A 6-year-old child was badly burned when his house caught on fire. To aid in reducing the pain associated with dressing changes, he is given Ketamine I.V this drug has been associated with which of the following adverse reactions?

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Distortion of reality and terrifying dreams. Ketamine is a dissociative anesthetic that can cause hallucinations, vivid dreams, and a feeling of detachment from reality. These effects are more common in children and can be distressing if not properly explained or managed. Option A) Bronchospasm is not a common adverse reaction to Ketamine. Bronchospasm is more commonly associated with drugs like beta-agonists or aspirin. Option B) Hypotension is also not a typical adverse reaction to Ketamine. In fact, Ketamine is known to have minimal effects on blood pressure, making it a preferred choice in patients who are hemodynamically unstable. Option C) Malignant hyperthermia is a severe reaction usually triggered by certain anesthetic agents like succinylcholine or volatile anesthetics, not Ketamine. Educationally, it is important to understand the pharmacological effects and potential adverse reactions of drugs used in pediatric patients, especially in critical situations like burn management. Proper education and monitoring can help healthcare professionals anticipate and manage adverse reactions effectively to ensure the safety and well-being of the child undergoing treatment.

Correct Answer: D

Rationale: In the context of treating hypothyroid coma, it is crucial to understand the pharmacology of the drugs listed in the options. The correct answer is D) Propranolol. Propranolol is a beta-blocker that can exacerbate hypothyroidism by inhibiting the conversion of T4 to T3. Therefore, it is contraindicated in hypothyroid coma treatment. A) Liothyronine and B) L-thyroxine are thyroid hormones used to replace deficient thyroid hormones in hypothyroidism. These are essential for restoring thyroid hormone levels in hypothyroid coma. C) Hydrocortisone is a corticosteroid that can be used in hypothyroid coma to support adrenal function, as adrenal insufficiency can accompany severe hypothyroidism. Educationally, this question highlights the importance of understanding drug mechanisms and interactions in treating endocrine emergencies. It reinforces the need for healthcare providers to be aware of contraindications and appropriate treatment options in managing complex conditions like hypothyroid coma.

Correct Answer: D

Rationale: In this question, the correct answer is D) The posterior pituitary. The posterior pituitary gland is the site where antidiuretic hormone (ADH), also known as vasopressin, is secreted. ADH plays a crucial role in regulating the body's water balance by controlling the reabsorption of water in the kidneys. When ADH is released, it acts on the kidneys to increase water reabsorption, leading to decreased urine output and concentrated urine. Option A) The kidney cortex is incorrect because ADH is not secreted from the kidney itself but rather from the posterior pituitary gland. Option B) The kidney medulla is incorrect for the same reason as option A. Option C) The anterior pituitary is also incorrect as ADH is not secreted from the anterior pituitary gland but from the posterior pituitary. Educational Context: Understanding the source and function of hormones like ADH is essential in the study of the endocrine system. Knowing where hormones are produced and how they act in the body helps healthcare professionals, including nurses preparing for the NCLEX, to comprehend the physiological processes and imbalances that can occur. This knowledge is crucial in providing safe and effective patient care, especially when managing conditions related to fluid balance and electrolyte levels.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Hypoglycemia. Prolonged therapy with glucocorticoids can lead to various adverse effects, such as peptic ulcers, increased susceptibility to infections, and suppression of pituitary-adrenal function. Glucocorticoids can cause hyperglycemia by promoting gluconeogenesis and insulin resistance, rather than hypoglycemia. Peptic ulcers can develop due to the suppression of prostaglandins, which help protect the stomach lining. Increased susceptibility to infections occurs because glucocorticoids suppress the immune response. Suppression of pituitary-adrenal function is a common side effect of prolonged glucocorticoid therapy, leading to adrenal insufficiency when the medication is tapered or stopped abruptly. Educationally, understanding the side effects of glucocorticoids is crucial for healthcare professionals, especially nurses, to monitor patients receiving these medications. Nurses need to assess for signs and symptoms of these potential adverse effects to provide safe and effective care. Knowledge of glucocorticoid therapy and its implications is essential for nursing practice to ensure patient safety and optimal outcomes.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Desmopressin. Desmopressin is a synthetic form of vasopressin, which is a hormone that helps regulate water balance in the body. Pituitary diabetes insipidus is a condition where the body cannot properly regulate water balance due to a deficiency of vasopressin. By administering desmopressin, the patient can replace the missing hormone and effectively manage the excessive thirst, urination, and hypernatremia associated with the condition. Option A) Corticotropin is not the correct answer because it is a hormone that stimulates the adrenal glands to produce cortisol, which is not relevant to treating pituitary diabetes insipidus. Option C) HCG (human chorionic gonadotropin) is not the correct answer either as it is a hormone involved in pregnancy-related processes and not relevant to treating diabetes insipidus. Option D) Thyrotropin is a hormone that stimulates the thyroid gland and is not used in the treatment of pituitary diabetes insipidus. Educationally, understanding the role of hormones in the body and how imbalances can lead to various conditions is crucial for nursing practice. Knowing the specific treatments for hormone-related disorders, like diabetes insipidus, is essential for providing optimal patient care and ensuring positive outcomes. This question also reinforces the importance of critical thinking and applying knowledge of endocrine disorders in clinical scenarios.