A patient who has type 2 diabetes is scheduled for an oral endoscopy and has been NPO (nothing by mouth) since midnight. What is the best action by the nurse regarding the administration of her oral antidiabetic drugs?

Correct Answer: D

Rationale: The correct answer is D, to contact the prescriber for further orders. Since the patient has been NPO and is scheduled for an oral procedure, it is crucial to clarify whether the oral antidiabetic drugs should be administered, withheld, or adjusted. Contacting the prescriber ensures patient safety and adherence to specific protocols. Administering half the original dose (choice A) without consulting the prescriber can lead to hypoglycemia. Withholding all medications (choice C) may result in uncontrolled blood sugar levels. Choice B is incomplete. Contacting the prescriber is the best course of action to confirm the appropriate management plan.

Correct Answer: C

Rationale: The correct answer is C: Increased carbohydrate utilization. Growth hormone primarily promotes lipolysis, leading to increased fat utilization and protein synthesis. It also induces insulin resistance, resulting in glucose intolerance. However, growth hormone does not directly increase carbohydrate utilization. Therefore, choice C is the exception among the actions of growth hormone.

Correct Answer: C

Rationale: Rationale for correct answer C: Somatostatin is used to treat bleeding esophageal varices by reducing portal pressure, inhibiting vasodilation, and decreasing blood flow to the varices. This helps in preventing further bleeding episodes and stabilizing the condition. The other choices are incorrect because: A: Macroprolactinoma is usually treated with dopamine agonists, not somatostatin. B: Zollinger Ellison syndrome is treated with proton pump inhibitors or H2 blockers, not somatostatin. D: Steatorrhoea is not typically treated with somatostatin; it is usually managed with dietary modifications or pancreatic enzyme replacement therapy.

Correct Answer: A

Rationale: The correct answer is A: Dopamine D2 agonism. Bromocriptine is a dopamine D2 receptor agonist, meaning it activates D2 receptors. This leads to inhibiting prolactin secretion, making it a treatment for hyperprolactinemia. Dopamine D2 antagonism (B) would have the opposite effect. Dopamine D1 antagonism (C) is not a prominent action of bromocriptine. α adrenergic antagonism (D) is not related to the mechanism of action of bromocriptine.

Correct Answer: A

Rationale: The correct answer is A: Myxoedema. High serum TSH levels indicate primary hypothyroidism, which is characterized by decreased thyroid hormone levels. Myxoedema is a severe form of hypothyroidism where TSH levels increase as the body tries to stimulate the thyroid to produce more hormones. In Grave's disease (B), TSH levels are typically low due to thyroid overactivity. Carcinoma thyroid (C) may present with normal or slightly elevated TSH levels. Toxic nodular goiter (D) is associated with low TSH levels due to autonomous thyroid hormone production.