Nokea
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.
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The hypophyseal portal system transports releasing and inhibiting hormones from the hypothalamus to the __________.
- A. parathyroid glands
- B. thyroid gland
- C. anterior pituitary gland (adenohypophysis)
- D. adrenal glands
Correct Answer: C
Rationale: The correct answer is C, the anterior pituitary gland. The hypophyseal portal system is a network of blood vessels that connects the hypothalamus to the anterior pituitary gland. This system allows the hypothalamus to release hormones that regulate the secretion of hormones from the anterior pituitary gland. The releasing and inhibiting hormones travel through this portal system directly to the anterior pituitary gland to exert their effects. Choices A, B, and D are incorrect because the hypophyseal portal system specifically targets the anterior pituitary gland, not the parathyroid glands, thyroid gland, or adrenal glands.
In general, beta blockers produce all of the following EXCEPT:
- A. Decrease blood pressure
- B. Propranolol is extensively metabolized in the liver
- C. Atenolol is eliminated mainly unchanged in urine
- D. They increase renin activity
Correct Answer: D
Rationale: The correct answer is D: They increase renin activity. Beta blockers block beta-adrenergic receptors, leading to decreased renin secretion and ultimately decreased renin activity. This results in reduced renin-angiotensin-aldosterone system activation, leading to decreased blood pressure. Choices A, B, and C are incorrect because beta blockers are known to decrease blood pressure, propranolol is extensively metabolized in the liver, and atenolol is eliminated mainly unchanged in urine.
Which of the following structures lies posterior to body of pancreas:
- A. IVC
- B. Portal vein
- C. Common bile duct
- D. Splenic vein
Correct Answer: D
Rationale: The correct answer is D: Splenic vein. The splenic vein lies posterior to the body of the pancreas. Step 1: Locate the pancreas in the abdominal cavity. Step 2: Identify the structures behind the body of the pancreas. Step 3: The splenic vein runs posterior to the body of the pancreas, making it the correct answer. Other choices are incorrect because A: IVC is located more inferiorly, B: Portal vein is located more superiorly, and C: Common bile duct is located more anteriorly to the body of the pancreas.
The pituitary hormone that stimulates the male testes to produce sperm and stimulates the development of the follicle in the female on a monthly cycle is:
- A. growth hormone
- B. luteinizing hormone
- C. prolactin
- D. follicle-stimulating hormone
Correct Answer: D
Rationale: The correct answer is D: follicle-stimulating hormone (FSH). FSH is produced by the pituitary gland and plays a crucial role in both male and female reproductive systems. In males, FSH stimulates the testes to produce sperm. In females, FSH stimulates the development of ovarian follicles, which contain eggs. This hormone is essential for the process of ovulation and the menstrual cycle.
A: Growth hormone is not directly involved in the reproductive system but rather promotes overall growth and development.
B: Luteinizing hormone (LH) is responsible for ovulation and the production of testosterone in males. It does not directly stimulate sperm production or follicle development.
C: Prolactin is primarily involved in milk production and has no direct role in sperm production or follicle development.
Which of the following descriptions best fits the drug phenylephrine?
- A. Blocks muscarinic receptors
- B. Stimulates α-adrenergic receptors, causing useful mucous membrane decongestion, or overall vasoconstriction and a rise of blood pressure
- C. Blocks β-adrenergic receptors
- D. Useful drug for managing hypertension
Correct Answer: B
Rationale: The correct answer is B because phenylephrine stimulates α-adrenergic receptors, leading to vasoconstriction and mucous membrane decongestion. This action helps relieve nasal congestion. Choice A is incorrect because phenylephrine does not block muscarinic receptors. Choice C is incorrect because phenylephrine does not block β-adrenergic receptors. Choice D is incorrect because phenylephrine is not typically used for managing hypertension.