Nokea
Gluconeogenesis occurs in the liver due to the action of ________.
- A. aldosterone
- B. insulin
- C. secretin
- D. cortisol
Correct Answer: D
Rationale: The correct answer is D: cortisol. Gluconeogenesis is the process of synthesizing glucose from non-carbohydrate sources, primarily in the liver. Cortisol plays a key role in stimulating gluconeogenesis by promoting the breakdown of proteins and fats to generate substrates for glucose production. Aldosterone, insulin, and secretin do not directly stimulate gluconeogenesis. Aldosterone regulates electrolyte balance, insulin promotes glucose uptake and storage, and secretin stimulates pancreatic enzyme secretion. Cortisol is the hormone responsible for activating gluconeogenesis in the liver.
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An excess of thyroid hormones produces hyperthyroidism, a speeded-up metabolic state that is known as:
- A. Cushing syndrome.
- B. Graves’ disease.
- C. Addison’s disease.
- D. ADH hypersecretion.
Correct Answer: B
Rationale: The correct answer is B: Graves' disease. Graves' disease is an autoimmune disorder that leads to overproduction of thyroid hormones, causing hyperthyroidism. This is characterized by symptoms such as weight loss, increased heart rate, and anxiety. Cushing syndrome (A) is caused by excess cortisol, not thyroid hormones. Addison's disease (C) is a condition where the adrenal glands do not produce enough hormones. ADH hypersecretion (D) refers to excessive production of antidiuretic hormone, not thyroid hormones. Therefore, the correct answer is Graves' disease due to its direct association with hyperthyroidism.
A 38-year-old farmer is brought to the emergency room by his wife with symptoms of sudden difficulty breathing, sweatiness, and anxiety. He was spraying insecticide when this happened. It has been 25 minutes since the symptoms started. The patient is emergently intubated and given atropine and another medication that acts to reactivate acetylcholinesterase. What medication is it?
- A. Physostigmine
- B. Propranolol
- C. Pralidoxime
- D. Phenylephrine
Correct Answer: C
Rationale: The correct answer is C: Pralidoxime. Pralidoxime is used to reactivate acetylcholinesterase in cases of organophosphate poisoning, which is likely the cause of the patient's symptoms after spraying insecticide. Reactivating acetylcholinesterase helps to break down excess acetylcholine, reducing the toxic effects of the insecticide. Physostigmine (choice A) is an acetylcholinesterase inhibitor, which would worsen the patient's condition. Propranolol (choice B) is a beta-blocker and does not address the underlying issue of acetylcholinesterase inhibition. Phenylephrine (choice D) is a sympathomimetic drug used for vasoconstriction and would not be appropriate in this scenario.
Which gland is responsible for the production of growth hormone?
- A. anterior pituitary
- B. thyroid
- C. adrenal medulla
- D. pancreas
Correct Answer: A
Rationale: The correct answer is A: anterior pituitary. The anterior pituitary gland is responsible for producing growth hormone, also known as somatotropin. This hormone plays a key role in promoting growth, cell regeneration, and overall development. The other choices are incorrect because the thyroid gland primarily produces thyroid hormones that regulate metabolism, the adrenal medulla produces adrenaline and noradrenaline in response to stress, and the pancreas produces insulin and glucagon to regulate blood sugar levels. Therefore, the correct answer is the anterior pituitary gland as it specifically produces growth hormone.
Atrial natriuretic hormone (ANH) is produced by cells of the ___.
- A. kidney tubules.
- B. right atrium of the heart.
- C. adrenal cortex.
- D. pancreas.
Correct Answer: B
Rationale: The correct answer is B: right atrium of the heart. Atrial natriuretic hormone (ANH) is produced by specialized cells in the right atrium of the heart called atrial myocytes. When the heart senses an increase in blood volume or pressure, these cells release ANH to help regulate fluid and electrolyte balance by promoting sodium and water excretion by the kidneys. Choices A, C, and D are incorrect because ANH is not produced by the kidney tubules, adrenal cortex, or pancreas. The primary site of ANH production is specifically within the cardiac atria.
Priority Decision: A patient taking insulin has recorded fasting glucose levels above 200 mg/dL (11.1 mmol/L) on awakening for the last five mornings. What should the nurse advise the patient to do first?
- A. Increase the evening insulin dose to prevent the dawn phenomenon.
- B. Use a single-dose insulin regimen with an intermediate-acting insulin.
- C. Monitor the glucose level at bedtime, between 2:00 am and 4:00 am, and on arising.
- D. Decrease the evening insulin dosage to prevent night hypoglycemia and the Somogyi effect.
Correct Answer: C
Rationale: Monitoring glucose at multiple times will help identify if the issue is related to the dawn phenomenon or the Somogyi effect.