Nokea
A patient is scheduled for a bilateral adrenalectomy. During the postoperative period, what should the nurse expect related to the administration of corticosteroids?
- A. Reduced to promote wound healing
- B. Withheld until symptoms of hypocortisolism appear
- C. Increased to promote an adequate response to the stress of surgery
- D. Reduced because excessive hormones are released during surgical manipulation of adrenal glands
Correct Answer: C
Rationale: Corticosteroids are increased postoperatively after bilateral adrenalectomy to prevent adrenal insufficiency and support the body's response to surgical stress.
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Which of the following is not a steroid-based hormone?
- A. estrogen
- B. aldosterone
- C. epinephrine
- D. cortisone
Correct Answer: C
Rationale: The correct answer is C: epinephrine. Steroid-based hormones are derived from cholesterol and include estrogen, aldosterone, and cortisone. Epinephrine is a catecholamine hormone, not a steroid hormone. Catecholamines are derived from the amino acid tyrosine, not cholesterol like steroid hormones. Therefore, epinephrine does not belong to the category of steroid-based hormones.
Individualized nutrition therapy for patients using conventional, fixed insulin regimens should include teaching the patient to
- A. eat regular meals at regular times.
- B. restrict calories to promote moderate weight loss.
- C. eliminate sucrose and other simple sugars from the diet.
- D. limit saturated fat intake to 30% of dietary calorie intake.
Correct Answer: A
Rationale: Patients with fixed insulin regimens should eat regular meals to match insulin action and prevent hypoglycemia.
Insulin enhances the membrane transport of glucose in all of the following tissues EXCEPT __________.
- A. the brain
- B. skeletal muscle
- C. the myocardium
- D. adipose tissue
Correct Answer: A
Rationale: Insulin enhances glucose transport by promoting the translocation of glucose transporter proteins to the cell membrane. The brain does not require insulin for glucose uptake as it has a specialized transporter. Skeletal muscle, myocardium, and adipose tissue all rely on insulin for increased glucose transport. Therefore, the correct answer is A. The other choices (B, C, and D) are incorrect as they all depend on insulin to enhance glucose transport in their respective tissues.
Portal capillaries carry releasing hormones from the brain to the:
- A. neurohypophysis.
- B. pancreas.
- C. anterior pituitary gland.
- D. posterior pituitary gland.
Correct Answer: C
Rationale: The correct answer is C: anterior pituitary gland. Portal capillaries carry releasing hormones from the hypothalamus to the anterior pituitary gland, where they regulate the release of hormones. Releasing hormones do not target the neurohypophysis (choice A) or the posterior pituitary gland (choice D) directly. They also do not affect the pancreas (choice B) in this context. Thus, the correct answer is the anterior pituitary gland due to its role in receiving and responding to releasing hormones from the hypothalamus.
Which of the following is least characteristic of the function of insulin?
- A. Increases glucose transport (into the cell).
- B. Suppresses gluconeogenesis.
- C. Lowers blood glucose.
- D. Increases the generation of ketone bodies.
Correct Answer: D
Rationale: The correct answer is D because insulin does not increase the generation of ketone bodies. Insulin actually inhibits ketogenesis by promoting glucose utilization and storage, preventing the breakdown of fats for energy. A, B, and C are all characteristics of insulin's function: A) Insulin increases glucose transport into the cell to lower blood glucose levels; B) It suppresses gluconeogenesis, the production of new glucose in the liver; C) Insulin lowers blood glucose levels by promoting the uptake and storage of glucose in cells.