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Which statement best describes atherosclerotic disease affecting the cerebrovascular, cardiovascular, and peripheral vascular systems in patients with diabetes?
- A. It can be prevented by tight glucose control.
- B. It occurs with a higher frequency and earlier onset than in the nondiabetic population.
- C. It is caused by the hyperinsulinemia related to insulin resistance common in type 2 diabetes.
- D. It cannot be modified by reduction of risk factors such as smoking, obesity, and high fat intake.
Correct Answer: B
Rationale: Atherosclerotic disease develops earlier and more frequently in diabetic patients due to the effects of hyperglycemia and related risk factors.
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Atrial natriuretic hormone (ANH) is produced by cells of the ___.
- A. kidney tubules.
- B. right atrium of the heart.
- C. adrenal cortex.
- D. pancreas.
Correct Answer: B
Rationale: The correct answer is B: right atrium of the heart. Atrial natriuretic hormone (ANH) is produced by specialized cells in the right atrium of the heart called atrial myocytes. When the heart senses an increase in blood volume or pressure, these cells release ANH to help regulate fluid and electrolyte balance by promoting sodium and water excretion by the kidneys. Choices A, C, and D are incorrect because ANH is not produced by the kidney tubules, adrenal cortex, or pancreas. The primary site of ANH production is specifically within the cardiac atria.
Mrs. Good, a diabetic, states that she has taken the oral hypoglycemic, phenformin hydrochloride (DBI), for years. From this information, the nurse knows that Mrs. Good
- A. has not been receiving close medical supervision
- B. has moderately severe diabetes
- C. has active beta-cell function
- D. will soon need to switch to insulin therapy
Correct Answer: A
Rationale: Phenformin has been largely discontinued due to safety concerns, and it suggests the patient may not be receiving proper diabetes management.
Miss White, a known diabetic, is experiencing headache, weakness, irritability, lack of muscular coordination, and apprehension. The nurse realizes that these are early symptoms of
- A. diabetic ketoacidosis
- B. hyperglycemic hyperosmolar nonketotic coma (HHNK)
- C. microangiopathy
- D. hypoglycemia
Correct Answer: D
Rationale: These are all early symptoms of hypoglycemia, which occurs when blood sugar drops too low.
Which is NOT an action of CCK?
- A. gallbladder contraction
- B. increased gastric motility and emptying
- C. glucagon secretion
- D. secretion of pancreatic juice
Correct Answer: B
Rationale: The correct answer is B: increased gastric motility and emptying. Cholecystokinin (CCK) is a hormone that primarily functions to stimulate gallbladder contraction (A), secretion of pancreatic juice (D), and inhibit gastric motility and emptying. Choice C, glucagon secretion, is not directly related to the actions of CCK. The incorrect choices (A, C, D) are all actions associated with CCK, while choice B goes against the typical action of CCK on gastric motility.
A patient presents with rhabdomyolysis and depletion of 2-3-diphosphoglycerate. A common complication of high levels of the molecule being affected in this patient would be:
- A. Metastatic Calcification
- B. Dystrophic Calcification
- C. Heart Failure
- D. Respiratory Failure
Correct Answer: A
Rationale: The correct answer is A: Metastatic Calcification. Rhabdomyolysis leads to release of intracellular contents, including 2-3-diphosphoglycerate, causing hyperphosphatemia. High phosphates bind with calcium and deposit in tissues, leading to metastatic calcification. Dystrophic calcification occurs in damaged tissues, not due to high levels of 2-3-diphosphoglycerate. Heart failure and respiratory failure are not directly related to the depletion of this molecule.