Nokea
The patient has newly diagnosed type 2 diabetes. Which task should you delegate to the nursing assistant?
- A. Arrange consult with the dietitian for patient.
- B. Verify patient's insulin injection technique.
- C. Teach patient to use glucometer for monitoring glucose at home.
- D. Remind patient to check glucose level prior to each meal.
Correct Answer: D
Rationale: Reminding the patient to check glucose level prior to each meal is a simple task that can be delegated to the nursing assistant.
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During surgery, we administer hexamethonium to an anesthetized patient. Which of the following effects should you expect in response to this drug?
- A. Bradycardia mediated by activation of the baroreceptor reflex
- B. Increased GI tract motility, possible spontaneous defecation
- C. Increased salivary secretions
- D. Vasodilation
Correct Answer: D
Rationale: The correct answer is D: Vasodilation. Hexamethonium is a ganglionic blocking agent that blocks nicotinic receptors in autonomic ganglia, leading to vasodilation due to inhibition of sympathetic vasoconstrictor tone. This causes a decrease in blood pressure.
A: Bradycardia is not a direct effect of hexamethonium.
B: Increased GI motility and defecation are not expected effects of hexamethonium.
C: Increased salivary secretions are not directly affected by hexamethonium.
In summary, the correct answer is D because hexamethonium causes vasodilation by blocking nicotinic receptors in autonomic ganglia, leading to a decrease in blood pressure.
Intravenous administration of epinephrine to a patient results in a severe decrease in diastolic pressure and an increase in cardiac output. Which of the following drugs might the patient have previously taken that could account for this unexpected effect?
- A. Propranolol
- B. Atropine
- C. Phenylephrine
- D. Prazosin
Correct Answer: D
Rationale: The correct answer is D: Prazosin. Prazosin is an alpha-1 adrenergic receptor antagonist, which blocks the vasoconstrictor effect of catecholamines like epinephrine, leading to vasodilation and a decrease in diastolic pressure. The unexpected effect of a decrease in diastolic pressure and an increase in cardiac output after epinephrine administration suggests that the patient might have taken a drug that blocks alpha-1 receptors. Propranolol (A) is a beta-blocker, which would not cause this effect. Atropine (B) is a muscarinic receptor antagonist and would not explain the observed effects. Phenylephrine (C) is an alpha-1 agonist, so it would not result in the described response. Therefore, Prazosin (D) is the most likely drug the patient previously took to account for the unexpected effects of epinephrine administration.
All of the following are hormones of the anterior pituitary except:
- A. Human growth hormone (GH).
- B. Follicle-stimulating hormone (FSH).
- C. Parathyroid hormone(PTH).
- D. Thyroid-stimulating hormone (TSH).
Correct Answer: C
Rationale: The correct answer is C: Parathyroid hormone (PTH). The anterior pituitary gland secretes hormones that regulate various bodily functions, such as growth, reproduction, and metabolism. PTH is actually produced by the parathyroid glands, not the anterior pituitary. Human growth hormone (GH), follicle-stimulating hormone (FSH), and thyroid-stimulating hormone (TSH) are all hormones secreted by the anterior pituitary gland. Therefore, C is the correct answer as it is not a hormone produced by the anterior pituitary gland.
Which stimulates parietal cell secretion?
- A. prostaglandins
- B. aspirin
- C. vinegar
- D. acetylcholine
Correct Answer: D
Rationale: The correct answer is D: acetylcholine. Acetylcholine directly stimulates parietal cells in the stomach to secrete hydrochloric acid. It binds to muscarinic receptors on parietal cells, leading to an increase in acid production. Prostaglandins (A) inhibit acid secretion, aspirin (B) can cause gastric irritation and ulcers, and vinegar (C) does not directly stimulate parietal cells.
A common second messenger used in signaling pathways of water-soluble hormones is
- A. tRNA.
- B. ATP.
- C. cAMP.
- D. PTH.
Correct Answer: C
Rationale: The correct answer is C: cAMP. Water-soluble hormones, such as adrenaline or glucagon, bind to cell surface receptors and activate a signaling cascade that often involves cAMP as a second messenger. Upon hormone binding, the receptor activates adenylyl cyclase, which converts ATP to cAMP. cAMP then activates protein kinase A, leading to phosphorylation of target proteins, ultimately affecting cellular responses.
Explanation for incorrect choices:
A: tRNA is involved in protein synthesis, not in signaling pathways of water-soluble hormones.
B: ATP is used as an energy source in various cellular processes, but it is not a second messenger in hormone signaling pathways.
D: PTH (parathyroid hormone) is a hormone involved in calcium regulation and does not act through cAMP signaling in the same manner as water-soluble hormones.