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A patient with diabetes insipidus is treated with nasal desmopressin acetate (DDAVP). The nurse determines that the drug is not having an adequate therapeutic effect when the patient experiences
- A. Headache and weight gain.
- B. A urine specific gravity of 1.002.
- C. Nasal irritation and nausea.
- D. An oral intake greater than urinary output.
Correct Answer: B
Rationale: If the drug is not effective, the patient's urine specific gravity will remain low (1.002), indicating continued inability to concentrate urine.
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Hypothyroidism in children:
- A. Cretinism
- B. Myxoedema
- C. Graves disease
- D. Acromegaly
Correct Answer: A
Rationale: The correct answer is A: Cretinism. Cretinism is a condition of severe hypothyroidism during childhood, leading to stunted growth, intellectual disability, and physical deformities. Myxoedema refers to severe hypothyroidism in adults, not children. Graves disease is a form of hyperthyroidism, opposite of hypothyroidism. Acromegaly is a condition caused by excess growth hormone, not related to thyroid dysfunction. Therefore, Cretinism is the correct answer for hypothyroidism in children due to its specific characteristics and presentation.
After a thyroidectomy, Mr. M begins to show signs of tetany. The nurse should suspect a deficiency of which of the following?
- A. Insulin
- B. Parathyroid hormone
- C. Thyroid hormone
- D. Corticosteroids
Correct Answer: B
Rationale: Tetany is often caused by a decrease in parathyroid hormone, which can lead to hypocalcemia, a common complication after thyroid surgery.
Steroids:
- A. are secreted by the adrenal medulla.
- B. include the glucocorticoids, mineralocorticoids, and androgens.
- C. stimulate the membranes of the target cells to produce the second chemical messenger, cAMP.
- D. are secreted by the pancreas.
Correct Answer: B
Rationale: The correct answer is B because steroids include glucocorticoids, mineralocorticoids, and androgens, which are hormones secreted by the adrenal cortex. Glucocorticoids regulate metabolism and immune response, mineralocorticoids regulate electrolyte balance, and androgens are male sex hormones.
Choice A is incorrect because steroids are secreted by the adrenal cortex, not the adrenal medulla. Choice C is incorrect because steroids act by entering the target cells and binding to intracellular receptors, not by stimulating second messengers like cAMP. Choice D is incorrect because steroids are not secreted by the pancreas; instead, the pancreas secretes hormones like insulin and glucagon.
A man has been searching for an aphrodisiac or some other agent to enhance 'sexual performance' discovers yohimbine. He consumes the drug in excess and develops symptoms of toxicity that require your intervention. Which of the following should you expect as a response to this drug?
- A. Bradycardia
- B. Bronchoconstriction
- C. Excessive secretions by exocrine glands (salivary, lacrimal, etc.)
- D. Hypertension
Correct Answer: D
Rationale: The correct answer is D: Hypertension. Yohimbine is a known alpha-2 adrenergic antagonist, leading to increased sympathetic activity and consequently, hypertension. This occurs due to increased norepinephrine release and vasoconstriction. Bradycardia (A) is unlikely as yohimbine usually causes tachycardia. Bronchoconstriction (B) is not a common effect of yohimbine. Excessive secretions by exocrine glands (C) are not associated with yohimbine toxicity.
Excessive eating despite plenty of glucose in the blood is called:
- A. acidosis.
- B. polyuria.
- C. polydipsia.
- D. polyphagia.
Correct Answer: D
Rationale: The correct answer is D: polyphagia. Polyphagia is the medical term for excessive eating despite adequate glucose levels in the blood, commonly seen in conditions like diabetes mellitus. This excessive hunger is due to the body's inability to use glucose effectively, leading to a constant feeling of hunger.
A: Acidosis refers to an excess of acid in the blood, not related to excessive eating.
B: Polyuria is excessive urination, not directly related to excessive eating.
C: Polydipsia is excessive thirst, also not directly related to excessive eating.
In summary, polyphagia is the correct term for excessive eating despite adequate glucose levels, while the other choices are unrelated to this specific symptom.