Nokea
The patient is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). What manifestation should the nurse expect to find?
- A. Decreased body weight
- B. Decreased urinary output
- C. Increased plasma osmolality
- D. Increased serum sodium levels
Correct Answer: B
Rationale: In SIADH, inappropriate ADH secretion causes water retention, leading to decreased urine output and dilutional hyponatremia.
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With respect to calcium metabolism / bone formation:
- A. osteoclasts secrete alkaline phosphatase
- B. osteoblasts are haemopoietic derivatives of monocyte lineage
- C. 1,25(OH)2 ???D3 and PTH stimulate both osteoblasts and osteoclasts
- D. oestrogens are thought to be protective of osteoporosis as their main effect is osteoblasts stimulation
Correct Answer: C
Rationale: Rationale for Correct Answer (C):
1,25(OH)2 D3 and PTH stimulate both osteoblasts and osteoclasts. 1,25(OH)2 D3 enhances calcium absorption in the gut, promotes bone resorption, and stimulates osteoclast activity. PTH increases calcium levels in the blood by enhancing calcium reabsorption in the kidney and stimulating osteoclast activity. Both hormones indirectly stimulate osteoblasts by increasing calcium availability for bone formation.
Summary of Incorrect Choices:
A: Osteoclasts actually secrete acid, not alkaline phosphatase.
B: Osteoblasts are derived from mesenchymal stem cells, not monocytes.
D: Estrogens have a dual effect, inhibiting bone resorption by osteoclasts and stimulating bone formation by osteoblasts; their main effect is inhibiting osteoclast activity, not solely stimulating osteoblasts.
Drug X causes an increase in blood pressure and a decrease in heart rate when administered to a patient intravenously. If an antagonist at ganglionic nicotinic receptors is administered first, drug X causes an increase in blood pressure and an increase in heart rate. Drug X most likely is
- A. Propranolol
- B. Norepinephrine
- C. Isoproterenol
- D. Terbutaline
Correct Answer: B
Rationale: The correct answer is B: Norepinephrine. When an antagonist at ganglionic nicotinic receptors is administered, it blocks the inhibitory effect on sympathetic tone. Since norepinephrine is a sympathetic neurotransmitter that increases blood pressure and heart rate, it is likely that Drug X is norepinephrine. Propranolol (A) is a beta-blocker that decreases heart rate, Isoproterenol (C) is a beta-agonist that increases heart rate, and Terbutaline (D) is a beta-agonist that also increases heart rate. These choices do not align with the observed effects of Drug X when the ganglionic nicotinic receptor antagonist is administered.
The secretions from which of these glands differs between males and females?
- A. Adrenal.
- B. Parathyroid.
- C. Gonadal.
- D. Pancreas.
Correct Answer: C
Rationale: The correct answer is C: Gonadal. The secretions from gonads (testes in males, ovaries in females) differ between males and females due to the production of sex hormones (testosterone in males, estrogen and progesterone in females). Adrenal glands (A) secrete similar hormones in both genders. Parathyroid (B) and Pancreas (D) do not secrete hormones that differ based on gender.
A patient with mild iatrogenic Cushing syndrome is on an alternate-day regimen of corticosteroid therapy. What does the nurse explain to the patient about this regimen?
- A. It maintains normal adrenal hormone balance.
- B. It prevents ACTH release from the pituitary gland.
- C. It minimizes hypothalamic-pituitary-adrenal suppression.
- D. It provides a more effective therapeutic effect of the drug.
Correct Answer: C
Rationale: Alternate-day corticosteroid therapy minimizes hypothalamic-pituitary-adrenal axis suppression, which helps prevent long-term adrenal insufficiency.
Which of the following is NOT true of growth hormone?
- A. stimulates rate of amino acid entrance into the cell
- B. stimulates protein synthesis in bones, cartilage, and muscles
- C. promotes glucose metabolism
- D. promotes fat metabolism
Correct Answer: C
Rationale: The correct answer is C: growth hormone does not promote glucose metabolism. Growth hormone primarily promotes protein synthesis in bones, cartilage, and muscles (B), stimulates the rate of amino acid entrance into the cell (A), and promotes fat metabolism (D). Glucose metabolism is mainly regulated by insulin, not growth hormone.