Nokea
Mrs. A. is scheduled for a unilateral adrenalectomy. Her postoperative course is uneventful. Which discharge goal is most realistic for Mrs. A.?
- A. Being free of symptoms without medication
- B. Having greatly reduced symptoms on maintenance cortisone
- C. Being free of symptoms on daily ACTH injections
- D. Having activity restricted for life
Correct Answer: B
Rationale: Postoperatively, the goal for Cushing syndrome patients is typically symptom reduction with the help of maintenance cortisone.
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The nurse has identified the nursing diagnosis of fatigue for a patient who is hypothyroid. What should the nurse do while caring for this patient?
- A. Monitor for changes in orientation, cognition, and behavior.
- B. Monitor for vital signs and cardiac rhythm response to activity.
- C. Monitor bowel movement frequency, consistency, shape, volume, and color.
- D. Assist in developing well-balanced meal plans consistent with level of energy expenditure.
Correct Answer: B
Rationale: Hypothyroid patients often experience fatigue due to a slowed metabolic rate, so it's essential to monitor vital signs and cardiac response to physical activity to assess for complications.
A nurse is teaching a client regarding a hormone that is released by beta islet cells in the pancreas. Which hormone is it?
- A. Progesterone
- B. Glucagon
- C. Insulin
- D. Parathormone
Correct Answer: C
Rationale: Insulin is released by beta cells in the pancreas and helps regulate blood sugar levels by promoting glucose uptake into cells.
Which part of pancreas lies near the hilum of the spleen?
- A. Head
- B. Neck
- C. Body
- D. Tail
Correct Answer: D
Rationale: Step 1: The pancreas is an elongated organ located behind the stomach.
Step 2: The tail of the pancreas is the left end of the organ and is closest to the hilum of the spleen.
Step 3: The spleen and the tail of the pancreas are adjacent to each other in the upper left quadrant of the abdomen.
Step 4: Therefore, the correct answer is D: Tail.
Summary:
- A: Head is incorrect as it is the right end of the pancreas, farther away from the spleen.
- B: Neck is incorrect as it is the narrow portion between the head and body, not near the spleen.
- C: Body is incorrect as it is the central and longest part of the pancreas, not near the spleen.
- D: Tail is correct as it is the left end of the pancreas, nearest to the hilum of the spleen.
To ensure accurate results of a fasting blood glucose analysis, the nurse instructs the patient to fast for at least how long?
- A. 2 hours
- B. 4 hours
- C. 8 hours
- D. 12 hours
Correct Answer: C
Rationale: A fasting blood glucose test requires the patient to fast for at least 8 hours to ensure accurate results.
A patient presents with tiredness, weakness, anorexia, apathy, abdominal pain, hyperpigmentation and postural hypertension. Upon infection he appears to be in cardiogenic shock and his blood volume is depleted. His sodium levels are low, potassium levels are high. Which of the following would also be elevated?
- A. TSH
- B. T4
- C. Adrenal hormone
- D. ACTH
Correct Answer: D
Rationale: The correct answer is D: ACTH. In this scenario, the patient is exhibiting symptoms of adrenal insufficiency, specifically Addison's disease. ACTH levels would be elevated due to the lack of negative feedback from cortisol, which is typically low in adrenal insufficiency. TSH (A) and T4 (B) would be normal or low due to the hypofunction of the adrenal gland, not the thyroid. Adrenal hormones (C) would be low in adrenal insufficiency, not elevated.