Nokea
The following are true about parathyroid hormone:
- A. it is an 84 amino acid peptide hormone
- B. it increases calcium absorption from the gastrointestinal tract
- C. it acts on a cell surface receptor that increases intracellular cyclic AMP
- D. all above
Correct Answer: D
Rationale: Parathyroid hormone (PTH) is an 84-amino acid peptide that increases calcium absorption from the gut, mobilizes calcium from bones, and reduces calcium excretion by the kidneys. It acts via a cell surface receptor that activates cyclic AMP signaling.
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During muscle strength testing, the patient has active movement against gravity and some resistance to pressure. What score should the nurse give this finding?
- A. 2
- B. 3
- C. 4
- D. 5
Correct Answer: C
Rationale: Grade 4 indicates movement against gravity and moderate resistance.
A young male client visits a nurse with a complaint of chronic tension headaches. Which of the following is the most appropriate nursing instruction to manage the client?
- A. Instructing the client to monitor for signs of bruising or bleeding
- B. Suggesting eating and swallowing techniques that reduce the potential for aspiration
- C. Counseling on alternate therapies
- D. Advising the client to change sleeping positions frequently
Correct Answer: C
Rationale: Alternate therapies, such as relaxation techniques, can help manage tension headaches.
A previously healthy 26-year-old male is brought to the emergency department due to muscle weakness. He reports mild weakness in his legs that has progressively worsened over a few days to the point that he can barely move his legs. He has some numbness in his legs and his arms feel weak. He has recently recovered from a respiratory infection. 1/5 muscle strength is noted throughout the lower extremities, as well as absent patellar and ankle reflexes. 3 to 4-/5 muscle strength is appreciated throughout his upper extremities. A lumbar puncture is performed, which shows the following: Cell count: 4 cells/mm3, Glucose: 67 mg/dL, Protein: 187 mg/dL Gram stain: no organisms Spirometry is performed, which shows a forced vital capacity of 0.85 L. Which of the following is the best next step in management?
- A. Intravenous (IV) immunoglobulin
- B. Intubation
- C. IV corticosteroids
- D. Immunomodulating agent
Correct Answer: B
Rationale: The patient's presentation of rapidly progressive weakness, areflexia, and elevated cerebrospinal fluid protein with normal cell count (albuminocytologic dissociation) is classic for Guillain-Barre syndrome (GBS). The forced vital capacity of 0.85 L indicates respiratory failure, necessitating immediate intubation to protect the airway and provide mechanical ventilation. Intravenous immunoglobulin and plasma exchange are treatments for GBS but are secondary to securing the airway in this critically ill patient.
When Mr. Jones develops an attack of autonomic dysreflexia, it is initially most important to
- A. elevate the head of his bed
- B. monitor his blood pressure closely
- C. assess for bowel and bladder distention
- D. encourage him to ventilate his concerns
Correct Answer: C
Rationale: Assessing for bowel and bladder distention is critical as these can trigger autonomic dysreflexia.
In reviewing Mrs. Post's laboratory results, which abnormal test is most likely to confirm the diagnosis?
- A. Sedimentation rate
- B. Rheumatoid factor
- C. LE cells
- D. Antinuclear antibody
Correct Answer: D
Rationale: Antinuclear antibodies are highly indicative of systemic lupus erythematosus.