Nokea
A patient has been receiving high doses of corticosteroids for an extended perioWhich side effect is most commonly seen in patients receiving long-term corticosteroid therapy?
- A. Hyperglycemia
- B. Bradycardia
- C. Diarrhea
- D. Decreased appetite
Correct Answer: A
Rationale: The correct answer is A: Hyperglycemia. Long-term corticosteroid therapy can lead to insulin resistance and increased blood glucose levels. This occurs due to the corticosteroids interfering with insulin action and glucose metabolism. Hyperglycemia is a common side effect that can potentially lead to diabetes. Bradycardia (B), diarrhea (C), and decreased appetite (D) are not commonly associated with long-term corticosteroid therapy. Bradycardia is more commonly associated with medications such as beta-blockers, while diarrhea and decreased appetite are not typical side effects of corticosteroids.
You may also like to solve these questions
What is the role of hydrochloric acid in the stomach?
- A. Break down carbohydrates
- B. Break down proteins
- C. Emulsify fats
- D. None of the above
Correct Answer: B
Rationale: The correct answer is B: Break down proteins. Hydrochloric acid in the stomach helps to activate pepsin, an enzyme that breaks down proteins into smaller peptides. This process is essential for proper digestion of proteins. Choice A is incorrect because carbohydrates are broken down by amylase enzymes in the mouth and small intestine. Choice C is incorrect because emulsification of fats occurs in the small intestine with the help of bile. Choice D is incorrect as hydrochloric acid plays a significant role in the digestion of proteins in the stomach.
Stimulation by the sympathetic nervous system will cause which one of the following effects in the inferior esophagus, stomach, small intestine and large intestine?
- A. nothing, because skeletal muscle is found in the walls of these areas
- B. increases peristalsis by stimulation of smooth muscle
- C. decreases peristalsis by inhibition of smooth muscle
- D. decreases peristalsis by stimulation of smooth muscle
Correct Answer: C
Rationale: The correct answer is C: decreases peristalsis by inhibition of smooth muscle. The sympathetic nervous system inhibits gastrointestinal motility by decreasing peristalsis. This is achieved through the release of norepinephrine, which binds to adrenergic receptors on smooth muscle cells, leading to reduced contraction and motility. Choices A and B are incorrect because the sympathetic nervous system can still affect smooth muscle, not just skeletal muscle. Choice D is incorrect because sympathetic stimulation does not directly increase peristalsis.
Priority Decision: A postoperative patient has a nursing diagnosis of pain related to effects of medication and decreased GI motility as evidenced by abdominal pain and distention and inability to pass flatus. Which nursing intervention is most appropriate for this patient?
- A. Ambulate the patient more frequently.
- B. Assess the abdomen for bowel sounds.
- C. Place the patient in high Fowler's position.
- D. Withhold opioids because they decrease bowel motility.
Correct Answer: A
Rationale: Rationale for Correct Answer (A): Ambulating the patient more frequently helps to stimulate GI motility, reduce abdominal distention, and promote passage of flatus. Movement aids in peristalsis, which can alleviate postoperative GI issues.
Summary of Incorrect Choices:
B: Assessing bowel sounds is important but does not directly address the issue of stimulating GI motility or addressing the patient's pain and distention.
C: Placing the patient in a high Fowler's position may improve respiratory function but does not specifically target GI motility or pain relief.
D: Withholding opioids may be necessary in some cases, but pain management is crucial for postoperative care. There are other ways to address decreased GI motility without completely withholding pain medications.
Which of the following are liver waste products?
- A. bilirubin
- B. bile salts
- C. cholesterol
- D. electrolytes
Correct Answer: A
Rationale: The correct answer is A: bilirubin. Bilirubin is a waste product produced during the breakdown of red blood cells in the liver. It is excreted in bile and gives feces its brown color. Bile salts aid in digestion, cholesterol is a lipid used for various functions, and electrolytes are essential for bodily functions but are not liver waste products. Therefore, bilirubin is the only true liver waste product in this list.
A patient with cirrhosis that is refractory to other treatments for esophageal varices undergoes a portacaval shunt. As a result of this procedure, what should the nurse expect the patient to experience?
- A. An improved survival rate
- B. Decreased serum ammonia levels
- C. Improved metabolism of nutrients
- D. Improved hemodynamic function and renal perfusion
Correct Answer: D
Rationale: The correct answer is D: Improved hemodynamic function and renal perfusion. A portacaval shunt is a surgical procedure that diverts blood flow from the portal vein directly into the vena cava, reducing portal hypertension. This leads to improved hemodynamic function by decreasing pressure in the portal system, which can improve renal perfusion. Choices A, B, and C are incorrect because a portacaval shunt may not necessarily improve survival rate, decrease serum ammonia levels, or improve metabolism of nutrients.