A patient is hospitalized with adrenocortical insufficiency. Which nursing activity should you delegate to the nursing assistant?

Correct Answer: A

Rationale: In the scenario of a patient hospitalized with adrenocortical insufficiency, delegating the task of reminding the patient to change positions slowly to the nursing assistant is appropriate. This task falls within the scope of the nursing assistant's role as it involves a simple reminder that does not require specialized nursing knowledge or expertise. It is important for patients with adrenocortical insufficiency to change positions slowly to prevent orthostatic hypotension, a common complication in these patients. Checking the patient for muscle weakness (option B) requires a higher level of assessment skill and understanding of the condition, making it more suitable for a registered nurse to perform. Teaching the patient how to collect 24-hour urine (option C) involves patient education and requires a higher level of understanding of the endocrine system and its related conditions, making it beyond the scope of a nursing assistant's role. Planning nursing interventions to promote fluid balance (option D) involves critical thinking and decision-making skills that are typically within the realm of a registered nurse's responsibilities. Educationally, understanding delegation in nursing is crucial for effective teamwork and optimizing patient care. Delegating tasks appropriately based on the skill level and scope of practice of each team member ensures that patient needs are met efficiently and safely. It also allows nurses to focus on tasks that require their specialized knowledge and expertise, ultimately improving patient outcomes.

Correct Answer: A

Rationale: The correct answer is A: Angle-closure (narrow-angle) glaucoma. Scopolamine, an anticholinergic medication, can worsen angle-closure glaucoma by causing pupil dilation leading to increased intraocular pressure. This can result in a sudden and severe increase in eye pressure, leading to potential vision loss. Therefore, it is contraindicated in patients with narrow-angle glaucoma. B: Bradycardia is not a contraindication for scopolamine use as it may actually help in treating motion sickness. C: History of shellfish allergies is not a contraindication for scopolamine as the medication is not derived from shellfish and is safe for patients with this allergy. D: Resting blood pressure of 112/70 is not a contraindication for scopolamine use as it falls within the normal range and should not pose any significant risk.

Correct Answer: D

Rationale: The correct answer is D because pralidoxime is used to treat poisoning from organophosphate insecticides, which are commonly used in agriculture. The patient is likely a farm/field worker who was accidentally exposed to insecticide. A: Amphetamine poisoning does not require pralidoxime. B: Neostigmine is not an organophosphate insecticide. C: Prazosin is not an organophosphate insecticide and is unlikely to require pralidoxime in this context. In summary, the correct answer is D because the patient's exposure to insecticide aligns with the indication for pralidoxime use, while the other choices involve different substances that do not require pralidoxime treatment.

Correct Answer: D

Rationale: In this question, the correct answer is D) Phenylephrine. The rationale behind this is that Phenylephrine is an alpha-adrenergic agonist, not a beta-adrenergic agonist. Understanding the classification of adrenergic receptors is crucial in pharmacology. Adrenaline (epinephrine), Noradrenaline (norepinephrine), and Dopamine are all beta-adrenergic agonists. Adrenaline and Noradrenaline act on both beta-1 and beta-2 receptors, while Dopamine primarily acts on beta-1 receptors. Educationally, this question tests the student's knowledge of adrenergic receptors and their corresponding agonists. It requires students to differentiate between alpha and beta adrenergic agonists, emphasizing the importance of understanding drug classifications in pharmacology. By knowing which receptors specific drugs act on, healthcare professionals can predict their effects and potential side effects accurately. This knowledge is vital in clinical practice when prescribing or administering medications to achieve the desired therapeutic outcomes.

Correct Answer: D

Rationale: Noradrenaline acts on alpha receptors in the cardiovascular system, leading to increased systolic and diastolic blood pressure. It also causes reflex bradycardia by activating baroreceptors. However, noradrenaline does not directly constrict coronary blood vessels, as it primarily acts on alpha receptors and not on coronary vessels. This lack of direct effect on coronary blood vessels is why option D is the correct answer.