Nokea
Adrenaline is contraindicated in:
- A. Cardiac arrest
- B. Acute bronchial asthma
- C. Anaphylactic shock
- D. Hypertension
Correct Answer: D
Rationale: Adrenaline is contraindicated in hypertension because it can worsen high blood pressure and increase the risk of cardiovascular events. Adrenaline's vasoconstrictive effects can further elevate blood pressure in individuals with hypertension, potentially leading to severe complications. Therefore, it is crucial to avoid administering adrenaline in patients with hypertension to prevent adverse cardiovascular outcomes.
Summary:
- A: Adrenaline is indicated in cardiac arrest to improve cardiac output.
- B: Adrenaline is indicated in acute bronchial asthma to relax bronchial smooth muscles.
- C: Adrenaline is indicated in anaphylactic shock to reverse severe allergic reactions.
- D (Correct): Adrenaline is contraindicated in hypertension due to its vasoconstrictive effects.
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A patient has been receiving a large dose of prednisone for the relief of arthritic pain for 6 months. He suddenly stops taking his medication. What is the most serious concern?
- A. His arthritic pain will recur.
- B. He will develop an acute adrenal insufficiency.
- C. He will continue to exhibit symptoms of Cushing syndrome.
- D. He will develop a moon face and buffalo hump.
Correct Answer: B
Rationale: The correct answer is B: He will develop an acute adrenal insufficiency. When a patient abruptly stops taking a large dose of prednisone after long-term use, it can suppress the body's natural production of cortisol. This sudden withdrawal can lead to adrenal insufficiency, a potentially life-threatening condition. The adrenal glands may not be able to produce enough cortisol to meet the body's needs, causing symptoms such as fatigue, weakness, low blood pressure, and even shock. This is a serious concern that requires medical attention.
Incorrect choices:
A: His arthritic pain will recur - While this is a valid concern, it is not the most serious issue compared to acute adrenal insufficiency.
C: He will continue to exhibit symptoms of Cushing syndrome - Cushing syndrome is a result of prolonged exposure to high levels of cortisol, not sudden withdrawal.
D: He will develop a moon face and buffalo hump - These are physical symptoms associated with Cushing syndrome, not acute adrenal
Which one of the following is a cardio selective β1-blocker:
- A. Timolol
- B. Metoprolol
- C. Nadolol
- D. Sotalol
Correct Answer: B
Rationale: The correct answer is B: Metoprolol. Metoprolol is a cardioselective beta-1 blocker, meaning it primarily blocks beta-1 receptors in the heart, leading to a decrease in heart rate and contractility. This selectivity reduces the risk of bronchoconstriction compared to non-selective beta blockers like Timolol (Choice A), Nadolol (Choice C), and Sotalol (Choice D), which can also block beta-2 receptors in the lungs, potentially causing respiratory issues in patients with asthma or COPD. Therefore, Metoprolol is the best choice for patients with cardiovascular conditions who also have respiratory concerns.
A patient with diabetes is learning to mix regular insulin and NPH insulin in the same syringe. The nurse determines that additional teaching is needed when the patient does what?
- A. Withdraws the NPH dose into the syringe first
- B. Injects air equal to the NPH dose into the NPH vial first
- C. Removes any air bubbles after withdrawing the first insulin
- D. Adds air equal to the insulin dose into the regular vial and withdraws the dose
Correct Answer: A
Rationale: When mixing insulin, the correct order is to draw up the regular insulin first, followed by NPH insulin.
Mr. T, who has Cushing syndrome, is being treated with corticosteroids for an extended period. He has been instructed to avoid sudden discontinuation of the drug. Why should this instruction be given?
- A. To prevent adrenal crisis
- B. To increase potassium retention
- C. To reduce sodium retention
- D. To avoid an overdose of the medication
Correct Answer: A
Rationale: Discontinuing corticosteroids abruptly can lead to adrenal insufficiency or adrenal crisis because the adrenal glands cannot produce cortisol quickly enough after being suppressed.
Underproduction of growth hormone during the growing years produces ______.
- A. myxedema.
- B. gigantism.
- C. pituitary dwarfism.
- D. acromegaly.
Correct Answer: C
Rationale: The correct answer is C: pituitary dwarfism. Growth hormone deficiency during growing years results in pituitary dwarfism due to stunted growth. Myxedema (choice A) is associated with hypothyroidism, not growth hormone deficiency. Gigantism (choice B) occurs due to excessive growth hormone production in childhood. Acromegaly (choice D) is caused by excess growth hormone in adulthood, not during the growing years. Thus, choice C is the most appropriate based on the impact of growth hormone deficiency on growth during childhood.