A patient is admitted to the emergency department with signs of respiratory depression after self-injection with hydromorphone. The admitting nurse knows that which drug will reverse respiratory depression caused by opioid overdose?

Correct Answer: B

Rationale: The correct answer is B: Naloxone. Naloxone is an opioid antagonist that competitively blocks opioid receptors, reversing the effects of opioid overdose such as respiratory depression. It has a rapid onset of action and can quickly restore normal breathing. A: Fentanyl is an opioid agonist, and administering more opioids would worsen respiratory depression. C: Butorphanol is a mixed opioid agonist-antagonist, which may not be as effective in reversing respiratory depression compared to a pure antagonist like naloxone. D: Sufenta is an opioid agonist similar to fentanyl, so it would not reverse respiratory depression caused by opioid overdose.

Correct Answer: B

Rationale: The correct answer is B: Pituitary somatotrophs. Octreotide is a somatostatin analog that inhibits the release of growth hormone. Somatotrophs in the pituitary gland are the cells responsible for producing and releasing growth hormone. By acting on these cells, octreotide can effectively reduce the elevated levels of growth hormone seen in acromegaly. Supraoptic neurons (A) are responsible for producing and releasing vasopressin, not growth hormone. Pituitary thyrotrophs (C) produce and release thyroid-stimulating hormone, not growth hormone. Paraventricular neurons (D) are involved in regulating oxytocin release, not growth hormone. Therefore, the main site of action of octreotide in acromegaly is on pituitary somatotrophs.

Correct Answer: D

Rationale: The correct answer is D: Cabergoline. Cabergoline is a dopamine agonist used to treat hyperprolactinemia. It is appropriate to add to therapy if the patient has hyperprolactinemia symptoms. Cosyntropin (A) is a synthetic ACTH used to test adrenal gland function. Mecasermin (B) is a recombinant IGF-1 used to treat growth hormone insensitivity. Leuprolide (C) is a GnRH agonist used to treat conditions like endometriosis and prostate cancer. None of these options are appropriate for hyperprolactinemia, making D the correct choice.

Correct Answer: A

Rationale: Step-by-step rationale for the correct answer (A: Pegvisomant): 1. Patient likely has acromegaly due to elevated growth hormone levels. 2. Pegvisomant is a growth hormone receptor antagonist used to treat acromegaly by blocking the effects of growth hormone. 3. This drug would be appropriate to normalize the patient's growth hormone levels and improve symptoms. Summary of why other choices are incorrect: - B: Degarelix is a gonadotropin-releasing hormone antagonist used in prostate cancer, not for acromegaly. - C: Leuprolide is a gonadotropin-releasing hormone agonist used in various conditions like prostate cancer and endometriosis, not for acromegaly. - D: Cosyntropin is a synthetic form of adrenocorticotropic hormone used in diagnostic testing for adrenal function, not for acromegaly treatment.

Correct Answer: C

Rationale: The correct answer is C: Methimazole. Methimazole is an antithyroid drug used to treat hyperthyroidism by inhibiting thyroid hormone synthesis. The results described are likely due to hyperthyroidism, which methimazole would help regulate. Radioactive iodine (A) is used to destroy thyroid tissue, potassium iodide (B) is used to protect the thyroid from radiation, and propranolol (D) is a beta-blocker used to manage symptoms but does not directly address thyroid hormone levels.