Nokea
While awaiting surgery for removal of an adrenal tumor that has produced Cushing syndrome, Mrs. A. has been placed on a strict diet to help manage her symptoms. The nurse's evaluation that the diet has been helpful includes observations that Mrs. A.
- A. has gained 5 lb
- B. has consistently low blood sugar values
- C. maintains blood pressure within normal limits
- D. becomes more moody
Correct Answer: C
Rationale: Maintaining normal blood pressure is an important goal in the management of Cushing syndrome.
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A benign tumor of the adrenal medulla:
- A. causes life-threatening low blood pressure.
- B. is called a pheochromocytoma.
- C. causes Addison’s disease.
- D. causes excess secretion of cortisol.
Correct Answer: B
Rationale: The correct answer is B: A benign tumor of the adrenal medulla is called a pheochromocytoma. Pheochromocytomas are tumors that arise from the adrenal medulla, leading to overproduction of catecholamines like adrenaline and noradrenaline. This excess secretion can result in symptoms such as high blood pressure, palpitations, and sweating. Choices A and C are incorrect because a benign tumor of the adrenal medulla typically causes high blood pressure, not low blood pressure or Addison's disease. Choice D is incorrect because excess cortisol secretion is associated with conditions like Cushing's syndrome, not pheochromocytoma.
During care of the patient with SIADH, what should the nurse do?
- A. Monitor neurologic status at least every 2 hours.
- B. Teach the patient receiving treatment with diuretics to restrict sodium intake.
- C. Keep the head of the bed elevated to prevent antidiuretic hormone (ADH) release.
- D. Notify the health care provider if the patient's blood pressure decreases more than 20 mm Hg from baseline.
Correct Answer: A
Rationale: Frequent neurologic monitoring is essential for patients with SIADH due to the risk of cerebral edema from hyponatremia.
As plasma levels of calcium decrease:
- A. insulin is secreted.
- B. the parathyroid glands secrete an osteoclastic hormone.
- C. the kidneys excrete calcium and phosphorus.
- D. calcitonin is secreted.
Correct Answer: B
Rationale: The correct answer is B because as plasma levels of calcium decrease, the parathyroid glands secrete an osteoclastic hormone called parathyroid hormone (PTH). PTH acts to increase calcium levels by stimulating the release of calcium from bones via osteoclasts. Insulin secretion (choice A) is not directly related to calcium levels. The kidneys excreting calcium and phosphorus (choice C) would further decrease calcium levels. Calcitonin (choice D) actually decreases blood calcium levels by inhibiting bone breakdown, so it is not secreted when calcium levels decrease.
Which if the following gland which can be classified as an endocrine and an exocrine gland?
- A. Thyroid.
- B. Thymus.
- C. Pancreas.
- D. Pituitary.
Correct Answer: C
Rationale: The correct answer is C: Pancreas. The pancreas is both an endocrine and exocrine gland. It secretes hormones like insulin and glucagon (endocrine function) into the bloodstream to regulate blood sugar levels, while also producing digestive enzymes (exocrine function) that are released into the small intestine to aid in digestion. The other choices are incorrect because:
A: Thyroid - primarily an endocrine gland that produces hormones like thyroxine.
B: Thymus - strictly an endocrine gland responsible for T-cell development.
D: Pituitary - also an endocrine gland that controls various other endocrine glands in the body.
Which two elements react together to form an ionic compound?
- A. R and T
- B. T and X
- C. X and Z
- D. Z and R
Correct Answer: C
Rationale: The correct answer is C, X and Z. Ionic compounds are formed when a metal (X) reacts with a nonmetal (Z) by transferring electrons to achieve a stable octet configuration. Metal atoms tend to lose electrons to form positively charged cations, while nonmetal atoms tend to gain electrons to form negatively charged anions. In this case, X (metal) and Z (nonmetal) will react to form an ionic compound through electron transfer. Choices A, B, and D are incorrect because they do not involve a metal-nonmetal combination, which is essential for the formation of an ionic compound.