The health care provider orders an 1800-calorie diabetic diet and 40 units of NPH insulin subcutaneously daily for a patient with diabetes mellitus. For which reason will a mid-afternoon snack of milk and crackers be given?
- A. To improve nutrition.
- B. To improve carbohydrate metabolism.
- C. To prevent hypoglycemia
- D. To prevent diabetic coma.
Correct Answer: C
Rationale: NPH insulin peaks in 6-10 hours. The nurse should be alert for signs of hypoglycemia (low blood glucose) at the peak of action of whatever type of insulin the patient is receiving.
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Which information should be obtained from the patient before treatment with iodine-131?
- A. Presence of metal in the body
- B. Allergy to sulfa drugs
- C. Status of possible pregnancy
- D. Use of prescription drugs for hypertension
Correct Answer: C
Rationale: Iodine-131 is not a radiation hazard to the nonpregnant patient but is absolutely contraindicated during pregnancy. Pregnant nurses should not care for this patient for several days.
The nurse explains that the negative feedback inhibition controls hormone release by communication between which two anatomical areas?
- A. the pituitary and the target organ.
- B. the thymus and the bloodstream.
- C. lymphatic system and the target organ.
- D. central nervous system and the bloodstream.
Correct Answer: A
Rationale: The amount of hormone released is controlled by negative feedback inhibition. The negative feedback inhibition process is when a gland releases a primary hormone, which stimulates target cells to release a secondary hormone; the gland slows the release of the primary hormone as it senses the rise of the secondary hormone. Information is constantly being exchanged via the bloodstream between target organs and endocrine glands.
The nurse is administering long-acting insulin once a day, which provides insulin coverage for 24 hours. This insulin is ___
Correct Answer: Glargine
Rationale: Glargine is a long-acting synthetic (recombinant DNA origin, human-made) human insulin. It is used once a day at bedtime and works around the clock for 24 hours.
Only ___ insulin can be administered intravenously.
Correct Answer: regular
Rationale: Insulin is given subcutaneously, although intravenous (IV) administration of regular insulin can be done when immediate onset of action is desired.
Which gland is the master gland of the endocrine system?
- A. Thyroid
- B. Parathyroid
- C. Pancreas
- D. Pituitary
Correct Answer: D
Rationale: The pituitary gland, located in the brain, is the master gland of the endocrine system. It has been called the 'master gland' because through the negative feedback inhibition, it exerts its control over the other endocrine glands.
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