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A patient with SIADH is treated with water restriction. What does the patient experience when the nurse determines that treatment has been effective?
- A. Increased urine output, decreased serum sodium, and increased urine specific gravity
- B. Increased urine output, increased serum sodium, and decreased urine specific gravity
- C. Decreased urine output, increased serum sodium, and decreased urine specific gravity
- D. Decreased urine output, decreased serum sodium, and increased urine specific gravity
Correct Answer: B
Rationale: Effective water restriction in SIADH leads to increased urine output, increased serum sodium, and a decrease in urine specific gravity due to dehydration correction.
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Propranolol produces all of the following actions EXCEPT:
- A. Negative inotropic effect
- B. Negative chronotropic effect
- C. Slowing of A-V conduction
- D. Bronchodilation in asthmatic patients
Correct Answer: D
Rationale: Propranolol is a non-selective beta-blocker which primarily affects the heart. Bronchodilation is not a common effect of propranolol due to its non-selectivity for beta-2 receptors in the lungs. Therefore, choice D is the correct answer. Choices A, B, and C are correct because propranolol typically causes negative inotropic effect (reduced force of heart contraction), negative chronotropic effect (slowing of heart rate), and slowing of A-V conduction (delay in electrical signal between atria and ventricles), respectively.
The nurse should observe the patient for symptoms of ketoacidosis when
- A. illnesses causing nausea and vomiting lead to bicarbonate loss with body fluids.
- B. glucose levels become so high that osmotic diuresis promotes fluid and electrolyte loss.
- C. an insulin deficit causes the body to metabolize large amounts of fatty acids rather than glucose for energy.
- D. the patient skips meals after taking insulin, leading to rapid metabolism of glucose and breakdown of fats for energy
Correct Answer: C
Rationale: Ketoacidosis is caused by a lack of insulin, which leads to the body breaking down fats for energy, producing ketones that cause metabolic acidosis.
For the patient with hyperthyroidism, what intervention should you delegate to the experienced certified nursing assistant?
- A. Instruct the patient to report palpitations, dyspnea, vertigo, or chest pain.
- B. Check the apical pulse, blood pressure, and temperature every 4 hours.
- C. Draw blood for thyroid-stimulating hormone, T3, and T4 levels.
- D. Explain the side effects of propylthiouracil (PTU) to the patient.
Correct Answer: B
Rationale: Checking the apical pulse, blood pressure, and temperature every 4 hours is within the scope of practice for a certified nursing assistant and helps monitor the patient's condition.
Which of the following statements regarding pituitary hormones is FALSE?
- A. Hyposecretion of follicle-stimulating hormone (FSH) or luteinizing hormone (LH) leads to sterility in both males and females.
- B. Antidiuretic hormone (ADH), released by the posterior pituitary, causes urine volume to increase as blood volume decreases.
- C. Oxytocin is released in significant amounts ONLY during childbirth and nursing in woman.
- D. Luteinizing hormone, an anterior pituitary hormone, triggers ovulation of an egg from the ovary and causes the ruptured follicle to produce progesterone and some estrogens.
Correct Answer: B
Rationale: The correct answer is B because antidiuretic hormone (ADH) actually causes urine volume to decrease as blood volume decreases, not increase. ADH acts on the kidneys to reabsorb water, leading to concentrated urine and conservation of body fluids.
Rationale summary:
A: True, hyposecretion of FSH or LH can lead to sterility in both males and females.
C: False, oxytocin is also released during sexual activity, breastfeeding, social bonding, and stress responses, not just during childbirth and nursing.
D: True, luteinizing hormone triggers ovulation and stimulates the production of progesterone and some estrogens.
ADH ________.
- A. increases urine production
- B. promotes dehydration
- C. is produced in the adenohypophysis
- D. is inhibited by alcohol
Correct Answer: D
Rationale: The correct answer is D because alcohol inhibits the release of antidiuretic hormone (ADH) from the pituitary gland. ADH helps regulate water balance by promoting water reabsorption in the kidneys, reducing urine output. Alcohol impairs this process, leading to increased urine production and dehydration. Choices A, B, and C are incorrect because ADH decreases urine production, prevents dehydration, and is produced in the neurohypophysis (posterior pituitary), not the adenohypophysis (anterior pituitary).