Nokea
The nurse is caring for a patient in the outpatient clinic who has a prescription for blood cortisol testing. Which of the following instructions should the nurse provide for the patient?
- A. Avoid adding any salt to your foods for 24 hours before the test.
- B. You will need to lie down for 30 minutes before the blood is drawn.
- C. Come to the laboratory to have the blood drawn early in the morning.
- D. Do not have anything to eat or drink before the blood test is obtained.
Correct Answer: C
Rationale: Cortisol levels are usually drawn in the morning when levels are highest. The other instructions would be given to patients who were having other endocrine testing.
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The nurse is caring for a patient who is undergoing a water deprivation test. Which of the following findings is most important for the nurse to communicate to the health care provider?
- A. Intense thirst
- B. 2.3 kg weight loss
- C. Orthostatic hypotension
- D. No change in urine osmolality
Correct Answer: B
Rationale: A drop in the weight of more than 2 kg indicates severe dehydration, and the test should be discontinued. The other assessment data are not unusual with this test.
A patient with a possible pituitary adenoma is scheduled for a computed tomography (CT) scan with contrast media. Which of the following patient information is most important for the nurse to communicate to the health care provider before the test?
- A. Bilateral poor peripheral vision
- B. Allergies to iodine and shellfish
- C. Recent weight loss of 8.5 kg
- D. History of ongoing headaches
Correct Answer: B
Rationale: Since the usual contrast media is iodine-based, the health care provider will need to know about the allergy before the CT scan. The other findings are common with any mass in the brain such as a pituitary adenoma.
The nurse is teaching a patient how to prepare for an oral glucose tolerance test (OGTT). Which of the following patient response indicates that the teaching has been effective?
- A. Fast 12 hours before the procedure
- B. Clear fluid diet 12 hours prior to the test
- C. Drink only full fluids 6 hours before the test
- D. No fluid or food restrictions prior to the test
Correct Answer: A
Rationale: Fasting for 12 hours before the procedure demonstrates that teaching has been effective. The patient is to be NPO 12 hours prior to the test. A clear fluid diet 12 hours pretest is not indicated. A full fluid diet 6 hours pretest is not indicated.
The regulation of oxytocin during childbirth is an example of which of the following mechanisms?
- A. Physiological rhythm
- B. Secondary input
- C. Loop regulation
- D. Positive feedback
Correct Answer: D
Rationale: An example of the regulation of oxytocin during childbirth is an example of positive feedback. The positive feedback mechanism increases the target organ action beyond normal. The release of oxytocin is stimulated by pressure receptors in the vagina. As the fetus enters the vagina during childbirth, the pressure receptors sense increased pressure and signal the brain to release more oxytocin.
The nurse is caring for a patient who is scheduled for a 24-hour urine collection for 17-ketosteroids. Which of the following actions should the nurse implement?
- A. Keep the specimen on ice.
- B. Insert a retention catheter.
- C. Have the patient void and save that specimen to start the collection.
- D. Encourage the patient to drink 2-3 L of fluid during the 24 hours.
Correct Answer: A
Rationale: The specimen must be kept on ice or refrigerated until the collection is finished. Voided or catheterized specimens are acceptable for the test. The initial voided specimen is discarded. There is no fluid intake requirement for the 24-hour collection.