Patho II Exam 6 (practice questions)

A client has developed hydrocephalus and asks the nurse what may have caused this to occur. The best response would be:

Overproduction of cerebrospinal fluid

A nursing instructor is teaching a group of students about the action of hormones. The instructor determined that teaching was effective when the students recognize the local action of hormones as:

Paracrine

What disease results from the degeneration of the dopamine Nigrostriatal system of the basal ganglia?

Parkinson disease

Which structure controls the functions of the greatest number of target glands and cells?

Pituitary gland

A client's recent computed tomography (CT) scan has revealed the presence of hydrocephalus. Which treatment measure is most likely to resolve this health problem?

Placement of a shunt

The nurse taking a report on a client coming into the emergency room plans care for a client with brain dysfunction based on which symptom?

Stupor

A 38-year-old male has presented to a clinic for the treatment of severe dermatitis after contact with poison ivy on a camping trip. The client has been prescribed prednisone, a corticosteroid, for the treatment of his skin condition. The client's care provider has emphasized that dosages of the drug will be gradually tapered off rather than stopped upon resolution of the symptoms. What is the most accurate rationale for this dosing protocol? A) The client's hypothalamic-pituitary-adrenal (HPA) system will require recovery time before normal function is restored. B) Steroids can induce a dependency that it best addressed with a gradual withdrawal. C) HPA function is heightened during steroid administration and must return to normal levels before the drug is completely stopped. D) Abrupt cessation of the drug can contribute to symptoms similar to Cushing syndrome.

A

When the suspected diagnosis is bacterial meningitis, what assessment techniques can assist in determining if meningeal irritation is present?

Brudzinski sign and Kernig sign

A 51-year-old woman has been diagnosed with Cushing syndrome after a diagnostic workup that reveals cortisol hypersecretion. The nurse knows which of the following assessment findings would be inconsistent with her diagnosis? A) Increased blood pressure and decreased potassium levels B) A protruding abdomen and a "buffalo hump" on the back C) Poor stress management and hyperpigmentation D) A "moon face" and muscle weakness

C

The nurse working in an emergency room is caring for a client who is exhibiting signs and symptoms of a stroke. What does the nurse anticipate that the physician's orders will include?

CT scan

A client has received an injection containing thyrotropin-releasing hormone (TRH) and is now being assessed for serum levels of thyroid-stimulating hormone (TSH). Which type of diagnostic testing is this client undergoing?

Stimulation testing

The nurse is educating parents of a child with arteriovenous malformation. The nurse determines that the parents need additional education when the parents state:

"It is a rare complication of concussions."

Which intracranial pressure (ICP) would the nurse consider a normal reading?

0 to 15 mm Hg

A female patient presented to her primary care physician with classic signs and symptoms of Cushing syndrome. Upon testing, it was discovered that the patient had vaginal small cell carcinoma. How can the health care providers explain her Cushing syndrome signs and symptoms to this patient? A) "Your tumor in your vagina is secreting a hormone called adrenocorticotropic hormone (ACTH), which is responsible for these signs and symptoms." B) "We are going to have to run some more tests. We think you might have a problem with your pituitary gland." C) "There is no connection between the Cushing syndrome and the vaginal carcinoma. You have two very distinct problems occurring at the same time." D) "We need to check your thyroid. Your Cushing syndrome may be caused by hypofunction of this gland."

A

A nurse on a medical unit is providing care for a 37-year-old female patient who has a diagnosis of Graves disease. Which of the following treatments would the nurse most likely anticipate providing for the client? A) -Adrenergic-blocking medications to reduce sympathetic nervous stimulation B) Administration of levothyroxine to supplement thyroid function C) Calcium channel blocking medications to reduce heart rate and cardiac risks D) Administration of somatostatin analogs to inhibit GH production

A

Testing for short stature growth hormone (GH) problems can be done by pharmacologic means. Which of the following medications can be utilized to test for a rise in GH? Select all that apply. A) Insulin B) Levodopa C) Persantine D) Dobutamine E) Sestamibi

A B

Of the following list of nursing interventions, which would be considered priority when managing a patient with life-threatening myxedematous coma? Select all that apply. A) Administer 3% sodium IV solution to increase sodium levels. B) Administer 50% dextrose to raise glucose levels. C) Place on oxygen therapy to encourage deep breathing. D) Place on a warming bed to raise body temperature. E) Administer sedatives frequently to prevent seizures.

A B C

Which principle best explains symptoms of amyotrophic lateral sclerosis (ALS), including dysphasia, muscle weakness and spasticity, and dysphonia?

ALS is caused by both an upper motor neuron and lower motor neuron disturbance

What medication teaching should be done for a woman of childbearing age with a seizure disorder?

Antiseizure drugs increase the risk for congenital abnormalities.

Myasthenia gravis is characterized by muscle weakness caused by antibody-mediated loss of which physiologic function?

Acetylcholine receptors

Cyclic adenosine monophosphate (cAMP) performs which role in the functioning of the endocrine system?

Acting as a second messenger to mediate hormone action on target cells

Paracrine action involves which characteristic?

Action locally on cells other than those that produce the hormone

The nurse is assessing a client with thyrotoxicosis and the nurse is explaining how the thyroid gland is stimulated to release thyroid hormones. The nurse should describe what process?

Action of releasing hormones from hypothalamus

For seizure disorders that do not respond to anticonvulsant medications, the option for surgical treatment exists. What is removed in the most common surgery for seizure disorders?

Amygdala

When discussing luteinizing hormone and follicle-stimulating hormone with students, the instructor will emphasize that these hormones are under the control of:

Anterior pituitary gland

A client with a spinal cord injury at T8 would likely retain normal motor and somatosensory function of her:

Arms

The nurse is caring for a client with a brain tumor when the client begins to vomit. Which intervention should the nurse do first?

Assess for other signs/symptoms of increased intracranial pressure.

The release of insulin from the pancreatic beta cells can inhibit further release of insulin from the same cells. This is an example of which type of hormone action?

Autocrine

Following destruction of the pituitary gland, ACTH stimulation stops. Without ACTH to stimulate the adrenal glands, the adrenals' production of cortisol drops. This is an example of which type of endocrine disorder? A) Primary B) Secondary C) Tertiary D) Somatic

B

A teenager has been in a car accident and experienced an acceleration-deceleration head injury. Initially, the client was stable but then started to develop neurological signs/symptoms. The nurse caring for this client should be assessing for which type of possible complication?

Brain contusions and hematomas

A client has sustained a severe, diffuse brain injury that resulted in seriously compromised brain function. The client is at greatest risk for:

Brain death

Manifestations of brain tumors are focal disturbances in brain function and increased ICP. What causes the focal disturbances manifested by brain tumors?

Brain edema and disturbances in blood flow

The nurse is conducting a community education program on concussions. The nurse evaluates that the participants understand the education when they state that which of these offers the brain protection from external forces?

Cerebrospinal fluid

Which intracranial volume is most capable of compensating for increasing intracranial pressure?

Cerebrospinal fluid

The nurse is planning to collect a 24-hour urine sample for hormone assay. In which situation does the nurse collaborate with the health care provider to find an alternate type of testing?

Client has anuria.

The nurse is working in the emergency room. One client's presenting symptoms include the worst headache ever, nuchal rigidity, and nausea. Another client's presenting symptoms include fever, stiff back, and positive Kernig sign. Which client should the nurse assess first?

Client with the worst headache, nuchal rigidity, and nausea

A client's emergency room report includes the presence of a contrecoup injury. The nurse plans care for a client with which of the following?

Closed head injury opposite the area of impact

After having a very stressful day in pathophysiology class, the student knows that which hormone (secreted by the adrenal cortex) will help decrease the effects of stress?

Cortisol, a glucocorticoid

The nurse knows that which treatment plan listed below is most likely to be prescribed after a computerized tomography (CT) scan of the head reveals a new-onset aneurysmal subarachnoid hemorrhage?

Craniotomy and clipping of the affected vessel

A patient is admitted to the hospital in adrenal crisis 1 month after a diagnosis of Addison disease. The nurse knows which of the following clinical manifestations would support this diagnosis? A) Hyperactive deep tendon reflexes and slow, shallow breathing B) Cerebral spinal fluid leakage and impaired swallowing C) Irregular heart rate and decreased temperature D) Change in the level of consciousness and profound hypotension

D

Growth hormone (GH) secretion is inhibited by A) hypoglycemia. B) starvation. C) heavy exercise. D) obesity.

D

A client experiences an increase in thyroid hormone as a result of a thyroid tumor. Which hormonal response demonstrates the negative feedback mechanism?

Decreased thyroid-stimulating hormone (TSH)

Which statement best describes the pathophysiology of Parkinson disease?

Degeneration of the Nigrostriatal dopamine system

A client's recent diagnosis of Parkinson disease has prompted the care provider to promptly begin pharmacologic therapy. The drugs prescribed will likely influence the client's levels of which substance?

Dopamine

The vesicle-mediated pathway has a role in synthesis and release of which hormones? Select all that apply.

Dopamine Follicle-stimulating hormone Antidiuretic hormone

A client with Parkinson disease presents with Bradykinesia and an altered gait. These symptoms arise in response to the progressive deterioration of which structure in the brain?

Dopamine nigrostriatal system

A nurse examines the laboratory values of a client in heart failure. Which value indicates a compensatory hormone mechanism?

Elevated atrial natriuretic hormone

A child is being seen in the emergency department (ED) after ingesting crayons with lead in them. He is disoriented and having seizures. The provider suspects he has which of the following?

Encephalitis

Which of the following is an example of a positive feedback system?

Estradiol and follicle-stimulating hormone (FSH)

The underlying causative problem in parkinsonism is:

Failure of dopamine release

Which hormone is secreted based on a cyclic rather than a diurnal manner?

Follicle-stimulating hormone (FSH)

While discussing the regulation of hormone levels, the instructor gives an example of hormones regulated by feedback mechanisms. Which example of this regulation is best?

Following a meal that was high in carbohydrates, a person's blood glucose elevates, which stimulates the release of insulin from the pancreas.

In what part of the body does the highest level of motor function occur?

Frontal cortex of the brain

Which hormone is produced by the anterior pituitary gland?

Growth hormone (GH)

A high school student sustained a concussion during a football game. The school nurse will educate the family about postconcussion syndrome and ask them to watch for and report which manifestations of its presence?

Headaches and poor concentation

The nurse planning a community education class on brain tumors and their prevention should include which risk factors in the presentation? Select all that apply.

High dose irradiation exposure Acquired immune suppression

A nurse is assessing a client with symptoms of botulism. The nurse will question the client regarding ingestion of which food?

Home-grown and canned vegetables

Which physiologic process allows hormones to exert influence upon some cells and not others?

Hormone receptors

Which statement best explains the function of hormone receptors?

Hormone receptors recognize a specific hormone and translate the hormonal signal into a cellular response.

When hypofunction of an endocrine organ is suspected, which type of diagnostic test can be administered to measure and assess target gland response?

Hormone stimulation

The hypophysis is a unit formed by the pituitary and the hypothalamus. These two glands are connected by the blood flow in what system?

Hypophyseal portal system

Which gland acts as a signal-relaying bridge between multiple body systems and the pituitary gland?

Hypothalamus

An infant whose mother had myxedema during the pregnancy has failed to meet standards for growth and is developmentally delayed. Which hormonal imbalance is this child exhibiting?

Hypothyroidism

The nurse is planning an inservice on hypoxia versus ischemia in brain-injured clients. The nurse should include which of the following?

Hypoxia produces a generalized depressive effect on the brain.

A family brings a client to the emergency department with increasing lethargy and disorientation. They think the client had a seizure on the drive over to the hospital. The client has been sick with a "cold virus" for the last few days. On admission, the client's temperature is 102°F (38.9°C). Which other clinical manifestations may lead to the diagnosis of encephalitis?

Impaired neck flexion resulting from muscle spasm

The nurse is discussing positive feedback mechanisms. Which example best explains this mechanism?

Increased estradiol production causes increased follicle-stimulating hormone (FSH) production.

Reflexes are basically "hardwired" into the CNS. Anatomically, the basis of a reflex is an afferent neuron that synapses directly with an effector neuron to cause muscle movement. Sometimes the afferent neuron synapses with what intermediary between the afferent and effector neurons?

Interneuron

Which neuron connections sensory and motor neurons?

Interneurons

While teaching a science class, the instructor mentions that both autocrine and paracrine hormonal actions occur without entering the bloodstream. A student asks, "What cells do paracrine actions affect?" Which response is correct?

Local

The emergency room doctor suspects a client may have bacterial meningitis. The most important diagnostic test to perform would be:

Lumbar puncture

A client diagnosed with Parkinson disease is displaying the following manifestations: tremor, rigidity, and slowness of movement. The nurse would interpret these as:

Normal manifestations of Parkinson disease

Restoration of the integrity of Myelin sheaths would likely result in a slowing or stopping of the progression of:

Multiple Sclerosis (MS)

The nurse is caring for an older adult client with hemiplegia following a stroke. While planning the client's care, the nurse knows the client is at risk for developing which condition?

Muscle atrophy

Which disease is thought to be caused by antibody-mediated loss of acetylcholine receptors in the neuromuscular junction?

Myasthenia gravis

Which treatment should take place immediately in a client experiencing autonomic dysreflexia?

Position the client in upright position, and correct the initiating stimulus

A client receives steroids for several months to treat an inflammatory condition. Which action by the primary health care provider indicates an understanding of the negative feedback mechanism when the client no longer needs the medication?

Prescribing a tapering dose of the medication over weeks

As part of maintaining homeostasis, why are hormones, secreted by endocrine cells, continuously inactivated?

Prevent accumulation

As a client explains to the nurse what occurred prior to the onset of seizure activity, the client describes perceiving a feeling or warning that the seizure would occur. The nurse documents the perceived warning as which of the following?

Prodrome

A client with a history of brain tumors that resulted in partial removal of the pituitary gland years ago expresses concern to the health care provider about whether she will be able to breast-feed her infant. Which physiologic function of the pituitary gland facilitates breast milk production?

Prolactin

The nurse is caring for a client who is receiving exogenous corticosteroids for rheumatoid arthritis. Recognizing that hormone levels are regulated by negative feedback, which laboratory test result does the nurse anticipate uncovering when reviewing the medical record?

Reduction in ACTH

A parent brought her 8-year-old child to the emergent care center to be examined following a fall off a playground set, resulting in a head injury. On discharge, the nurse explains to the parent that some symptoms may continue, including the inability to remember what happened before the fall. Which term best describes the diagnosis?

Retrograde amnesia

The nurse is caring for a client with decreased serum protein levels secondary to liver failure. When administering medications that are highly protein bound, the nurse anticipates the resulting drug level will respond in which of these ways?

The drug level will be elevated as lack of protein allows more free drug to circulate.

What do you deep tendon reflexes assess?

The stretch reflex at different spinal cord segments

The nurse is teaching a client who has been newly diagnosed with hypothyroidism about the function of the thyroid. Which statement about the role of the thyroid gland is most accurate?

The thyroid gland is responsible for increasing the metabolic rate.

A client suffering a thrombotic stroke is brought into the emergency department by ambulance and the health care team is preparing to administer a synthetic tissue plasminogen activator for which purpose?

Thrombolysis

The most common cause of an ischemic stroke is which of the following?

Thrombosis

Autonomic dysreflexia (autonomic hyperreflexia) is characterized by which of the following?

Vasospasms and hypertension

A client is brought to the emergency department and is diagnosed with an ischemic stroke confirmed by CT scan. The most important treatment for this client would be to:

administer IV tissue plasminogen activator (tPA).

A client has suffered a stroke that has affected his speech. The physician has identified the client as having expressive aphasia. Later in the day, the family asks the nurse to explain what this means. The most accurate response would be aphasia that is:

characterized by an inability to communicate spontaneously with ease or translate thoughts or ideas into meaningful speech or writing.

Select the laboratory blood test that would be used to suggest a diagnosis of muscular dystrophy (MD).

creatine kinase

A client suffering global cerebral ischemia a week after a suicide attempt by hanging is in the intensive care unit receiving treatment. The parent asks the nurse why it is necessary to keep the client paralyzed with medications and on the ventilator. The most appropriate response would be that these therapies:

decrease metabolic needs and increase oxygenation.

The chart of a client admitted because of seizures notes that the seizure activity began simultaneously in both cerebral hemispheres. The nurse should interpret this to mean that the client experienced:

generalized seizure.

A client with hyperthyroidism is being treated with medication that blocks the activity of thyroid-stimulating hormone. Her care team has determined that she has been overproducing TSH. This client will have lost her ability to:

have negative feedback regulation.

During a near-miss accident while cycling, a client marvels at how fast he was able to react. He attributes this to his "fight or flight" response but then wonders why it lasts for only a short period. The client had a short burst of catecholamine activity because catecholamines are:

rapidly degraded by enzymes in circulation and at the tissue.

The nurse observes a new nurse performing the test for Kernig sign on a client. The new nurse performs the test by providing resistance to flexion of the knees while the client is lying with the hip flexed at a right angle. The nurse should explain to the new nurse that:

resistance should be provided with the knee in a flexed position.

The nurse is assessing a client and notes the client is now displaying decerebrate posturing. The position would be documented as:

rigidity of the arms with palms of the hands turned away from the body and with stiffly extended legs and plantar flexion of the feet.

While reviewing the major actions of follicle-stimulating hormone (FSH), the faculty points out that in males this hormone is responsible for the:

sperm production.

Of the following patient conditions, which patients would be at risk for experiencing a thyroid problem due to a decrease in thyroxine-binding globulin (TBG)? Select all that apply. A) A 55-year-old male with cirrhosis due to alcohol abuse B) A 47-year-old female experiencing hot flashes and excess diaphoresis related to menopause C) A 75-year-old man receiving chronic glucocorticoid therapy to treat his severe chronic obstructive pulmonary disease (COPD) D) A 18-year-old female anorexia nervosa patient weighing 78 lb and has consumed no protein for the past 3 years

A C D

A nurse who works in the office of an endocrinologist is orienting a new staff member. Which teaching point should the nurse include in the orientation?

"A single hormone can act on not only one process or organ but often on several different locations or processes."

The parent of an infant who developed hydrocephalus while in utero is very concerned that the child will have significant intellectual dysfunction. The best response to the parent would be:

"Because the skull sutures are not fused there may be no brain damage."

The nurse is caring for a client admitted to the emergency room with suspected meningitis. The nurse prepares to perform which nursing intervention upon physician orders, while diagnostic testing is being completed?

Administration of antibiotics

The mother of 6-year-old male and female fraternal twins has brought her son to see a pediatrician because he is nearly 4 inches shorter than his sister. Which of the following phenomena would the physician most likely suspect as contributing factor to the boy's short stature? A) Genetic short stature B) Lack of IGF receptors in epiphyseal long bones C) A shortage of hypothalamic GHRH production D) Excess insulin production resulting in chronically low blood glucose levels

C

Following the identification of low levels of T3 and T4 coupled with the presence of a goiter, a 28-year-old female has been diagnosed with Hashimoto thyroiditis. In light of this diagnosis, which of the following assessment results would constitute an unexpected finding? A) The presence of myxedema in the woman's face and extremities B) Recent weight gain despite a loss of appetite and chronic fatigue C) Coarse, dry skin and hair with decreased sweat production D) Increased white cell count and audible crackles on chest auscultation

D

A client experiences an increase in cortisol as a result of Cushing disease. Which hormonal responses demonstrate the negative feedback mechanism?

Decreased adrenocorticotropic hormone (ACTH)

The health care provider is concerned that a client may be at risk for problems with cerebral blood flow. The most important data to assess would be:

Decreased level of oxygen

Hormones that cause the subsequent stimulation or release of another hormone, such as thyroid-stimulating hormone, typically belong to which structural classification?

Peptide proteins and glycoproteins

A nurse is caring for a client with multiple sclerosis notes that the client has mood swings. Which cars can best explain this?

Psychological manifestation due to involvement of white matter of cerebral cortex

Following a car accident in which the driver did not have his seatbelt on, the client is diagnosed with a traumatic brain injury requiring emergent craniotomy for severe cerebral edema. Which assessments should the nurse report immediately since they correspond to a supratentorial herniation progressing to midbrain involvement? Select all that apply.

Pupils fixed at ~ 5 mm in diameter Respiration rate of 40 breaths/min Decerebrate posturing following painful stimulation of the sternum

The physician suspects a client may be experiencing hypofunction of an endocrine organ. Select the most appropriate test to determine organ function.

Stimulation tests

What term is used to describe a level of consciousness that sees a client responding only to vigorous and repeated stimuli and has minimal or no spontaneous movement?

Stupor

Which physiologic process best exemplifies a positive feedback mechanism?

The increase in prolactin secretion that occurs with more frequent breast-feeding

An infant born with congenital hypothyroidism and has not sought care from any health care provider is likely to develop which of the following complications? Select all that apply. A) Deformed joints and bone spurs B) Impaired physical growth C) Mental retardation D) Loss of fine motor control and arthritis E) Down syndrome

B C

Peripheral nerve disorders or not uncommon. What is an example of a fairly common mononeuropathy?

Carpal tunnel syndrome

The nurse assessing a client with a traumatic brain injury assesses for changes in which neurologic component? Select all that apply.

Cognition Level of consciousness Motor function Sensory function

While lecturing to a group of physiology students, the instructor asks, "What metabolic factors cause vasodilation of cerebral vessels, thereby increasing cerebral blood flow to the brain?" The best student response would be:

Increased carbon dioxide level

A client's emergency magnetic resonance imaging (MRI) has been examined by the physician and tissue plasminogen activator (tPA) has been administered to the client. What was this client's most likely diagnosis?

Ischemic stroke

The hormone levels in the body need to be kept within an appropriate range. How is this accomplished for many of the hormones in the body?

Negative feedback loop

The brainstem contains gray matter that is made up of:

Neurons

When trying to explain hypothyroidism to a newly diagnosed client, the nurse stresses the fact that the thyroid hormone is transported in blood by specific:

Proteins

A family brings their father to his primary care physician for a check up. Since their last visit, they note their dad has developed a tremor in his hands and feet. He also rolls his fingers like he has a marble in his hand. The primary physician suspects the onset of Parkinson disease when he notes which abnormality in the client's gait?

Slow to start walking and has difficulty when asked to "stop" suddenly

A client undergoing an evaluation of hormone levels asks, "What regulates the hormone levels?" Which response by the nurse would be considered most accurate?

The hypothalamic-pituitary-target cell system

A client who is being seen in the outpatient clinic reports a single episode of unilateral arm and leg weakness and blurred vision that lasted approximately 45 minutes. The client is most likely experiencing:

Transient ischemic attack (TIA)

A 28-year-old male who is 611 tall has a diagnosis of acromegaly. The man is explaining to a curious but sympathetic coworker exactly what accounts for his extraordinary height. Which of the following explanations demonstrates a sound understanding of his health problem? A) "My pituitary gland produced a much higher than normal amount of growth hormone when I was a child." B) "A tumor in my brain threw off my hormone levels after I was finished adolescence." C) "My liver is malfunctioning and produces too many of the hormones that ultimately cause growth." D) "The high sugar levels that go along with my diabetes made my pituitary gland overproduce the hormones that cause you to grow."

B

Following a long history of fatigue, weakness, and poor appetite, a 39-year-old male has been diagnosed with hypopituitarism. Which of the following clinical findings would most likely cause his care team to suspect that the man has an additional endocrine disorder from a different source? A) The man has a low sperm count and has been unable to have children. B) The man has a chronic platelet deficiency and is occasionally anemic. C) The client is 5'2'' tall and was consistently short for his age as a child. D) The man displays the signs and symptoms of hypothyroidism.

B

Following the identification of low blood levels of cortisol and low 24-hour urinary free cortisol, a 51-year-old female client has been diagnosed with a primary adrenal cortical insufficiency. Which of the following health consequences would be attributable to her low levels of cortisol? A) Visible exophthalmos B) Impaired immunological and inflammatory response C) Diminished secondary sex characteristics D) Insufficient regulation of serum potassium and sodium levels

B

Which of the following statements best captures an aspect of the function of the hypothalamic-pituitary-adrenal (HPA) system? A) Adrenocorticotropic hormone (ACTH) released by the hypothalamus controls to release of cortisol. B) The pituitary gland communicates with the adrenal cortex through the release of ACTH. C) The adrenal cortex receives corticotrophin-releasing hormone (CRH) and in turn releases cortisol. D) The pituitary gland causes a release of CRH from the hypothalamus, which promotes hormone release from the adrenal cortex.

B

Which of the following statements best captures the role of the adrenal cortex in maintaining homeostasis? A) The adrenal cortex is responsible for the production of epinephrine and norepinephrine that are part of the sympathetic nervous system. B) The adrenal cortical hormones are primarily steroids and sex hormones. C) Redundant, secondary production of adrenal cortical hormones can compensate for the loss of the adrenal glands. D) Normal sexual function is dependent on adequate adrenal cortical function.

B

After receiving change-of-shift report about the following four patients, which patient should the nurse assess first? A) A 22-year-old admitted with SIADH who has a serum sodium level of 130 mEq/L B) A 31-year-old who has iatrogenic Cushing syndrome with a capillary blood glucose level of 204 mg/dL C) A 53-year-old who has Addison disease and is due for a scheduled dose of hydrocortisone (Solu-Cortef) D) A 70-year-old returning from PACU following partial thyroidectomy who is extremely agitated, has an irregular pulse rate of 134, and has an elevated temperature of 103.2°F

D

An endocrinologist is providing care for a 30-year-old male who has lived with the effects of increased levels of growth hormone (GH). Which of the following teaching points about the client's future health risks is most accurate? A) "It's not unusual for high GH levels to cause damage to your hypothalamus." B) "GH excess inhibits your pancreas from producing enough insulin." C) "The high levels of GH that circulate in your body can result in damage to your liver." D) "When your pituitary gland is enlarged, there's a real risk that you'll develop some sight deficiencies."

D

Generalized convulsive status epilepticus is a medical emergency caused by a tonic-clonic seizure that does not spontaneously end, or recurs in succession without recovery. What is the first-line drug of choice to treat status epilepticus?

Intravenous lorazepam

A nurse is caring for a client experiencing muscle fasciculations. Fasciculations appear as:

Spontaneous contractions of muscle fibers presenting as twitching

When describing to a client newly diagnosed with diabetes how insulin is regulated, the nurse will draw upon her knowledge of which hormonal regulation mechanism?

The hypothalamic-pituitary-target cell system