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During care of the patient with SIADH, what should the nurse do?
- A. Monitor neurologic status at least every 2 hours.
- B. Teach the patient receiving treatment with diuretics to restrict sodium intake.
- C. Keep the head of the bed elevated to prevent antidiuretic hormone (ADH) release.
- D. Notify the health care provider if the patient's blood pressure decreases more than 20 mm Hg from baseline.
Correct Answer: A
Rationale: Frequent neurologic monitoring is essential for patients with SIADH due to the risk of cerebral edema from hyponatremia.
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Which two elements react together to form an ionic compound?
- A. R and T
- B. T and X
- C. X and Z
- D. Z and R
Correct Answer: C
Rationale: The correct answer is C, X and Z. Ionic compounds are formed when a metal (X) reacts with a nonmetal (Z) by transferring electrons to achieve a stable octet configuration. Metal atoms tend to lose electrons to form positively charged cations, while nonmetal atoms tend to gain electrons to form negatively charged anions. In this case, X (metal) and Z (nonmetal) will react to form an ionic compound through electron transfer. Choices A, B, and D are incorrect because they do not involve a metal-nonmetal combination, which is essential for the formation of an ionic compound.
Selective beta2 stimulants frequently cause:
- A. Skeletal muscle tremors
- B. Tolerance
- C. Tachycardia
- D. All of the above
Correct Answer: D
Rationale: Selective beta2 stimulants typically cause skeletal muscle tremors due to their action on beta2 receptors in skeletal muscles. They can also lead to tolerance with prolonged use, requiring higher doses for the same effect. Additionally, they can cause tachycardia by stimulating beta2 receptors in the heart. Therefore, all of the above choices (A, B, and C) are correct.
The term catecholamine best describes drugs that are:
- A. Adrenergic receptor blockers
- B. Atropine-like in terms of their mechanisms and sites of action
- C. Classified like neostigmine and physostigmine
- D. Similar to adrenaline and noradrenaline in terms of structure and major pharmacologic properties
Correct Answer: D
Rationale: The correct answer is D because catecholamines are structurally similar to adrenaline and noradrenaline, sharing a catechol nucleus and amine group. This similarity allows them to exert similar pharmacologic effects such as increasing heart rate and blood pressure. Adrenergic receptor blockers (A) inhibit the action of catecholamines, atropine-like drugs (B) block muscarinic receptors, and neostigmine and physostigmine (C) are cholinesterase inhibitors, not catecholamines.
A patient has a low serum T3 level. The health care provider orders measurement of the TSH level. If the TSH level is elevated, what does this indicate?
- A. The cause of the low T3 level is most likely primary hypothyroidism.
- B. The negative feedback system is failing to stimulate the anterior pituitary gland.
- C. The patient has an underactive thyroid gland that is not receiving TSH stimulation.
- D. Most likely there is a tumor on the anterior pituitary gland that is causing increased production of TSH.
Correct Answer: A
Rationale: Elevated TSH levels indicate that the thyroid gland is underactive and is not producing enough T3 and T4, characteristic of primary hypothyroidism.
The plan of care for the diabetic patient includes all of the following interventions. Which intervention could you delegate to the nursing assistant?
- A. Check to make sure that the patient's bath water is not too hot.
- B. Discuss community resources for diabetic outpatient care.
- C. Instruct the patient to perform daily foot inspections.
- D. Check the patient's technique for drawing insulin into a syringe.
Correct Answer: A
Rationale: Checking the temperature of the patient's bath water is a simple task that can be delegated to the nursing assistant to ensure safety and prevent burns.