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A patient with acromegaly is treated with a transsphenoidal hypophysectomy. What should the nurse do postoperatively?
- A. Ensure that any clear nasal drainage is tested for glucose.
- B. Maintain the patient flat in bed to prevent cerebrospinal fluid (CSF) leakage.
- C. Assist the patient with toothbrushing every 4 hours to keep the surgical area clean.
- D. Encourage deep breathing, coughing, and turning to prevent respiratory complications.
Correct Answer: A
Rationale: Clear nasal drainage should be tested for glucose to rule out cerebrospinal fluid leakage, which can occur after transsphenoidal surgery.
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Each of the following parasympathomimetics is paired with an appropriate therapeutic use EXCEPT:
- A. Physostigmine - eye drops in glaucoma
- B. Neostigmine - postoperative retention of urine
- C. Edrophonium - diagnosis of myasthenia gravis
- D. Parathion - organophosphorus poisoning
Correct Answer: D
Rationale: The correct answer is D because parathion is not a parasympathomimetic drug; it is an organophosphorus insecticide. Physostigmine (A), Neostigmine (B), and Edrophonium (C) are all parasympathomimetics used for their respective therapeutic purposes. Physostigmine is used in glaucoma to reduce intraocular pressure, Neostigmine is used to treat postoperative urinary retention by improving bladder emptying, and Edrophonium is used in the diagnosis of myasthenia gravis by temporarily improving muscle strength. In contrast, parathion is not a medication but a toxic substance used in insecticides, and it does not have any therapeutic use as a parasympathomimetic drug.
To aid digestion the stomach produces?
- A. Alkali
- B. Trypsin
- C. Acid
- D. Amylase
Correct Answer: C
Rationale: The correct answer is C: Acid. The stomach produces hydrochloric acid to aid in digestion by creating an acidic environment that helps break down food and kill bacteria. Alkali (A) would not aid digestion as it neutralizes acids. Trypsin (B) and Amylase (D) are enzymes produced in the pancreas, not the stomach, and play a role in digesting proteins and carbohydrates, respectively. Thus, they are not the products of the stomach for aiding digestion.
You are preparing to review a teaching plan for a patient with type 2 diabetes. What will you check to determine the patient's level of compliance with his diabetic regimen?
- A. Patient's fasting glucose level
- B. Patient's oral glucose tolerance test results
- C. Patient's glycosylated hemoglobin assay
- D. Patient's fingerstick glucose check for 24 hours
Correct Answer: C
Rationale: The glycosylated hemoglobin assay (HbA1c) provides an average blood glucose level over the past 2-3 months and is the best indicator of long-term compliance with the diabetic regimen.
Which of the following hormones does the skin produce?
- A. erythropoietin
- B. melatonin
- C. renin
- D. cholecalciferol
Correct Answer: D
Rationale: The correct answer is D: cholecalciferol. The skin produces cholecalciferol, also known as vitamin D, in response to sunlight exposure. This hormone plays a crucial role in calcium absorption and bone health. Erythropoietin (A) is produced by the kidneys to stimulate red blood cell production. Melatonin (B) is produced by the pineal gland to regulate sleep-wake cycles. Renin (C) is produced by the kidneys to regulate blood pressure. Therefore, the skin does not produce erythropoietin, melatonin, or renin, making them incorrect choices.
A 35-year-old female presents to your office for a regular check-up. Her only complaint is recurrent migraine headaches, which have increased in frequency over the years. On examination, her blood pressure is elevated at 150/70. You decide to start her on antihypertensive therapy that is also used for prophylaxis of migraines. Which medication is it?
- A. Clonidine
- B. Prazosin
- C. Hydrochlorothiazide
- D. Propranolol
Correct Answer: D
Rationale: The correct answer is D: Propranolol. Propranolol is a beta-blocker that is commonly used for migraine prophylaxis. It helps reduce the frequency and severity of migraines by blocking the action of adrenaline on blood vessels in the brain. In this case, the patient has elevated blood pressure and migraines, so starting her on propranolol can address both issues effectively.
Choice A: Clonidine is an alpha-2 agonist used for hypertension, but it is not commonly used for migraine prophylaxis.
Choice B: Prazosin is an alpha-1 blocker primarily used for the treatment of hypertension, but it is not typically used for migraine prophylaxis.
Choice C: Hydrochlorothiazide is a diuretic used for hypertension by reducing blood volume, but it is not effective for migraine prophylaxis.
In summary, propranolol is the most appropriate choice as it addresses both the elevated blood pressure and the recurrent