Nokea
Adrenaline combination with local anesthetics has the following effects EXCEPT:
- A. Reduces the absorption of local anesthetic
- B. Increases the duration of its local anesthetic activity
- C. Decreases the toxicity of the local anesthetic
- D. Increases blood flow to the injection area
Correct Answer: D
Rationale: Correct Answer: D. Increases blood flow to the injection area.
Rationale:
1. Adrenaline is a vasoconstrictor that reduces blood flow in the injection area.
2. By constricting blood vessels, adrenaline limits the absorption of the local anesthetic, leading to prolonged local action.
3. Adrenaline also helps in reducing the systemic toxicity of the local anesthetic by limiting its absorption.
4. Therefore, the correct answer is D as adrenaline does not increase blood flow to the injection area.
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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
Pheochromocytoma is a tumor of the adrenal medulla. The tumor results in extraordinarily high blood noradrenaline levels. What drug or drug combination can block all of the adrenergic receptors and normalize all the signs and symptoms caused by pheochromocytoma?
- A. Propranolol
- B. Phentolamine
- C. Phentolamine plus propranolol
- D. Atropine plus phenylephrine
Correct Answer: C
Rationale: The correct answer is C - Phentolamine plus propranolol. Phentolamine is an alpha-adrenergic blocker that can counteract the effects of high noradrenaline levels, while propranolol is a non-selective beta blocker that can further control the symptoms by blocking beta-adrenergic receptors. Combining both drugs can effectively block all adrenergic receptors and normalize the signs and symptoms of pheochromocytoma.
A: Propranolol alone cannot block all adrenergic receptors, as it only targets beta receptors.
B: Phentolamine alone can block alpha receptors but does not address the beta receptors.
D: Atropine plus phenylephrine combination does not cover all adrenergic receptors involved in pheochromocytoma.
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.
Identify an endocrine gland within the brain.
- A. Adrenal gland
- B. Pancreas
- C. Pituitary gland
- D. Parathyroid glands
Correct Answer: C
Rationale: The correct answer is C: Pituitary gland. The pituitary gland is an endocrine gland located at the base of the brain, below the hypothalamus. It secretes various hormones that regulate important functions in the body. The other choices are incorrect because:
A: Adrenal gland - located on top of the kidneys, not in the brain.
B: Pancreas - located in the abdomen, not in the brain.
D: Parathyroid glands - located in the neck, not in the brain.
The primary target of the releasing and inhibiting hormones of the hypothalamus is the:
- A. Liver and adipose tissue
- B. Gonads
- C. Anterior pituitary
- D. Bone marrow
Correct Answer: C
Rationale: The correct answer is C. The primary target of releasing and inhibiting hormones from the hypothalamus is the anterior pituitary. The hypothalamus secretes these hormones into the hypophyseal portal system, which directly connects to the anterior pituitary. This interaction controls the release of various hormones from the anterior pituitary, regulating functions such as growth, reproduction, and stress response. Choices A, B, and D are incorrect because releasing and inhibiting hormones from the hypothalamus do not primarily target the liver, adipose tissue, gonads, or bone marrow directly.