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A patient presents with muscle weakness, fatigue, constipation, and hyperpigmentation of the skin. Laboratory tests reveal low serum cortisol levels and elevated adrenocorticotropic hormone (ACTH) levels. Which endocrine disorder is most likely responsible for these symptoms?
- A. Hyperthyroidism
- B. Hypothyroidism
- C. Diabetes mellitus
- D. Addison's disease
Correct Answer: D
Rationale: The symptoms described - muscle weakness, fatigue, constipation, hyperpigmentation of the skin, low serum cortisol levels, and elevated ACTH levels - are classic findings in Addison's disease. Addison's disease is a primary adrenal insufficiency characterized by the insufficient production of cortisol and, to some extent, aldosterone. The low cortisol levels result in symptoms such as muscle weakness, fatigue, and skin hyperpigmentation due to increased levels of ACTH stimulating melanin production. In contrast, in conditions like hyperthyroidism, hypothyroidism, and diabetes mellitus, the symptoms and laboratory findings would not fully align with those described in the patient in this scenario.
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Endocrine changes often result in a bulimic patient. Which of the following would be an expected change in Sherry?
- A. Delayed Thyroid Stimulating Hormone response to Hormone Replacement Therapy
- B. Increased production of Follicle Stimulating Hormone
- C. Hypopituitarism
- D. Decreased Adrenocorticotropic Hormone in response to cortisone
Correct Answer: C
Rationale: Endocrine changes in a bulimic patient, such as Sherry, can lead to disruptions in the pituitary gland's function. Hypopituitarism refers to a disorder in which the pituitary gland does not produce one or more of its hormones adequately. This can result in hormonal imbalances and have various effects on the body's functions. In Sherry's case, developing hypopituitarism would be an expected change due to the endocrine disruptions associated with bulimia. It is important for healthcare providers to monitor and address these endocrine changes in bulimic patients to prevent further complications.
While performing the assessment your are guided that the organs found in the epigastrium include which of the following?
- A. Protion of duodenum & jejunum, left kidney, appendix & ovary
- B. Duodenum, pancreas, portion of the liver and pyloric end of the stomach.
- C. Stomach, spleen, tail of pancreas and adrenal gland
- D. Gallblader, duodenum, gallbladder and portion of the right kidney.
Correct Answer: B
Rationale: The epigastrium is the upper middle region of the abdomen, lying above the umbilical region and between the hypochondriac regions. It contains several organs including the duodenum, pancreas, portion of the liver, and the pyloric end of the stomach. The duodenum is the first part of the small intestine, the pancreas is a crucial organ for digestion and hormone regulation, the liver aids in digestion and detoxification, and the pyloric end of the stomach connects the stomach to the small intestine for further digestion and absorption of nutrients. These organs are typically assessed and examined when focusing on the epigastrium during a physical examination.
A postpartum client who delivered a preterm infant expresses concerns about milk supply and worries about meeting the baby's nutritional needs. What nursing intervention should be prioritized to address the client's concerns?
- A. Providing education on techniques to enhance milk production and supply
- B. Recommending supplemental formula feedings to ensure adequate nutrition
- C. Encouraging the client to avoid breastfeeding until the infant reaches full term
- D. Referring the client to a dietitian for specialized nutritional support
Correct Answer: A
Rationale: Providing education on techniques to enhance milk production and supply should be prioritized to address the client's concerns about milk supply and meeting the baby's nutritional needs. By educating the client on proper breastfeeding techniques, frequent nursing sessions, skin-to-skin contact, and the importance of staying hydrated, the nurse can help promote successful breastfeeding and potentially increase milk production. Supplemental formula feedings are not the first line of intervention, as breastfeeding should be encouraged, especially for a preterm infant who may benefit significantly from breast milk. Encouraging the client to avoid breastfeeding until the infant reaches full term is not appropriate, as breastfeeding can still be beneficial for a preterm infant. Referring the client to a dietitian for specialized nutritional support may be beneficial, but addressing milk supply concerns through education should be prioritized initially to support breastfeeding success.
As a newly 1icensed nurse employed in a tertiary hospital, you are required to attend Continuing Professional Development (CPD) program. When the training program is for the enrichment of nurses in the hospital, it is called __________.
- A. informal training program
- B. formal education program
- C. self-directed
- D. In-service training program
Correct Answer: D
Rationale: In-service training programs are specifically designed to provide continuing education and professional development for employees within a particular organization, in this case, a hospital. These programs are tailored to meet the needs of the staff and enhance their skills and knowledge within their work environment. Since the CPD program in the tertiary hospital is aimed at enriching and supporting the growth of the nurses' knowledge and expertise within the hospital setting, it falls under the category of an in-service training program.
After the successful vaginal1 delivery, medication was ordered to be given immediately. The supervisor reassured the newly hired nurse that everything will be fine because the medication will
- A. promote vasoconstriction of uterine muscles
- B. hasten uterine contractility and control bleeding
- C. facilitate the return of pre pregnancy vital signs
- D. promote vasodilation of uterine muscles
Correct Answer: B
Rationale: The medication given after a successful vaginal delivery that helps to hasten uterine contractility and control bleeding is typically an oxytocic agent, such as oxytocin. Oxytocin helps the uterus to contract effectively, which is important for preventing excessive bleeding after delivery. This medication is commonly used in the postpartum period to help the uterus return to its normal size and position. The supervisor reassured the newly hired nurse that everything will be fine because this medication will help promote uterine contractions and control bleeding, which are crucial steps in the postpartum management.