A 75-year-old woman with type 2 diabetes has recently been placed on glipizide (Glucotrol), 10 mg daily. She asks the nurse when the best time would be to take this medication. What is the nurse’s best response?

Correct Answer: A

Rationale: The correct answer is A: Take this medication in the morning, 30 minutes before breakfast. Glipizide is a sulfonylurea medication that helps lower blood sugar levels by stimulating the pancreas to release more insulin. Taking it in the morning, before breakfast, helps synchronize the peak action of the medication with the body's natural rise in blood sugar levels in the morning. This timing helps prevent hypoglycemia during the night and early morning hours when the risk is higher. Choice B is incorrect because taking the medication in the evening may increase the risk of hypoglycemia during the night. Choice C is incorrect as there is no specific requirement to take the medication after the midday meal. Choice D is incorrect because the timing of glipizide intake does matter for optimal effectiveness and safety.

Correct Answer: A

Rationale: Calcitriol, the active form of vitamin D, acts through a cytoplasmic receptor. First, calcitriol enters the cell and binds to its cytoplasmic receptor. Then, the hormone-receptor complex translocates to the nucleus, where it regulates gene expression. This mechanism is characteristic of hormones that act through cytoplasmic receptors. Prolactin and vasopressin, on the other hand, act through cell surface receptors, triggering signaling cascades without entering the cell. Therefore, the correct answer is A (Calcitriol), as it follows the characteristic pathway of a hormone acting through a cytoplasmic receptor.

Correct Answer: D

Rationale: Somatostatin inhibits the release of growth hormone, insulin, and thyrotropin. It acts as a hormone and neurotransmitter, regulating the endocrine system. By inhibiting these hormones, somatostatin helps maintain homeostasis in the body. Therefore, the correct answer is D. Choices A, B, and C are incorrect because somatostatin does not selectively inhibit only one of these hormones; it affects all of them.

Correct Answer: C

Rationale: Hyperprolactinemia causes an increase in prolactin levels, which can lead to amenorrhea due to inhibition of gonadotropin-releasing hormone, gynecomastia due to decreased testosterone levels, and depressed fertility due to disrupted ovulation. Multiple ovulation is not typically a direct consequence of hyperprolactinemia, as it primarily affects the menstrual cycle and fertility. Therefore, the correct answer is C.

Correct Answer: B

Rationale: The correct answer is B: Cryptorchism in a boy less than 7 years old. Gonadotropins are not indicated in cryptorchism as it is a condition where one or both testes fail to descend into the scrotum. Gonadotropins are used to treat conditions like hypogonadotrophic hypogonadism, amenorrhoea, infertility, and polycystic ovaries by stimulating the production of sex hormones. For the other choices: A) Hypogonadotrophic hypogonadism in males - correct, as gonadotropins can help stimulate testosterone production. C) Amenorrhoea and infertility in women - correct, as gonadotropins can help induce ovulation. D) Polycystic ovaries - correct, as gonadotropins can help regulate hormone levels and promote ovulation.