Nokea
Concerning physostigmine, which of the following is CORRECT:
- A. Is a natural quaternary ammonium compound
- B. Has no CNS action
- C. It is an irreversible anti-cholinesterase
- D. It is used in the treatment of glaucoma
Correct Answer: D
Rationale: The correct answer is D because physostigmine is used in the treatment of glaucoma due to its ability to lower intraocular pressure. It works by inhibiting the enzyme acetylcholinesterase, leading to increased levels of acetylcholine which helps in constricting the pupil and improving drainage of fluid in the eye. Options A and C are incorrect as physostigmine is a tertiary amine and a reversible anti-cholinesterase. Option B is incorrect as physostigmine does have CNS action, crossing the blood-brain barrier and affecting brain function.
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Mr. B, diagnosed with hypothyroidism, is being discharged after starting thyroid hormone therapy. Which of the following would indicate that the treatment is effective?
- A. A decrease in weight
- B. Normal serum thyroid hormone levels
- C. Relief of fatigue
- D. Increased appetite
Correct Answer: B
Rationale: Effective treatment for hypothyroidism is indicated by normalization of thyroid hormone levels, which helps alleviate symptoms like fatigue and weight gain.
A patient is scheduled for a bilateral adrenalectomy. During the postoperative period, what should the nurse expect related to the administration of corticosteroids?
- A. Reduced to promote wound healing
- B. Withheld until symptoms of hypocortisolism appear
- C. Increased to promote an adequate response to the stress of surgery
- D. Reduced because excessive hormones are released during surgical manipulation of adrenal glands
Correct Answer: C
Rationale: Corticosteroids are increased postoperatively after bilateral adrenalectomy to prevent adrenal insufficiency and support the body's response to surgical stress.
Which of the following is not a steroid-based hormone?
- A. estrogen
- B. aldosterone
- C. epinephrine
- D. cortisone
Correct Answer: C
Rationale: The correct answer is C: epinephrine. Steroid-based hormones are derived from cholesterol and include estrogen, aldosterone, and cortisone. Epinephrine is a catecholamine hormone, not a steroid hormone. Catecholamines are derived from the amino acid tyrosine, not cholesterol like steroid hormones. Therefore, epinephrine does not belong to the category of steroid-based hormones.
A nurse assesses a client who is prescribed a medication that stimulates beta1 receptors. Which assessment finding would indicate that the medication is effective?
- A. Heart rate of 92 beats/min
- B. Respiratory rate of 18 breaths/min
- C. Oxygenation saturation of 92%
- D. Blood pressure of 144/69 mm Hg
Correct Answer: A
Rationale: The correct answer is A: Heart rate of 92 beats/min. Activation of beta1 receptors increases heart rate. Therefore, a heart rate of 92 beats/min indicates that the medication is effectively stimulating beta1 receptors. Choices B, C, and D are incorrect as they do not directly correlate with beta1 receptor stimulation. Choice B (Respiratory rate of 18 breaths/min) is influenced more by beta2 receptors. Choice C (Oxygenation saturation of 92%) is related to oxygen levels in the blood, not beta1 receptor stimulation. Choice D (Blood pressure of 144/69 mm Hg) is more affected by alpha receptor stimulation than beta1 receptor stimulation.
Which of the following are incorrectly paired?
- A. Gluconeogenesis : Cortisol
- B. Free fatty acid mobilization : Dehydroepiandrosterone
- C. Muscle glycogenolysis : Epinephrine
- D. Kaliuresis : Aldosterone
Correct Answer: B
Rationale: The correct answer is B because free fatty acid mobilization is primarily regulated by cortisol, not dehydroepiandrosterone. Cortisol promotes lipolysis and stimulates the release of free fatty acids from adipose tissue. Dehydroepiandrosterone is a precursor hormone mainly involved in sex hormone production and has minimal effects on free fatty acid mobilization. Choices A, C, and D are correctly paired as gluconeogenesis is stimulated by cortisol, muscle glycogenolysis is regulated by epinephrine, and kaliuresis is induced by aldosterone.