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?

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?

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?

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?

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?

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?

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, "How do anti-hormones work to help my condition?" Which is the nurse's best response?

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?

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?

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?

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?

Accepted Answer

Rationale 1: The pancreas functions through humoral stimuli and senses the level of glucose in the blood.
Rationale 2: Because the pancreas functions through humoral stimuli and senses the level of glucose in the blood, it either secretes insulin or stops the secretion of insulin.
Rationale 3: The pancreas does not respond to neuronal stimuli.
Rationale 4: The pancreas does not respond to hormonal stimuli.
Rationale 5: The pancreas does not respond to hormonal stimuli.

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?

Accepted Answer

Rationale 1: A hypophysectomy removes the anterior pituitary. Hormones normally produced by this portion of the pituitary are lacking. TSH is absent, so the thyroid gland does not receive messages to make thyroid hormone, and a life-long supplement is needed.
Rationale 2: This statement does not explain the role of the pituitary gland in thyroid regulation.
Rationale 3: The client's TSH level is not too high from surgery.
Rationale 4: The thyroid is in the neck, and the pituitary gland is in the cranium.

Quiz 15: Pharmacotherapy of Nutritional Disorders