Nokea
Which of the following information about a patient who is scheduled for an oral glucose tolerance test should be reported to the health care provider before starting the test?
- A. Occasional orthostatic dizziness
- B. A 5 kg weight gain in the last month
- C. Intake of 1 L of water an hour previously
- D. Oral corticosteroid use for rheumatoid arthritis
Correct Answer: D
Rationale: Corticosteroids can affect blood glucose results. The other information will be provided to the provider but will not affect the test results.
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The nurse is obtaining the health history from a patient. Which of the following statements by the patient indicates further assessment of thyroid function may be necessary?
- A. I notice my breasts are tender lately.
- B. I am so thirsty that I drink all day long.
- C. I get up several times at night to urinate.
- D. I feel a lump in my throat when I swallow.
Correct Answer: D
Rationale: Difficulty in swallowing can occur with a goitre. Nocturia is associated with diseases such as diabetes mellitus, diabetes insipidus, or persistent kidney disease. Breast tenderness would occur with excessive gonadal hormone levels. Thirst is a sign of disease such as diabetes.
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 is scheduled for a growth hormone stimulation test. Which of the following items should the nurse obtain in preparation for the test?
- A. Basin of ice
- B. Cardiac monitor
- C. Vial of glargine insulin
- D. Intravenous dextrose solution
Correct Answer: D
Rationale: Hypoglycemia is induced during the growth hormone stimulation test, and the nurse should be prepared to administer glucose IV immediately or have a sweet snack available for the patient immediately following the test. Regular insulin is used to induce hypoglycemia (glargine is never given intravenously). The patient does not require cardiac monitoring during the test. Although blood samples for some tests must be kept on ice, this is not true for the growth hormone stimulation test.
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.
A patient has a total serum calcium level of 3.3 mmol/L. Which of the following laboratory results should the nurse assess next?
- A. Calcitonin
- B. Catecholamine
- C. Thyroid hormone
- D. Parathyroid hormone
Correct Answer: D
Rationale: Parathyroid hormone is the major controller for blood calcium levels. Although calcitonin secretion is a counter-mechanism to parathyroid hormone, it does not play a major role in calcium balance. Catecholamine and thyroid hormone levels do not affect serum calcium level.