phenylephrine (C) is an alpha-1 agonist, so it would not result in the described response. Therefore, Prazosin (D) is the most likely drug the patient previously took to account for the unexpected effects of epinephrine administration.
Pituitary Gland, Which is Also the Master Endocrine Gland Is Controlled by Which of the Following?
- A. Thyroid
- B. Hypothalamus
- C. Pineal gland
- D. None of the above
Correct Answer: B
Rationale: The correct answer is B: Hypothalamus. The hypothalamus controls the pituitary gland by releasing hormones that stimulate or inhibit pituitary hormone production. This relationship is known as the hypothalamic-pituitary axis. The hypothalamus is considered the master controller of the endocrine system, making it the correct choice.
A: Thyroid - The thyroid gland is not directly responsible for controlling the pituitary gland. It is a separate endocrine gland that produces its own hormones.
C: Pineal gland - The pineal gland primarily regulates the sleep-wake cycle and produces melatonin. It does not play a direct role in controlling the pituitary gland.
D: None of the above - This is incorrect as the hypothalamus does indeed control the pituitary gland.
Which of the following is NOT related to adrenal medulla structure and function?
- A. Inner portion of adrenal gland.
- B. Controlled by the nervous system.
- C. Regulates levels of glucose and minerals in the blood.
- D. Produces epinephrine and norepinephrine.
Correct Answer: C
Rationale: The correct answer is C: Regulates levels of glucose and minerals in the blood. The adrenal medulla is responsible for producing epinephrine and norepinephrine, not regulating blood glucose and minerals. The inner portion of the adrenal gland refers to the adrenal medulla. It is controlled by the nervous system, specifically the sympathetic nervous system. Epinephrine and norepinephrine produced by the adrenal medulla are involved in the body's fight-or-flight response, not in regulating blood glucose and minerals. Therefore, choice C is the correct answer as it is not related to adrenal medulla structure and function.
Which of the following would be associated with the action of steroids on cells?
- A. extracellular receptors with a specificity for only a single amino acid sequence on the hormone
- B. an enzyme that catalyzes the formation of cyclic AMP
- C. second-messenger systems
- D. a hormone-receptor complex that interacts directly with the cellʹs DNA
Correct Answer: D
Rationale: The correct answer is D because steroids act by binding to intracellular receptors, forming a hormone-receptor complex that directly interacts with the cell's DNA to regulate gene expression. This leads to changes in protein synthesis and cell function.
A: Extracellular receptors do not have specificity for a single amino acid sequence on the hormone. Steroids act intracellularly.
B: Formation of cyclic AMP is associated with G-protein coupled receptors, not steroid receptors.
C: Second-messenger systems are typically involved in signaling cascades triggered by extracellular ligands, not steroids.
A patient who is on corticosteroid therapy for treatment of an autoimmune disorder has the following additional drugs ordered. Which one is used to prevent corticosteroid-induced osteoporosis?
- A. Potassium
- B. Alendronate (Fosamax)
- C. Furosemide (Lasix)
- D. Pantoprazole (Protonix)
Correct Answer: B
Rationale: Alendronate is used to prevent osteoporosis caused by corticosteroid therapy by inhibiting bone resorption and improving bone density.