Nokea
The secretion of parathyroid hormone is a good example of __________.
- A. pituitary gland stimuli
- B. humoral stimuli
- C. neural stimuli
- D. hormonal stimuli
Correct Answer: B
Rationale: The correct answer is B: humoral stimuli. Parathyroid hormone secretion is regulated by the concentration of calcium in the blood, which is an example of humoral stimuli. When blood calcium levels decrease, parathyroid hormone is released to increase calcium levels. Pituitary gland stimuli (A), neural stimuli (C), and hormonal stimuli (D) are not directly involved in the regulation of parathyroid hormone secretion.
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A patient with diabetes is learning to mix regular insulin and NPH insulin in the same syringe. The nurse determines that additional teaching is needed when the patient does what?
- A. Withdraws the NPH dose into the syringe first
- B. Injects air equal to the NPH dose into the NPH vial first
- C. Removes any air bubbles after withdrawing the first insulin
- D. Adds air equal to the insulin dose into the regular vial and withdraws the dose
Correct Answer: A
Rationale: When mixing insulin, the correct order is to draw up the regular insulin first, followed by NPH insulin.
As the shift begins, you are assigned these patients. Which patient should you assess first?
- A. A 38-year-old patient with Graves' disease and a heart rate of 94/minute
- B. A 63-year-old patient with type 2 diabetes and fingerstick glucose of 137 mg/dL
- C. A 58-year-old patient with hypothyroidism and heart rate of 48/minute
- D. A 49-year-old patient with Cushing's disease and +1 dependent edema
Correct Answer: C
Rationale: A heart rate of 48/minute in a patient with hypothyroidism could indicate bradycardia, which requires immediate assessment to ensure the patient's safety.
The receptor for a peptide hormone ___________.
- A. sits in the cell’s outer membrane and binds to a hydrophobic hormone
- B. sits in the cell’s outer membrane and binds to a hydrophilic hormone
- C. sits inside the cell and binds to a hydrophobic hormone
- D. sits inside the cell and binds to a hydrophilic hormone
Correct Answer: B
Rationale: The correct answer is B because peptide hormones are hydrophilic and cannot pass through the cell membrane. Therefore, their receptors must be located on the cell's outer membrane to bind and trigger intracellular signaling pathways. Option A is incorrect because hydrophobic hormones can directly pass through the cell membrane, so their receptors are typically inside the cell. Option C is incorrect because hydrophobic hormones do not require a receptor on the cell's outer membrane. Option D is incorrect because hydrophilic hormones, like peptide hormones, require receptors on the cell's outer membrane.
A patient presents with a moon face, truncal obesity, hypertension, purple straiae, buffalo hump, fragile skin and impaired glucose tolerance. The opposite of the current increased levels of the prime hormone involved in this patient is seen in:
- A. Addison's disease
- B. Pheochromocytoma
- C. Hyperaldosteronism
- D. Cushing's syndrome
Correct Answer: A
Rationale: Step 1: Identify the symptoms described in the patient: Moon face, truncal obesity, hypertension, purple striae, buffalo hump, fragile skin, impaired glucose tolerance.
Step 2: These symptoms are classic for Cushing's syndrome, which is caused by excess cortisol.
Step 3: The opposite of increased cortisol levels is decreased cortisol levels.
Step 4: Addison's disease is characterized by adrenal insufficiency, leading to decreased cortisol levels.
Step 5: Therefore, the correct answer is A: Addison's disease.
Summary:
- B: Pheochromocytoma is a tumor of the adrenal medulla, causing excess catecholamines, not related to cortisol.
- C: Hyperaldosteronism is excess aldosterone production, not related to cortisol.
- D: Cushing's syndrome is characterized by excess cortisol, not the opposite.
Mr. T, who has Cushing syndrome, is being treated with corticosteroids for an extended period. He has been instructed to avoid sudden discontinuation of the drug. Why should this instruction be given?
- A. To prevent adrenal crisis
- B. To increase potassium retention
- C. To reduce sodium retention
- D. To avoid an overdose of the medication
Correct Answer: A
Rationale: Discontinuing corticosteroids abruptly can lead to adrenal insufficiency or adrenal crisis because the adrenal glands cannot produce cortisol quickly enough after being suppressed.