Nokea
The “melting of flesh into urine,†an old-timey name, is most descriptive of untreated:
- A. diabetes mellitus.
- B. Addison’s disease.
- C. diabetes insipidus.
- D. Cushing syndrome.
Correct Answer: A
Rationale: The correct answer is A: diabetes mellitus. This term describes the breakdown of body tissues for energy due to lack of insulin, leading to the production of ketones in the urine. In diabetes mellitus, the body cannot use glucose properly, causing the breakdown of fats and proteins. Addison's disease (B) involves adrenal insufficiency, not tissue breakdown. Diabetes insipidus (C) is a disorder of water balance, not tissue breakdown. Cushing syndrome (D) is characterized by excess cortisol production, not tissue breakdown into urine.
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Verapamil is a drug used for treating hypertension. It should be used with caution with other drugs that can depress heart rate or contractility. Which drug, if given with verapamil, might therefore cause the greatest risk of depressing heart rate, contractile force, or impulse conduction?
- A. Albuterol
- B. Scopolamine
- C. Propranolol
- D. Isoproterenol
Correct Answer: C
Rationale: The correct answer is C: Propranolol. Verapamil is a calcium channel blocker that can depress heart rate and contractility. Propranolol is a beta-blocker that also decreases heart rate and contractile force. When combined, both drugs can have an additive effect leading to a significant decrease in heart rate and contractility, potentially causing bradycardia or heart failure.
Albuterol (A) is a beta-2 agonist that actually increases heart rate and contractility. Scopolamine (B) is an anticholinergic drug that may decrease heart rate, but its effect is not as significant as propranolol. Isoproterenol (D) is a beta agonist that increases heart rate and contractility, so its combination with verapamil would not pose the same risk as propranolol.
You are precepting a nurse who has recently graduated and passed the NCLEX examination. The new nurse has been on the unit for only 2 days. Which patient should you assign to the new nurse?
- A. A 68-year-old diabetic who is experiencing signs of hyperglycemia including rapid, deep breathing and mental status changes
- B. A 58-year-old diabetic with peripheral neuropathy and cellulitis of the left ankle
- C. A 49-year-old diabetic who has just returned from post-anesthesia care unit (PACU) after a below-the-knee amputation (BKA)
- D. A 72-year-old diabetic with diabetic ketoacidosis (DKA) on an IV insulin drip
Correct Answer: B
Rationale: The 58-year-old diabetic with peripheral neuropathy and cellulitis is a stable patient, and this case provides an opportunity for the new nurse to practice assessment and care management.
Mr. Johnson received his first dose of Lente insulin at 7:30 A.M. When should he be observed for signs of hypoglycemia?
- A. 10-11 A.M.
- B. 4-6 P.M.
- C. Between 2 A.M. and breakfast
- D. Immediately after the injection
Correct Answer: B
Rationale: Lente insulin has an onset of action that typically peaks 4-6 hours after injection, so this is when signs of hypoglycemia are most likely to occur.
A 59-year-old man complains of nocturia, urinary frequency, and an inability to urinate forcefully and empty his bladder. Following a complete workup, he was diagnosed with benign prostatic hypertrophy (BPH). We start daily therapy with tamsulosin. Which of the following is the most likely side effect the patient may experience from the tamsulosin, and about which he should be forewarned?
- A. Bradycardia
- B. Increased risk of statin-induced skeletal muscle pathology
- C. First dose hypotension
- D. Photophobia and other painful responses to bright lights
Correct Answer: C
Rationale: The correct answer is C: First dose hypotension. Tamsulosin is an alpha-1 blocker commonly used for BPH. It can cause orthostatic hypotension, especially after the first dose due to sudden vasodilation. This side effect is important to be forewarned about to prevent falls or accidents. Bradycardia (choice A) is not a common side effect of tamsulosin. Increased risk of statin-induced skeletal muscle pathology (choice B) is unrelated to tamsulosin. Photophobia and painful responses to bright lights (choice D) are not associated with tamsulosin use.
What is the origin of accessory pancreatic duct?
- A. Distal part of dorsal pancreatic bud
- B. Proximal part of dorsal pancreatic bud
- C. The distal part of ventral pancreatic bud
- D. The proximal part of ventral pancreatic bud
Correct Answer: B
Rationale: The correct answer is B: Proximal part of dorsal pancreatic bud. The accessory pancreatic duct originates from the dorsal pancreatic bud during embryonic development. This is because the dorsal pancreatic bud gives rise to the body and tail of the pancreas, which includes the accessory pancreatic duct. The proximal part of the dorsal pancreatic bud specifically gives rise to the proximal part of the accessory pancreatic duct. Choices A, C, and D are incorrect because they refer to the distal part of the dorsal pancreatic bud, the distal part of the ventral pancreatic bud, and the proximal part of the ventral pancreatic bud, respectively, which are not associated with the origin of the accessory pancreatic duct.