Nokea
A patient with hypoparathyroidism resulting from surgical treatment of hyperparathyroidism is preparing for discharge. What should the nurse teach the patient?
- A. Milk and milk products should be increased in the diet.
- B. Parenteral replacement of parathyroid hormone will be required for life.
- C. Calcium supplements with vitamin D can effectively maintain calcium balance.
- D. Bran and whole-grain foods should be used to prevent GI effects of replacement therapy.
Correct Answer: C
Rationale: Calcium supplements with vitamin D are essential to maintain calcium balance in patients with hypoparathyroidism.
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Which is INCORRECT regarding nerve supply to the gut?
- A. the blood vessels are known to have enteric, parasympathetic and sympathetic innervation
- B. the myenteric plexus lies between the longitudinal and circular muscle layers
- C. parasympathetic supply is via vagal and sacral nerve
- D. sympathetic supply is often inhibitory on cholinergic postganglionic fibres
Correct Answer: A
Rationale: The correct answer is A because blood vessels in the gut are primarily innervated by sympathetic and parasympathetic fibers, not by enteric nerves. Enteric nerves are confined to the gastrointestinal tract itself and are responsible for regulating gut motility, secretion, and blood flow. Sympathetic innervation typically causes vasoconstriction, while parasympathetic innervation promotes vasodilation. The myenteric plexus (Auerbach's plexus) lies between the longitudinal and circular muscle layers, regulating gut motility. Parasympathetic supply to the gut is mainly through the vagus nerve (cranial nerve X) and sacral nerves (pelvic splanchnic nerves). Sympathetic supply can either be inhibitory or excitatory, but generally, sympathetic fibers are inhibitory on cholinergic postganglionic fibers in the gut.
A patient with renal failure and high magnesium level would later have ________ and
- A. Cardiac Arrest
- B. Respiratory Paralysis
- C. Liver Encephalopathy
- D. Death From Hemorrhage
Correct Answer: A
Rationale: The correct answer is A: Cardiac Arrest. High magnesium levels in renal failure can lead to cardiac arrest due to the inhibitory effect on neuromuscular transmission and cardiac muscle activity. Magnesium impairs calcium entry into cells, affecting muscle contraction, potentially leading to fatal arrhythmias and cardiac arrest. Respiratory paralysis (B) is unlikely as magnesium does not directly affect respiratory muscles. Liver encephalopathy (C) is unrelated to high magnesium levels. Death from hemorrhage (D) is not a typical consequence of elevated magnesium levels in renal failure.
The left supra-renal vein drains into:
- A. Inferior vena cava
- B. Inferior mesenteric vein
- C. Left renal vein
- D. Superior mesenteric vein
Correct Answer: C
Rationale: The left supra-renal vein drains into the left renal vein. This is because the left adrenal gland is located above the left kidney, and the left renal vein is responsible for draining blood from the left kidney and adjacent structures, including the left adrenal gland. Therefore, the correct answer is C.
Incorrect options:
A: The inferior vena cava receives blood from various veins in the body but not specifically from the left supra-renal vein.
B: The inferior mesenteric vein drains the large intestine and does not receive blood from the left supra-renal vein.
D: The superior mesenteric vein drains blood from the small intestine and does not receive blood from the left supra-renal vein.
In summary, the left supra-renal vein drains into the left renal vein due to their anatomical proximity, making option C the correct answer.
Normal development of the immune response is due in part to hormones produced by the ________.
- A. adrenal medulla
- B. pancreas
- C. thyroid gland
- D. thymus gland
Correct Answer: D
Rationale: The correct answer is D: thymus gland. The thymus gland is crucial for the development and maturation of T cells, a type of immune cell. The hormones produced by the thymus gland, such as thymosin, play a key role in the proper functioning of the immune system. Without a functional thymus gland, the immune response would be compromised.
Explanation for why other choices are incorrect:
A: Adrenal medulla does not play a direct role in immune response development.
B: Pancreas primarily produces hormones related to blood sugar regulation, not immune response.
C: Thyroid gland produces hormones that regulate metabolism, not directly related to immune response development.
Which class of oral glucose-lowering agents is most commonly used for people with type 2 diabetes because it reduces hepatic glucose production and enhances tissue uptake of glucose?
- A. Insulin
- B. Meglitinide
- C. Biguanide
- D. Sulfonylurea
Correct Answer: B
Rationale: Biguanides, like metformin, are commonly used because they reduce glucose production in the liver and enhance tissue glucose uptake.