Nokea
A patient has a total serum calcium level of 3.3 mmol/L. Which of the following laboratory results should the nurse assess next?
- A. Calcitonin
- B. Catecholamine
- C. Thyroid hormone
- D. Parathyroid hormone
Correct Answer: D
Rationale: Parathyroid hormone is the major controller for blood calcium levels. Although calcitonin secretion is a counter-mechanism to parathyroid hormone, it does not play a major role in calcium balance. Catecholamine and thyroid hormone levels do not affect serum calcium level.
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The nurse is caring for a patient who is taking spironolactone. Which of the following parameters should the nurse monitor?
- A. Decreased urinary output
- B. Evidence of fluid overload
- C. Increased serum sodium levels
- D. Elevated serum potassium levels
Correct Answer: D
Rationale: Spironolactone is a diuretic and it blocks aldosterone. Recalling that aldosterone increases the excretion of potassium, a medication that blocks aldosterone will tend to cause hyperkalemia. Aldosterone also promotes the reabsorption of sodium and water in the renal tubules, so spironolactone will tend to cause increased urine output, a decreased or normal serum sodium level, and signs of dehydration.
The nurse is evaluating the laboratory results for a patient who has increased secretion of the anterior pituitary hormones. Which of the following findings should the nurse anticipate when reviewing the laboratory findings?
- A. Decreased serum thyroxine levels
- B. Elevated serum aldosterone levels
- C. An increase in urinary free cortisol
- D. Low urinary excretion of catecholamines
Correct Answer: C
Rationale: Increased secretion of adrenocorticotropic hormone (ACTH) by the anterior pituitary gland will lead to an increase in serum and urinary cortisol levels. An increase, rather than a decrease, in thyroxine level would be expected with increased secretion of thyroid-stimulating hormone (TSH) by the anterior pituitary. Aldosterone and catecholamine levels are not controlled by the anterior pituitary.
The regulation of oxytocin during childbirth is an example of which of the following mechanisms?
- A. Physiological rhythm
- B. Secondary input
- C. Loop regulation
- D. Positive feedback
Correct Answer: D
Rationale: An example of the regulation of oxytocin during childbirth is an example of positive feedback. The positive feedback mechanism increases the target organ action beyond normal. The release of oxytocin is stimulated by pressure receptors in the vagina. As the fetus enters the vagina during childbirth, the pressure receptors sense increased pressure and signal the brain to release more oxytocin.
A patient is scheduled for a growth hormone stimulation test. Which of the following items should the nurse obtain in preparation for the test?
- A. Basin of ice
- B. Cardiac monitor
- C. Vial of glargine insulin
- D. Intravenous dextrose solution
Correct Answer: D
Rationale: Hypoglycemia is induced during the growth hormone stimulation test, and the nurse should be prepared to administer glucose IV immediately or have a sweet snack available for the patient immediately following the test. Regular insulin is used to induce hypoglycemia (glargine is never given intravenously). The patient does not require cardiac monitoring during the test. Although blood samples for some tests must be kept on ice, this is not true for the growth hormone stimulation test.
The nurse is caring for a patient who has clinical manifestations of hypothyroidism. Which of the following laboratory tests is most accurate to evaluate thyroid function?
- A. Thyroxine (T4) level
- B. Triiodothyronine (T3) level
- C. Thyroid-stimulating hormone (TSH) level
- D. Thyrotropin-releasing hormone (TRH) level
Correct Answer: C
Rationale: The most sensitive and accurate laboratory test is measurement of TSH; thus it is often recommended as a first diagnostic test for evaluation of thyroid function. A low TSH level indicates that the patient's hypothyroidism is caused by decreased anterior pituitary secretion of TSH. Low T4 and T3 levels are not diagnostic of the primary cause of the hypothyroidism. TRH levels indicate the function of the hypothalamus.