Nokea
Mr. Weber, an insulin-dependent diabetic, states that in the afternoon he has occasional severe reactions during which he becomes unconscious. In planning his care, which of the following nursing actions is most appropriate?
- A. Placing a tube of commercially prepared glucose paste at his bedside
- B. Administering regular insulin
- C. Checking his level of consciousness every hour
- D. Keeping a supply of orange juice in the refrigerator
Correct Answer: A
Rationale: For a patient with severe hypoglycemic reactions, it's essential to have a quick source of glucose on hand, like glucose paste, to treat unconsciousness from low blood sugar.
You may also like to solve these questions
Identify functions of calcium within the body.
- A. Clotting
- B. Hardens bone
- C. Nerve conduction and muscle contraction
- D. All of the above.
Correct Answer: D
Rationale: The correct answer is D because calcium plays essential roles in clotting, bone health, nerve conduction, and muscle contraction. Calcium is crucial for the coagulation cascade in clotting, is a key component of bone mineralization, is required for neurotransmitter release in nerve conduction, and is involved in muscle contraction by regulating the interactions between actin and myosin. Choices A, B, and C are incorrect individually because they only represent some of the functions of calcium, whereas choice D encompasses all the vital functions of calcium in the body.
You are a resident in a hospital in a very poor part of the world. Their drug selection is limited. A patient presents with acute cardiac failure, for which your preferred drug is dobutamine, given intravenously. However, there is none available. Which of the following other drugs, or combination of drugs, would be a suitable alternative?
- A. Dopamine (at a very high dose)
- B. Ephedrine
- C. Ephedrine plus propranolol
- D. Norepinephrine plus phentolamine
Correct Answer: D
Rationale: The correct answer is D: Norepinephrine plus phentolamine. Norepinephrine is a potent vasopressor that can increase blood pressure and cardiac output in acute cardiac failure. Phentolamine is an alpha-blocker that can help counteract the vasoconstrictive effects of norepinephrine.
Rationale:
1. Norepinephrine: Increases blood pressure and cardiac output, improving perfusion to vital organs in acute cardiac failure.
2. Phentolamine: Counteracts the vasoconstrictive effects of norepinephrine, preventing excessive vasoconstriction.
Summary:
A: Dopamine at a very high dose may not be as effective as norepinephrine in acute cardiac failure.
B: Ephedrine is a less potent vasopressor compared to norepinephrine.
C: Ephedrine plus propranolol combination may lead to conflicting effects on blood pressure and heart rate
As plasma levels of calcium decrease:
- A. insulin is secreted.
- B. the parathyroid glands secrete an osteoclastic hormone.
- C. the kidneys excrete calcium and phosphorus.
- D. calcitonin is secreted.
Correct Answer: B
Rationale: The correct answer is B because as plasma levels of calcium decrease, the parathyroid glands secrete an osteoclastic hormone called parathyroid hormone (PTH). PTH acts to increase calcium levels by stimulating the release of calcium from bones via osteoclasts. Insulin secretion (choice A) is not directly related to calcium levels. The kidneys excreting calcium and phosphorus (choice C) would further decrease calcium levels. Calcitonin (choice D) actually decreases blood calcium levels by inhibiting bone breakdown, so it is not secreted when calcium levels decrease.
Your patient is diagnosed with myasthenia gravis, and she is given a prescription for pyridostigmine. Which of the following best summarizes the drug’s mechanism of action?
- A. Blocks muscarinic receptors, so that acetylcholine preferentially stimulates skeletal muscle
- B. Inhibits reuptake of acetylcholine by motor nerves
- C. Inhibits skeletal muscle activation at rest so that the muscles are less susceptible to fatigue during exercise
- D. Inhibits breakdown of acetylcholine, thereby improving activation of skeletal muscle by acetylcholine
Correct Answer: D
Rationale: The correct answer is D: "Inhibits breakdown of acetylcholine, thereby improving activation of skeletal muscle by acetylcholine."
Rationale:
1. Pyridostigmine is an acetylcholinesterase inhibitor, which means it blocks the breakdown of acetylcholine.
2. In myasthenia gravis, there is a decrease in acetylcholine receptor sites, leading to muscle weakness.
3. By inhibiting the breakdown of acetylcholine, pyridostigmine increases the availability of acetylcholine at the neuromuscular junction, improving muscle activation.
4. This mechanism helps alleviate muscle weakness in myasthenia gravis patients.
Summary:
A: Incorrect. Pyridostigmine does not block muscarinic receptors or change the preference of acetylcholine stimulation.
B: Incorrect. Pyridostigmine does not inhibit reuptake of acetylcholine; it acts by inhibiting its breakdown
Which gland secretes TSH, ACTH, and growth hormone?
- A. Neurohypophysis
- B. Pancreas
- C. Adrenal medulla
- D. Anterior pituitary gland
Correct Answer: D
Rationale: The correct answer is D, the anterior pituitary gland, because it secretes TSH, ACTH, and growth hormone. The anterior pituitary gland is also known as the adenohypophysis, and it plays a key role in regulating various bodily functions through the release of different hormones. The other choices are incorrect because the neurohypophysis (choice A) secretes hormones like oxytocin and vasopressin, the pancreas (choice B) secretes insulin and glucagon, and the adrenal medulla (choice C) secretes adrenaline and noradrenaline.