Nokea
A patient presents with polyuria and thirst. There appears to be no elevation of glucose in the body, however, the serum osmolality appears to be low. Upon performing the water deprivation test, the osmolatity is still low. Which of the following is true?
- A. The problem is in the pituitary
- B. The problem is in the kidneys
- C. The patient has diabetes mellitus
- D. The patient has high ADH in the serum
Correct Answer: B
Rationale: The correct answer is B: The problem is in the kidneys. In this scenario, the low serum osmolality despite water deprivation indicates the kidneys are unable to concentrate urine, leading to excessive loss of water. This condition is known as nephrogenic diabetes insipidus. Choice A is incorrect as pituitary dysfunction would result in high serum osmolality due to lack of ADH. Choice C is incorrect as diabetes mellitus would show high glucose levels. Choice D is incorrect as high ADH in the serum would lead to concentrated urine and high serum osmolality.
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All of the following are hormones of the anterior pituitary except:
- A. Human growth hormone (GH).
- B. Follicle-stimulating hormone (FSH).
- C. Parathyroid hormone(PTH).
- D. Thyroid-stimulating hormone (TSH).
Correct Answer: C
Rationale: The correct answer is C: Parathyroid hormone (PTH). The anterior pituitary gland secretes hormones that regulate various bodily functions, such as growth, reproduction, and metabolism. PTH is actually produced by the parathyroid glands, not the anterior pituitary. Human growth hormone (GH), follicle-stimulating hormone (FSH), and thyroid-stimulating hormone (TSH) are all hormones secreted by the anterior pituitary gland. Therefore, C is the correct answer as it is not a hormone produced by the anterior pituitary gland.
Which instruction given to a patient taking a β-blocker is essential to reduce the chance of an adverse response to the β-blocker, regardless of the purpose for which it’s been prescribed?
- A. Don’t stop taking this medication without a doctor’s advice first. A severe reaction can happen within days if you stop abruptly.
- B. Don’t go too far away from a bathroom; this drug usually causes urinary frequency.
- C. It’s likely to cause blurred vision for a few days; you may have trouble reading.
- D. It’s likely to cause constipation, so eat plenty of fiber and drink plenty of water.
Correct Answer: A
Rationale: The correct answer is A: "Don't stop taking this medication without a doctor's advice first." Abruptly stopping a β-blocker can lead to severe adverse reactions like rebound hypertension, angina exacerbation, or arrhythmias due to sudden withdrawal. This instruction is crucial to prevent these potentially dangerous consequences.
Explanation for why other choices are incorrect:
B: β-blockers are not known to commonly cause urinary frequency, so this warning is unnecessary.
C: Blurred vision is not a common side effect of β-blockers, so this warning is irrelevant.
D: While constipation can be a side effect of some medications, it is not a prominent side effect of β-blockers, so this advice is not essential for patients taking β-blockers.
The nurse determines that a patient with a 2-hour OGTT of 152 mg/dL has
- A. diabetes
- B. impaired fasting glucose
- C. elevated A1C
- D. impaired glucose tolerance
Correct Answer: D
Rationale: A 2-hour OGTT result of 152 mg/dL indicates impaired glucose tolerance, which is a prediabetes state.
A nurse is caring for a patient who has excessive catecholamine release. Which assessment finding would the nurse correlate with this condition?
- A. Decreased blood pressure
- B. Increased pulse
- C. Decreased respiratory rate
- D. Increased urine output
Correct Answer: B
Rationale: The correct answer is B: Increased pulse. Excessive catecholamine release, such as in a stress response, leads to sympathetic nervous system activation causing an increase in heart rate (pulse). This physiological response is known as the "fight or flight" response. Choices A, C, and D are incorrect as catecholamine release typically leads to increased blood pressure, increased respiratory rate, and decreased urine output due to vasoconstriction, increased oxygen demand, and fluid retention respectively.
Identify the hormone that causes the development of the breast and milk production.
- A. oxytocin
- B. prolactin
- C. estrogen
- D. antidiuretic hormone
Correct Answer: B
Rationale: The correct answer is B: prolactin. Prolactin is the hormone responsible for the development of the breast tissue and milk production in females. It is secreted by the anterior pituitary gland and plays a key role in lactation. Oxytocin is involved in milk ejection, not breast development. Estrogen plays a role in breast development but not specifically in milk production. Antidiuretic hormone regulates water balance and has no direct role in breast development or milk production.