Nokea
Calcium level in the blood is regulated by the:
- A. Thyroid
- B. Parathyroid
- C. Adrenal medulla
- D. Both A & B
Correct Answer: D
Rationale: The correct answer is D: Both A & B. The thyroid and parathyroid glands work together to regulate calcium levels in the blood. The parathyroid gland releases parathyroid hormone, which increases calcium levels, while the thyroid gland secretes calcitonin, which decreases calcium levels. Therefore, both glands play a crucial role in maintaining calcium homeostasis. Choice A, the thyroid gland, is incorrect as it primarily regulates metabolism. Choice C, the adrenal medulla, is incorrect as it is responsible for releasing adrenaline and noradrenaline, not regulating calcium levels.
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Which patient's nursing care would be most appropriate for the charge nurse to assign to the LPN, under the supervision of the RN team leader?
- A. A 51-year-old patient with bilateral adrenalectomy just returned from the post-anesthesia care unit
- B. An 83-year-old patient with type 2 diabetes and chronic obstructive pulmonary disease
- C. A 38-year-old patient with myocardial infarction who is preparing for discharge
- D. A 72-year-old patient admitted from long-term care with mental status changes
Correct Answer: A
Rationale: The care of a patient who just returned from surgery (bilateral adrenalectomy) is appropriate for an LPN under supervision, as it requires monitoring for complications and maintaining patient stability.
Portal capillaries carry releasing hormones from the brain to the:
- A. neurohypophysis.
- B. pancreas.
- C. anterior pituitary gland.
- D. posterior pituitary gland.
Correct Answer: C
Rationale: The correct answer is C: anterior pituitary gland. Portal capillaries carry releasing hormones from the hypothalamus to the anterior pituitary gland, where they regulate the release of hormones. Releasing hormones do not target the neurohypophysis (choice A) or the posterior pituitary gland (choice D) directly. They also do not affect the pancreas (choice B) in this context. Thus, the correct answer is the anterior pituitary gland due to its role in receiving and responding to releasing hormones from the hypothalamus.
The neurotransmitter released at the end of most sympathetic nerve fibers is:
- A. Epinephrine
- B. Noradrenaline
- C. Acetylcholine
- D. Acetylcholinesterase
Correct Answer: B
Rationale: The correct answer is B: Noradrenaline. Sympathetic nerve fibers release noradrenaline as the primary neurotransmitter to activate the fight-or-flight response. Noradrenaline acts on adrenergic receptors to increase heart rate, blood pressure, and blood flow to muscles. Epinephrine (choice A) is also released in the sympathetic nervous system but mainly by the adrenal glands. Acetylcholine (choice C) is the primary neurotransmitter in the parasympathetic nervous system. Acetylcholinesterase (choice D) is an enzyme that breaks down acetylcholine and is not a neurotransmitter.
Which of the following is characterized by excess urine production resulting in low blood volume?
- A. Cushing syndrome
- B. Tetany
- C. Diabetes insipidus
- D. Oversecretion of ACTH
Correct Answer: C
Rationale: Correct Answer: C - Diabetes insipidus
Rationale:
1. Diabetes insipidus is characterized by excess urine production due to inadequate ADH secretion.
2. Low blood volume occurs as a result of increased urine output, leading to dehydration.
3. Cushing syndrome involves excess cortisol production, not excess urine production.
4. Tetany is caused by low calcium levels, not excess urine production.
5. Oversecretion of ACTH leads to excess cortisol production, not excess urine production.
We have a 48-year-old female patient with a history of myasthenia gravis. She has been treated with an oral acetylcholinesterase inhibitor for several years and has done well till now. She presents with muscle weakness and other signs and symptoms that could reflect either a cholinergic crisis (excess dosages of her maintenance drug) or a myasthenic crisis (insufficient treatment). We will use a rapidly acting parenteral acetylcholinesterase inhibitor (AChE) to help make the differential diagnosis. Which of the following drugs would be most appropriate for this use?
- A. Edrophonium
- B. Malathion
- C. Physostigmine
- D. Pralidoxime
Correct Answer: A
Rationale: The correct answer is A: Edrophonium. Edrophonium is a short-acting acetylcholinesterase inhibitor that can help differentiate between a cholinergic crisis and a myasthenic crisis. In this scenario, administering edrophonium will temporarily increase acetylcholine levels at the neuromuscular junction. If the patient's symptoms improve following edrophonium administration, it suggests a myasthenic crisis due to insufficient treatment. On the other hand, if the symptoms worsen, it indicates a cholinergic crisis due to excess dosages of the maintenance drug.
Choice B: Malathion is an organophosphate insecticide and is not used for diagnosing myasthenia gravis.
Choice C: Physostigmine is a longer-acting acetylcholinesterase inhibitor and is not appropriate for rapidly assessing the patient's condition in this scenario.
Choice D: Pralidoxime is used as an antidote for organophosphate