Nokea
Priority Decision: What is the priority nursing intervention during the management of the patient with pheochromocytoma?
- A. Administering IV fluids
- B. Administering β-adrenergic blockers
- C. Monitoring blood pressure
- D. Monitoring intake and output and daily weights
Correct Answer: B
Rationale: In managing pheochromocytoma, monitoring and controlling blood pressure is the priority intervention due to the risk of hypertensive crises caused by catecholamine secretion from the tumor.
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Lispro insulin (Humalog) with NPH insulin is ordered for a patient with newly diagnosed type 1 diabetes. The nurse knows that when lispro insulin is used, when should it be administered?
- A. Only once a day
- B. 1 hour before meals
- C. 30 to 45 minutes before meals
- D. At mealtime or within 15 minutes of meals
Correct Answer: D
Rationale: Lispro insulin should be administered at mealtime or within 15 minutes of meals for optimal effect.
All the following adverse effects can be produced by beta-blockers EXCEPT:
- A. Hypotension
- B. Heart failure
- C. Bronchodilation
- D. Heart block
Correct Answer: C
Rationale: The correct answer is C: Bronchodilation. Beta-blockers primarily work by blocking the beta-adrenergic receptors, leading to a decrease in heart rate and contractility. This can result in adverse effects such as hypotension, heart failure, and heart block due to the reduced cardiac output. However, bronchodilation is not a typical adverse effect of beta-blockers. In fact, beta-blockers can cause bronchoconstriction in patients with underlying respiratory conditions like asthma, making choice C the correct answer. Choices A, B, and D are incorrect because hypotension, heart failure, and heart block are known adverse effects associated with beta-blockers due to their mechanism of action on the cardiovascular system.
What is the density of the block and does it float or sink in the liquid?
- A. 0.50, floats
- B. 0.50, sinks
- C. 2.0, floats
- D. 2.0, sinks
Correct Answer: D
Rationale: The correct answer is D: 2.0, sinks. Density is calculated by mass/volume. If the density of the block is 2.0, it means it is denser than the liquid (density of water is around 1.0), so it will sink. If the density was 0.50, it would be less dense than the liquid and float, making choices A and C incorrect. Choice B is also incorrect as a block with a density of 0.50 would float.
Chemical signals that affect the behavior of other glands and tissues are _____.
- A. enzymes.
- B. hormones.
- C. carbohydrates.
- D. metabolites.
Correct Answer: B
Rationale: The correct answer is B: hormones. Hormones are chemical signals produced by glands that travel through the bloodstream to affect the behavior of other glands and tissues. Enzymes (choice A) are catalysts for chemical reactions, not signaling molecules. Carbohydrates (choice C) are energy sources and structural components, not signaling molecules. Metabolites (choice D) are the byproducts of metabolism, not signaling molecules. Hormones are specifically designed to regulate physiological processes in the body by acting on target cells, making them the most fitting choice among the options provided.
Hypocalcemic tetany:
- A. is a consequence of a deficiency of calcitonin.
- B. is caused by a lack of TSH.
- C. is caused by osteoclastic activity.
- D. develops in response to a deficiency of parathyroid activity.
Correct Answer: D
Rationale: Step-by-step rationale:
1. Hypocalcemic tetany results from low blood calcium levels.
2. Parathyroid hormone (PTH) regulates calcium levels by increasing calcium release from bones and reabsorption in the kidneys.
3. A deficiency in parathyroid activity leads to decreased calcium levels, causing tetany.
4. Choice D is correct as it directly links hypocalcemic tetany to parathyroid dysfunction.
Summary:
A: Incorrect, calcitonin lowers blood calcium levels.
B: Incorrect, TSH regulates thyroid function, not calcium levels.
C: Incorrect, osteoclasts break down bone tissue but are not directly related to hypocalcemic tetany.