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A patient suspected of having acromegaly has an elevated plasma growth hormone (GH) level. In acromegaly, what would the nurse also expect the patient's diagnostic results to indicate?
- A. Hyperinsulinemia
- B. Plasma glucose of <70 mg/dL (3.9 mmol/L)
- C. Decreased GH levels with an oral glucose challenge test
- D. Elevated levels of plasma insulin-like growth factor-1 (IGF-1)
Correct Answer: D
Rationale: In acromegaly, elevated plasma IGF-1 levels are expected, as it is a key mediator of GH effects.
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Target cells for hypothalamic releasing hormones are in the
- A. thyroid
- B. hypothalamus
- C. anterior pituitary
- D. posterior pituitary
Correct Answer: C
Rationale: The correct answer is C: anterior pituitary. Hypothalamic releasing hormones target cells in the anterior pituitary to stimulate the release of specific pituitary hormones. The hypothalamus produces releasing hormones that travel through the hypophyseal portal system and bind to receptors on cells in the anterior pituitary, triggering the release of hormones such as ACTH, TSH, LH, FSH, and GH. This interaction between the hypothalamus and anterior pituitary forms the hypothalamic-pituitary axis, regulating various physiological processes. Choices A (thyroid) and D (posterior pituitary) are incorrect as they are not the primary targets of hypothalamic releasing hormones. Choice B (hypothalamus) is also incorrect as releasing hormones do not target cells within the hypothalamus itself, but rather the anterior pituitary.
Antidiuretic hormone _______________.
- A. controls metabolic rate
- B. controls the amount of urine one produces
- C. increases blood sugar
- D. controls reproduction
Correct Answer: B
Rationale: The correct answer is B: controls the amount of urine one produces. Antidiuretic hormone (ADH) acts on the kidneys to regulate water reabsorption, thereby controlling the amount of urine produced. It does not control metabolic rate (A), increase blood sugar (C), or control reproduction (D). ADH's main function is to maintain water balance in the body by reducing urine output.
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.
We have an emergency clinical situation, which requires a drug to produce both bronchodilation and raise blood pressure. Which one of the following drugs can achieve these two goals?
- A. Atropine
- B. Adrenaline
- C. Isoproterenol
- D. Noradrenaline
Correct Answer: B
Rationale: Rationale:
1. Adrenaline is a non-selective adrenergic agonist that acts on both alpha and beta receptors.
2. Activation of beta-2 receptors in the lungs causes bronchodilation.
3. Activation of alpha-1 receptors in blood vessels raises blood pressure.
4. Atropine (A) is a muscarinic antagonist, not adrenergic.
5. Isoproterenol (C) primarily targets beta receptors, not alpha for blood pressure.
6. Noradrenaline (D) mainly acts on alpha receptors, not beta for bronchodilation.
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.