Nokea
Priority Decision: When replacement therapy is started for a patient with long-standing hypothyroidism, what is most important for the nurse to monitor the patient for?
- A. Insomnia
- B. Nervousness
- C. Weight loss
- D. Dysrhythmias
Correct Answer: D
Rationale: Starting replacement therapy in patients with long-standing hypothyroidism requires close monitoring for potential cardiac dysrhythmias, especially as the thyroid hormones normalize.
You may also like to solve these questions
As the shift begins, you are assigned these patients. Which patient should you assess first?
- A. A 38-year-old patient with Graves' disease and a heart rate of 94/minute
- B. A 63-year-old patient with type 2 diabetes and fingerstick glucose of 137 mg/dL
- C. A 58-year-old patient with hypothyroidism and heart rate of 48/minute
- D. A 49-year-old patient with Cushing's disease and +1 dependent edema
Correct Answer: C
Rationale: A heart rate of 48/minute in a patient with hypothyroidism could indicate bradycardia, which requires immediate assessment to ensure the patient's safety.
Regarding thyroid hormones:
- A. little T3 is produced peripherally by deiodination T4
- B. albumin has more capacity to bind thyroid hormones than TBG
- C. TBG has less affinity for thyroid hormone than albumin
- D. thyroid hormones stimulate lipogenesis
Correct Answer: B
Rationale: Step 1: Albumin binds more thyroid hormones than TBG due to its higher concentration in the blood.
Step 2: TBG has higher affinity for thyroid hormones than albumin, leading to less free hormone.
Step 3: Hence, choice B is correct as albumin has more capacity to bind thyroid hormones.
Summary: Choice A is incorrect as significant T3 is produced peripherally. Choice C is incorrect as TBG has higher affinity. Choice D is incorrect as thyroid hormones stimulate lipolysis, not lipogenesis.
The secretions from which of these glands differs between males and females?
- A. Adrenal.
- B. Parathyroid.
- C. Gonadal.
- D. Pancreas.
Correct Answer: C
Rationale: The correct answer is C: Gonadal glands. These glands differ between males and females in terms of the hormones they secrete. In males, the gonadal glands (testes) produce testosterone, while in females, the gonadal glands (ovaries) produce estrogen and progesterone. Adrenal glands (A) secrete hormones like cortisol and adrenaline, which are not gender-specific. Parathyroid glands (B) regulate calcium levels and are not gender-specific. Pancreas (D) secretes insulin and glucagon, which are also not gender-specific. Therefore, the key difference in secretions between males and females lies in the gonadal glands.
Terbutaline specifically stimulates:
- A. Alpha1 receptors
- B. Alpha2 receptors
- C. Beta1 receptors
- D. Beta2 receptors
Correct Answer: D
Rationale: Terbutaline specifically stimulates Beta2 receptors. This leads to bronchodilation by relaxing smooth muscles in the airways. Beta2 receptors are predominantly found in the lungs. Option A and B are incorrect as terbutaline does not target Alpha receptors. Option C is incorrect as terbutaline does not primarily stimulate Beta1 receptors, which are mainly found in the heart.
Which of the following statements correctly describe the peritoneum?
- A. The largest serous membrane
- B. A serous membrane
- C. The largest synovial membrane
- D. A mucous membrane
Correct Answer: A
Rationale: The correct answer is A because the peritoneum is indeed the largest serous membrane in the body. It lines the abdominal cavity and covers the organs within it, providing lubrication and reducing friction. Choice B is incorrect because the peritoneum is a serous membrane, not a synovial membrane (Choice C) or a mucous membrane (Choice D). The peritoneum does not secrete synovial fluid like synovial membranes or produce mucus like mucous membranes. Hence, Choice A is the only statement that accurately describes the peritoneum.