Nokea
Which of the following post-operative nursing actions should the nurse perform when a client with acromegaly has nasal packing?
- A. Detect the signs of increased intracranial pressure and meningitis
- B. Detect the presence of cerebrospinal fluid
- C. Detect the signs of hypoglycemia
- D. Detect the presence of striae
Correct Answer: B
Rationale: The presence of cerebrospinal fluid (CSF) should be detected after nasal packing, as leakage of CSF may indicate a cerebrospinal fluid leak, which can occur after pituitary surgery.
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A patient is hospitalized with adrenocortical insufficiency. Which nursing activity should you delegate to the nursing assistant?
- A. Remind patient to change positions slowly.
- B. Check the patient for muscle weakness.
- C. Teach the patient how to collect 24-hour urine.
- D. Plan nursing interventions to promote fluid balance.
Correct Answer: A
Rationale: Reminding the patient to change positions slowly is a non-invasive task that is appropriate for delegation to a nursing assistant, as it helps prevent dizziness or hypotension due to adrenocortical insufficiency.
The anterior pituitary gland receives hormone messages from the hypothalamus via ________.
- A. a capillary network
- B. neurons that extend from the hypothalamus to the pituitary
- C. Schwann cells
- D. both a and b
Correct Answer: A
Rationale: The correct answer is A: a capillary network. The hypothalamus secretes hormones into the capillary network called the hypothalamic-hypophyseal portal system. These hormones travel directly to the anterior pituitary gland to regulate the release of its own hormones. Choice B is incorrect because neurons do not directly connect the hypothalamus and pituitary gland. Choice C is incorrect because Schwann cells are involved in myelination of peripheral nerves, not hormone transport. Choice D is incorrect because although both options A and B involve communication between the hypothalamus and pituitary gland, it is specifically the capillary network that carries hormone messages in this case.
Aldosterone ________.
- A. is secreted by the neurohypophysis
- B. functions to increase sodium reabsorption
- C. presence increases potassium concentration in the blood
- D. production is greatly influenced by ACTH
Correct Answer: B
Rationale: The correct answer is B: Aldosterone functions to increase sodium reabsorption. Aldosterone is a hormone produced by the adrenal glands that acts on the kidneys to enhance the reabsorption of sodium and water and excretion of potassium. This helps regulate blood pressure and electrolyte balance. The other choices are incorrect because: A: Aldosterone is not secreted by the neurohypophysis, but by the adrenal glands. C: Aldosterone actually decreases potassium concentration in the blood. D: Aldosterone production is primarily regulated by the renin-angiotensin-aldosterone system, not greatly influenced by ACTH.
Which of the following statements regarding hormones is incorrect?
- A. Hormones and neurotransmitters require a synapse in order to communicate information to other cells and tissues.
- B. Only cells that have receptors to a certain hormone may be affected by that hormone.
- C. Hormones can cause target cells to alter patterns of gene expression, producing proteins in different quantities
- D. G proteins and cAMP are second messengers that serve to enhance or amplify the hormonal effect.
Correct Answer: a
Rationale: The correct answer is A because hormones and neurotransmitters do not require a synapse to communicate with other cells. Hormones are typically released into the bloodstream and travel throughout the body to target cells with specific receptors. Neurotransmitters, on the other hand, communicate across synapses between nerve cells. Choice B is correct as hormones only affect cells with specific receptors. Choice C is correct as hormones can indeed influence gene expression in target cells. Choice D is correct as G proteins and cAMP are common second messengers that help transmit the hormonal signal within the cell.
A patient with a recent drug poisoning is transported to the emergency department. The physician orders (correctly, in this case) administration of pralidoxime as part of the comprehensive emergency treatment plan. Which one of the following best describes who the patient was?
- A. A 13-year-old boy who took an overdose of amphetamine for his ADD/ADHD
- B. A 43-year-old who took an overdose of neostigmine, prescribed for her myasthenia gravis, in a suicide attempt
- C. A 6-year-old who got into the family medicine cabinet and took 10 'adult doses' of her dad's prazosin
- D. A farm/field worker accidentally doused with insecticide from an overflying crop-duster plane
Correct Answer: D
Rationale: The correct answer is D because pralidoxime is used to treat poisoning from organophosphate insecticides, which are commonly used in agriculture. The patient is likely a farm/field worker who was accidentally exposed to insecticide.
A: Amphetamine poisoning does not require pralidoxime.
B: Neostigmine is not an organophosphate insecticide.
C: Prazosin is not an organophosphate insecticide and is unlikely to require pralidoxime in this context.
In summary, the correct answer is D because the patient's exposure to insecticide aligns with the indication for pralidoxime use, while the other choices involve different substances that do not require pralidoxime treatment.