Question 1

The client is a fitness enthusiast who adheres to a regimen of high vitamin supplement intake. Which vitamins would the nurse assess for hypervitaminosis?&#10;A) Vitamin A (Retinol)&#10;B) Vitamin E (tocopherols)&#10;C) Vitamin D (Ergocalciferol)&#10;D) Vitamin C (ascorbic acid)&#10;E) Vitamin B2 (riboflavin)&#10;

Accepted Answer

Rationale 1: Vitamin A (Retinol) is a fat-soluble vitamin and can cause hypervitaminosis when taken in large doses.
Rationale 2: Large doses of fat-soluble vitamin E (tocopherols) can cause hypervitaminosis.
Rationale 3: Hypervitaminosis can be caused by the fat-soluble vitamin D (Ergocalciferol).
Rationale 4: Vitamin C (ascorbic acid) has been associated with hypervitaminosis.
Rationale 5: The water-soluble vitamin B2 (riboflavin) is not likely a factor in hypervitaminosis.

Question 2

The school nurse has presented a learning activity for a high school health promotion course. Which student statement indicates an understanding of water-soluble vitamins?&#10;A) &#34;Vitamins C and B complex are the primary water-soluble vitamins.&#34;&#10;B) &#34;Water-soluble vitamins have the higher potential for toxicity and overdosing.&#34;&#10;C) &#34;Water-soluble vitamins can accumulate in the body for weeks before excretion.&#34;&#10;D) &#34;All water-soluble vitamins are stored in the liver.&#34;&#10;E) &#34;Daily intake of water-soluble vitamins is necessary.&#34;&#10;

Accepted Answer

Rationale 1: The primary water-soluble vitamins are vitamin C and B complex.
Rationale 2: Fat-soluble vitamins have the higher potential for toxicity or overdose.
Rationale 3: Water-soluble vitamins are stored briefly in the body and then excreted in the urine.
Rationale 4: Fat-soluble vitamins are stored in the liver and in fatty tissue.
Rationale 5: Water soluble vitamins are not stored so need to be consumed daily.

Question 3

The nurse is preparing to administer an enteral feeding to a client on a medical-surgical unit. How are enteral feeds administered?&#10;A) Nasogastric tube.&#10;B) Mouth.&#10;C) Percutaneous endoscopic gastrostomy (PEG) tube.&#10;D) Peripheral intravenous catheter.&#10;E) Central venous catheter.&#10;

Accepted Answer

Rationale 1: Enteral feedings can be administered by nasogastric tube.
Rationale 2: Enteral feedings can be administered by mouth.
Rationale 3: Enteral feedings can be administered by percutaneous endoscopic gastrostomy (PEG) tube.
Rationale 4: Enteral feedings cannot be administered by a peripheral intravenous catheter.
Rationale 5: Enteral feedings cannot be administered by a central venous catheter.

Question 4

Which complications does the nurse monitor for in a client receiving enteral nutrition?&#10;A) Aspiration&#10;B) Infiltration&#10;C) Diarrhea&#10;D) Systemic infections&#10;E) Electrolyte disturbances&#10;

Accepted Answer

Rationale 1: Aspiration is a complication associated with enteral feedings.
Rationale 2: Infiltration is not a complication associated with enteral feedings.
Rationale 3: Diarrhea is a complication associated with enteral feedings.
Rationale 4: Localized, not systemic, infections are associated with enteral feedings.
Rationale 5: Electrolyte imbalances are a complication associated with enteral feedings.

Question 5

A child who is small-for-age is to receive supplemental injections of growth hormone. The mother of the client asks, "Why does my child have to take these shots? I read in the paper that hormones are dangerous." Which response by the nurse is most appropriate?

A) "There are some hormones that are dangerous, but given under medical supervision the medication may be beneficial."
B) "Are you worried that your child will get hooked on drugs?"
C) "Your child's pituitary gland is not making enough growth hormone. This hormone makes bones and muscles grow to normal size. The shots are safe."
D) "Your child's parathyroid glands are not making enough of a hormone called GH. The injection is very safe."

Accepted Answer

Rationale 1: Supplemental growth hormone is administered to children who have low GH levels. There are real concerns with all hormone therapies, because the differences between too much, too little, and the right amount are very small.
Rationale 2: Reflection of the question back to the speaker can be therapeutic if the nurse believes that anxiety is high. However, this parent's question is a straightforward request for information. Physical or psychological dependence is not a concern.
Rationale 3: It is incorrect to state that the injections are safe.
Rationale 4: Growth hormone is not controlled by the parathyroid glands. It is incorrect to state that the injections are very safe.

Question 6

A client with an exacerbation of COPD is receiving steroid therapy in tapering doses. The nurse recognizes that this approach is medically appropriate because it applies what principle of up-regulation?

A) Up-regulation decreases the sensitivity of the cell-wall hormone receptors.
B) Up-regulation decreases the number of receptors on the cell-wall surface.
C) Up-regulation requires time for regrowth of cell-wall hormone receptors.
D) Up-regulation changes the configuration of cell-wall hormone receptors to allow them to bind better.

Accepted Answer

Rationale 1: Sensitivity of individual receptors is not an issue.
Rationale 2: Cell-wall receptors do not decrease in number.
Rationale 3: When a hormone that was administered in large doses is discontinued, it takes several days for cells to produce enough protein receptors to capture endogenous hormone. Tapering the dose allows time for the process to finish before the hormone is stopped.
Rationale 4: The shape of the receptors is unchanged.

Question 7

A client with hyperthyroidism has been reading about PTU on the internet. The client asks the nurse, &#34;How do anti-hormones work to help my condition?&#34; Which is the nurse's best response?&#10;A) &#34;Your body has been affected by too much thyroid hormone. PTU is a drug that can block your body's response to thyroid hormone.&#34;&#10;B) &#34;Anti-hormones oppose the action of estrogen, which allows thyroid to regain its effectiveness.&#34;&#10;C) &#34;PTU regenerates your thyroid gland and causes normal tissue to regrow, so the effects of too much thyroid will disappear.&#34;&#10;D) &#34;PTU replaces your abnormal thyroid hormone with normal thyroid hormone.&#34;&#10;

Accepted Answer

Rationale 1: Propylthiouracil (PTU) is an anti-hormone. It blocks thyroid hormone from various receptors throughout the body. Without access to the usual receptors, the signs and symptoms of hyperthyroidism are reduced.
Rationale 2: PTU has no effect on estrogen levels.
Rationale 3: PTU does not affect the growth or regeneration of thyroid tissue.
Rationale 4: PTU does not replace thyroid hormone.

Question 8

A nurse is instructing an adolescent on the reproductive system. Which of the following hormones does the nurse explain is responsible for maturation of ovarian follicles ant the production of estrogen?

A) Follicle-stimulating hormone
B) Gonadotropin-releasing hormone
C) Adrenocorticotropic hormone
D) Antidiuretic hormone
E) Growth hormone

Accepted Answer

Rationale 1: This hormone responds to gonadotropin-releasing hormone to promote maturation of ovarian follicles and estrogen production.
Rationale 2: This hormone stimulates follicle-stimulating hormone to promote maturation of ovarian follicles and estrogen production.
Rationale 3: This hormone has no impact on the reproductive system.
Rationale 4: This hormone has no impact on the reproductive system.
Rationale 5: This hormone has no effect on the reproductive system.

Question 9

A client's hormone replacement therapy for a health problem has been discontinued. The nurse should instruct the client about which effects because the therapy has been stopped?&#10;A) Body cells will need time to adjust to the new hormone level.&#10;B) Target cells are desensitized and are less responsive to the effects of the hormone.&#10;C) Body cells will create more receptors on the plasma membrane to capture hormone molecules.&#10;D) Body cells will send signals that hormone action is needed.&#10;E) Body cells will secrete more hormone.&#10;

Accepted Answer

Rationale 1: When therapy is discontinued, the cells will need time to synthesize more protein receptors and adjust to the new hormone level.
Rationale 2: When a hormone is provided for long periods, the body recognizes an abundance of the hormone and cells will down-regulate the number of receptors for that hormone. This causes a desensitization of the target cells, and they are less responsive to the effects of the hormone.
Rationale 3: This does not occur when hormone replacement therapy is stopped.
Rationale 4: This does not occur when hormone replacement therapy is stopped.
Rationale 5: This does not occur when hormone replacement therapy is stopped.

Question 10

The nurse is reviewing the process of ovulation with nursing students at a fertility clinic. What will the nurse include in her teaching?&#10;A) Gonadotropin-releasing hormone stimulates the luteinizing hormone to stimulate ovulation.&#10;B) Gonadotropin-releasing hormone stimulates luteinizing hormone to produce estrogen.&#10;C) The presence of estrogen stops gonadotropin-releasing hormone from secreting more hormone.&#10;D) The presence of estrogen signals the ovaries to continue releasing gonadotropin-releasing hormone.&#10;E) Luteinizing hormone stimulates estrogen to release gonadotropin-releasing hormone for ovulation to occur.&#10;

Accepted Answer

Rationale 1: Gonadotropin-releasing hormone does stimulate luteinizing hormone to stimulate ovulation.
Rationale 2: Gonadotropin-releasing hormone does stimulate luteinizing hormone to produce estrogen.
Rationale 3: Estrogen provides negative feedback to gonadotropin-releasing hormone to stop secreting.
Rationale 4: This is not the mechanism of ovulation.
Rationale 5: This is not the mechanism of ovulation.

Question 11

The nurse is reviewing the pathophysiology of type 1 diabetes mellitus with a client newly diagnosed with the disorder. How will the nurse explain the control of pancreatic hormones in this disorder?&#10;A) Cells in the pancreas sense the level of glucose in the blood.&#10;B) Depending on the level of glucose in the blood, the pancreas will either secrete insulin or stop the secretion of insulin.&#10;C) Nerve impulses to the pancreas stimulate the release of insulin.&#10;D) The pancreas reacts to other hormone levels in the blood.&#10;E) Insulin is secreted in response to hormone levels within other digestive system organs.&#10;

Accepted Answer

The answer of The nurse is reviewing the pathophysiology of...

Question 12

The nurse is teaching a client about the need for supplemental thyroid hormone following a hypophysectomy because of an anterior pituitary adenoma. The client says, "I thought thyroid hormone came from a gland in my neck." Which follow-up statement by the nurse is most appropriate?

A) "Your thyroid gland no longer gets messages from the pituitary."
B) "You will only need to take thyroid hormone until healing occurs."
C) "You need this hormone because your TSH is too high since surgery."
D) "Your thyroid gland was damaged because of the long surgical procedure."

Accepted Answer

The answer of The nurse is teaching a client about...

Deck 15: Pharmacotherapy of Nutritional Disorders