Nokea
You assess a patient with Cushing's disease. For which finding will you notify the physician immediately?
- A. Purple striae present on abdomen and thighs
- B. Weight gain of 1 pound since the previous day
- C. #ERROR!
- D. Crackles bilaterally in lower lobes of lungs
Correct Answer: D
Rationale: Crackles in the lungs may indicate fluid overload or heart failure, which requires immediate intervention, especially in a patient with Cushing's disease, who is at risk for fluid retention.
You may also like to solve these questions
The only amine hormone to act like a steroid is ________.
- A. TH
- B. ACTH
- C. GH
- D. ADH
Correct Answer: A
Rationale: The correct answer is A: TH (Thyroid Hormone). TH is the only amine hormone that acts like a steroid because it is derived from an amino acid but functions similarly to steroid hormones by entering target cells and binding to intracellular receptors to regulate gene expression. ACTH, GH, and ADH are peptide hormones that do not act like steroids. ACTH stimulates the adrenal glands to produce cortisol, GH stimulates growth, and ADH regulates water balance in the body.
A girl presents with delayed puberty, absent secondary sexual characteristics, and primary amenorrhea. She also appears to be hypertensive and hypokalemia. Which of the following enzymes is increased if there is virilization of a person?
- A. 11b-Hydroxylase
- B. 17a-Hydroxylase
- C. 21b-Hydroxylase
- D. Pyruvate Kinase
Correct Answer: A
Rationale: The correct answer is A: 11b-Hydroxylase. In cases of virilization, increased androgen production occurs. 11b-Hydroxylase is involved in the synthesis of cortisol and aldosterone. When there is a deficiency in this enzyme, excess androgens are diverted towards the production of testosterone, leading to virilization. In contrast, choices B (17a-Hydroxylase) and C (21b-Hydroxylase) deficiencies result in decreased androgen production. Choice D, Pyruvate Kinase, is not related to steroid hormone synthesis. Therefore, the correct enzyme in this scenario is 11b-Hydroxylase.
Which drug is most likely to cause muscle tremor:
- A. Ipratropium
- B. Terbutaline
- C. Atenolol
- D. Nicotinic acid
Correct Answer: B
Rationale: The correct answer is B: Terbutaline. Terbutaline is a beta-2 adrenergic agonist used as a bronchodilator. It can stimulate beta-2 receptors in skeletal muscle, leading to muscle tremors as a common side effect. Ipratropium (A) is an anticholinergic bronchodilator and typically does not cause muscle tremors. Atenolol (C) is a beta-blocker and is not associated with muscle tremors. Nicotinic acid (D) is used to treat dyslipidemia and does not commonly cause muscle tremors. Therefore, Terbutaline is the most likely drug to cause muscle tremor among the options provided.
The home care nurse should intervene to correct a patient whose insulin administration includes
- A. warming a prefilled refrigerated syringe in the hands before administration.
- B. storing syringes prefilled with NPH and regular insulin needle-up in the refrigerator.
- C. placing the insulin bottle currently in use in a small container on the bathroom countertop.
- D. mixing an evening dose of regular insulin with insulin glargine in one syringe for administration.
Correct Answer: D
Rationale: Insulin glargine should never be mixed with other insulins. This could alter its action and effectiveness.
Which of the following drugs selectively stimulates β2 adrenoceptors:
- A. Adrenaline
- B. Noradrenaline
- C. Isoprenaline
- D. Salbutamol
Correct Answer: D
Rationale: The correct answer is D: Salbutamol. Salbutamol is a selective β2 adrenoceptor agonist. It has a higher affinity for β2 receptors compared to β1 receptors, leading to bronchodilation without significant effects on the heart. A: Adrenaline and C: Isoprenaline stimulate both β1 and β2 receptors, causing increased heart rate and bronchodilation. B: Noradrenaline stimulates α1, α2, and β1 receptors, leading to vasoconstriction and increased heart rate. Therefore, salbutamol is the only drug that selectively stimulates β2 adrenoceptors, making it the correct choice.