You are preparing to review a teaching plan for a patient with type 2 diabetes. What will you check to determine the patient's level of compliance with his diabetic regimen?
- A. Patient's fasting glucose level
- B. Patient's oral glucose tolerance test results
- C. Patient's glycosylated hemoglobin assay
- D. Patient's fingerstick glucose check for 24 hours
Correct Answer: C
Rationale: The glycosylated hemoglobin assay (HbA1c) provides an average blood glucose level over the past 2-3 months and is the best indicator of long-term compliance with the diabetic regimen.
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A 35-year-old female presents to your office for a regular check-up. Her only complaint is recurrent migraine headaches, which have increased in frequency over the years. On examination, her blood pressure is elevated at 150/70. You decide to start her on antihypertensive therapy that is also used for prophylaxis of migraines. Which medication is it?
- A. Clonidine
- B. Prazosin
- C. Hydrochlorothiazide
- D. Propranolol
Correct Answer: D
Rationale: The correct answer is D: Propranolol. Propranolol is a beta-blocker that is commonly used for migraine prophylaxis. It helps reduce the frequency and severity of migraines by blocking the action of adrenaline on blood vessels in the brain. In this case, the patient has elevated blood pressure and migraines, so starting her on propranolol can address both issues effectively.
Choice A: Clonidine is an alpha-2 agonist used for hypertension, but it is not commonly used for migraine prophylaxis.
Choice B: Prazosin is an alpha-1 blocker primarily used for the treatment of hypertension, but it is not typically used for migraine prophylaxis.
Choice C: Hydrochlorothiazide is a diuretic used for hypertension by reducing blood volume, but it is not effective for migraine prophylaxis.
In summary, propranolol is the most appropriate choice as it addresses both the elevated blood pressure and the recurrent
The nurse is assessing a client who exhibits spontaneous spasm of the fingers or toes, mouth twitching or jaw tightening when he taps the cheek anteriorly to the earlobe. What sign does the nurse identify to document in the chart that is consistent with tetany?
- A. Lhermitte's sign
- B. Trousseau's sign
- C. Chvostek's sign
- D. Bulge sign
Correct Answer: C
Rationale: Chvostek's sign is a positive sign of tetany, where tapping the cheek causes twitching of the facial muscles, indicating low calcium levels.
Which is a nutritionally essential amino acid?
- A. taunine
- B. leucine
- C. glutamate
- D. alanine
Correct Answer: B
Rationale: Rationale for correct answer (B - leucine): Leucine is an essential amino acid, meaning it cannot be synthesized by the body and must be obtained through diet. It plays a crucial role in protein synthesis, muscle repair, and growth. It is essential for overall health and well-being.
Summary of why other choices are incorrect:
A - taurine: Taurine is a conditionally essential amino acid, not nutritionally essential.
C - glutamate: Glutamate is a non-essential amino acid, as the body can synthesize it.
D - alanine: Alanine is a non-essential amino acid, as the body can also produce it.
Select the correct statement about the structure or function of chemical messengers.
- A. Prostaglandins are biologically active peptides.
- B. Modified cholesterol forms the main structural component of the peptone hormones.
- C. An amino acid derivative can be a hormone.
- D. An example of a paracrine is testosterone.
Correct Answer: C
Rationale: The correct answer is C: An amino acid derivative can be a hormone. This statement is correct because many hormones are derived from amino acids, such as thyroid hormones (derived from tyrosine) and epinephrine (derived from phenylalanine). Hormones can be derived from various sources, including amino acids, peptides, lipids, and even gases.
Explanation of other choices:
A: Prostaglandins are not biologically active peptides; they are lipid compounds derived from fatty acids.
B: Modified cholesterol does not form the main structural component of peptone hormones; peptides are the main structural components of peptide hormones.
D: Testosterone is a steroid hormone and not an example of a paracrine, which is a type of chemical messenger that acts on nearby cells.
To prevent hyperglycemia or hypoglycemia related to exercise, what should the nurse teach the patient using glucose-lowering agents about the best time for exercise?
- A. Only after a 15-g carbohydrate snack is eaten
- B. About 1 hour after eating when blood glucose levels are rising
- C. When glucose monitoring reveals that the blood glucose is in the normal range
- D. When blood glucose levels are high, because exercise always has a hypoglycemic effect
Correct Answer: B
Rationale: Exercising about 1 hour after eating helps to ensure blood glucose is rising and reduces the risk of hypoglycemia.