Nokea
All of the following are effects of chronic tobacco smoking EXCEPT:
- A. Peripheral vascular disease
- B. Cardiac arrhythmias
- C. Hypotension
- D. Increased gastric secretion
Correct Answer: C
Rationale: The correct answer is C: Hypotension. Chronic tobacco smoking typically causes vasoconstriction, leading to increased blood pressure rather than hypotension. Peripheral vascular disease (A), cardiac arrhythmias (B), and increased gastric secretion (D) are common effects of chronic tobacco smoking due to the harmful impact on blood vessels, heart function, and gastrointestinal system.
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Priority Decision: What is the priority nursing intervention during the management of the patient with pheochromocytoma?
- A. Administering IV fluids
- B. Administering β-adrenergic blockers
- C. Monitoring blood pressure
- D. Monitoring intake and output and daily weights
Correct Answer: B
Rationale: In managing pheochromocytoma, monitoring and controlling blood pressure is the priority intervention due to the risk of hypertensive crises caused by catecholamine secretion from the tumor.
Mr. Johnson received his first dose of Lente insulin at 7:30 A.M. When should he be observed for signs of hypoglycemia?
- A. 10-11 A.M.
- B. 4-6 P.M.
- C. Between 2 A.M. and breakfast
- D. Immediately after the injection
Correct Answer: B
Rationale: Lente insulin has an onset of action that typically peaks 4-6 hours after injection, so this is when signs of hypoglycemia are most likely to occur.
The following sympathomimetic drug is a catecholamine:
- A. Ephedrine
- B. Phenylephrine
- C. Phentolamine
- D. Isoprenaline
Correct Answer: D
Rationale: Step-by-step rationale for why D (Isoprenaline) is the correct answer:
1. Isoprenaline is a catecholamine because it has a catechol structure, which consists of a benzene ring with two hydroxyl groups.
2. Catecholamines are a class of neurotransmitters that include dopamine, norepinephrine, and epinephrine.
3. Isoprenaline acts as a non-selective beta-adrenergic agonist, stimulating both beta-1 and beta-2 adrenergic receptors.
4. Its pharmacological effects include increased heart rate, bronchodilation, and vasodilation.
Summary of why other choices are incorrect:
A. Ephedrine is a sympathomimetic drug but is not a catecholamine as it lacks the catechol structure.
B. Phenylephrine is a sympathomimetic drug that acts as an alpha-adrenergic agonist,
Mrs. A. is scheduled for a unilateral adrenalectomy. Her postoperative course is uneventful. Which discharge goal is most realistic for Mrs. A.?
- A. Being free of symptoms without medication
- B. Having greatly reduced symptoms on maintenance cortisone
- C. Being free of symptoms on daily ACTH injections
- D. Having activity restricted for life
Correct Answer: B
Rationale: Postoperatively, the goal for Cushing syndrome patients is typically symptom reduction with the help of maintenance cortisone.
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).