Nokea
A patient is admitted to the hospital with thyrotoxicosis. On physical assessment of the patient, what should the nurse expect to find?
- A. Hoarseness and laryngeal stridor
- B. Bulging eyeballs and dysrhythmias
- C. Elevated temperature and signs of heart failure
- D. Lethargy progressing suddenly to impairment of consciousness
Correct Answer: C
Rationale: Thyrotoxicosis often causes hyperthermia, tachycardia, and signs of heart failure due to increased metabolic demand from excessive thyroid hormone levels.
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α-1 adrenergic receptors are selectively blocked by:
- A. Phentolamine
- B. Prazosin
- C. Propranolol
- D. Ergotamine
Correct Answer: B
Rationale: The correct answer is B: Prazosin. α-1 adrenergic receptors are selectively blocked by prazosin. Prazosin is a selective α-1 adrenergic receptor antagonist, specifically targeting these receptors. It works by blocking the effects of norepinephrine, leading to vasodilation and reduced blood pressure.
A: Phentolamine is a non-selective α-adrenergic receptor antagonist, blocking both α-1 and α-2 receptors.
C: Propranolol is a non-selective β-adrenergic receptor antagonist, blocking β-1 and β-2 receptors.
D: Ergotamine is a medication used for the treatment of migraines and has vasoconstrictive properties but does not selectively block α-1 adrenergic receptors.
A 34-year-old carpenter presents to the emergency room after an accident in which he inadvertently chopped off the tip of his index finger. He is taken to the operating room for reattachment of the digit, and after sedation, a local anesthetic is administered around the site of the injury. The local anesthetic used in the procedure did not contain any epinephrine, as it usually does for most surgical procedures. The reason for this is
- A. Epinephrine causes increased blood loss during delicate surgery
- B. Epinephrine causes swelling of the tissues, making surgery more challenging
- C. Epinephrine is contraindicated in emergency surgery
- D. Epinephrine causes vasoconstriction, which can lead to vascular ischemia in digits
Correct Answer: D
Rationale: The correct answer is D. Epinephrine causes vasoconstriction, which can lead to vascular ischemia in digits. In delicate surgeries like finger reattachment, maintaining adequate blood flow is crucial for successful outcomes. Using epinephrine can constrict blood vessels excessively, leading to reduced blood supply and potential tissue damage. This can result in vascular ischemia, compromising the viability of the reattached finger.
Explanation for incorrect choices:
A: Epinephrine actually helps in reducing blood loss by constricting blood vessels.
B: Epinephrine reduces tissue swelling, making surgery easier.
C: Epinephrine is not contraindicated in emergency surgery; it is often used to control bleeding and prolong anesthesia.
Which of the following statements about anticholinesterase drugs is WRONG:
- A. They can be divided into reversible and irreversible types
- B. They include neostigmine and physostigmine
- C. They can produce miosis and lacrimation
- D. They are useful bronchodilators
Correct Answer: D
Rationale: The correct answer is D because anticholinesterase drugs are not bronchodilators; they actually increase cholinergic activity by inhibiting the breakdown of acetylcholine. Reversible and irreversible types do exist (A), neostigmine and physostigmine are examples (B), and they can cause miosis and lacrimation due to increased cholinergic activity (C). Hence, D is the incorrect statement.
What are two effects of hypokalemia on the endocrine system?
- A. Decreased insulin and aldosterone release
- B. Decreased glucagon and increased cortisol release
- C. Decreased release of atrial natriuretic factor and increased ADH release
- D. Decreased release of parathyroid hormone and increased calcitonin release
Correct Answer: C
Rationale: Hypokalemia can lead to decreased release of atrial natriuretic factor and increased ADH release as the body attempts to balance sodium and fluid levels.
In type 1 diabetes there is an osmotic effect of glucose when insulin deficiency prevents the use of glucose for energy. Which classic symptom is caused by the osmotic effect of glucose?
- A. Fatigue
- B. Polyphagia
- C. Polydipsia
- D. Recurrent infections
Correct Answer: C
Rationale: Polydipsia is caused by the osmotic effect of glucose, leading to excessive urination and increased thirst.