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The female patient is admitted with a new diagnosis of Cushing syndrome with elevated serum and urine cortisol levels. Which assessment findings should the nurse expect to see in this patient?
- A. Hair loss and moon face
- B. Decreased weight and hirsutism
- C. Decreased muscle mass and thick skin
- D. Elevated blood pressure and blood glucose
Correct Answer: D
Rationale: In Cushing syndrome, elevated cortisol levels often lead to elevated blood pressure and blood glucose levels.
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Which gland controls basal metabolic rate (BMR)?
- A. Thyroid.
- B. Parathyroid.
- C. Testes.
- D. Pancreas.
Correct Answer: A
Rationale: The correct answer is A: Thyroid. The thyroid gland produces thyroid hormones T3 and T4, which regulate the body's metabolic rate. These hormones control the basal metabolic rate (BMR) by influencing the rate at which cells use energy. The other choices, B: Parathyroid, C: Testes, and D: Pancreas, do not directly control BMR. Parathyroid regulates calcium levels, Testes produce hormones related to reproduction, and Pancreas regulates blood sugar levels through insulin and glucagon secretion. Thyroid is the only gland among the choices that specifically influences BMR.
In relation to amphetamine, all are true EXCEPT:
- A. Indirect acting sympathomimetic
- B. Has prominent CNS action
- C. Chronic use can produce addiction
- D. Acidification of urine decreases its excretion
Correct Answer: D
Rationale: The correct answer is D because acidification of urine actually increases the excretion of amphetamine. Step 1: Amphetamine is an indirect acting sympathomimetic, which means it stimulates the release of norepinephrine. Step 2: It has prominent CNS action by increasing the release of dopamine and norepinephrine, leading to effects like increased alertness and euphoria. Step 3: Chronic use of amphetamine can indeed lead to addiction due to its reinforcing properties and impact on the brain's reward system. Therefore, D is incorrect as acidification of urine does not decrease amphetamine excretion; instead, it can enhance excretion by increasing its solubility in urine.
When caring for a diabetic client at night, the only symptom of insulin shock that a nurse might observe is
- A. dry mucous membranes
- B. acetone breath
- C. flushed appearance
- D. diaphoresis
Correct Answer: D
Rationale: The most common symptom of insulin shock or hypoglycemia is diaphoresis (sweating), which is a result of the body's stress response to low blood glucose levels.
Which of the following arteries supply the tail of pancreas?
- A. Inferior pancreaticoduodenal
- B. Left gastroepiploic artery
- C. Splenic artery
- D. Superior pancreaticoduodenal
Correct Answer: C
Rationale: The correct answer is C: Splenic artery. The splenic artery supplies the tail of the pancreas through its branches. The splenic artery runs along the superior border of the pancreas and gives off multiple branches that supply various parts of the pancreas, including the tail.
A: Inferior pancreaticoduodenal artery supplies the inferior part of the pancreas.
B: Left gastroepiploic artery supplies the greater curvature of the stomach.
D: Superior pancreaticoduodenal artery supplies the pancreatic head and duodenum.
Therefore, the splenic artery is the correct answer as it specifically supplies the tail of the pancreas.
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.