An endocrine gland that plays an important role in calcium metabolism is the:

Correct Answer: D

Rationale: The correct answer is D) Parathyroid. The parathyroid gland is responsible for regulating calcium levels in the body. It does this by secreting parathyroid hormone (PTH), which acts on the bones, kidneys, and intestines to increase calcium levels in the blood when they are too low. Option A) Pancreas is involved in regulating blood sugar levels by producing insulin and glucagon, not calcium metabolism. Option B) Adrenocortical refers to the adrenal cortex, which produces hormones like cortisol and aldosterone, but it is not primarily involved in calcium metabolism. Option C) Thyroid gland produces hormones such as thyroxine (T4) and triiodothyronine (T3), which regulate metabolism, growth, and development, but not specifically calcium metabolism. Understanding the roles of different endocrine glands in the body is crucial for healthcare professionals, especially when dealing with patients who have disorders related to hormone imbalances. Knowing the specific functions of each gland helps in diagnosing and treating various endocrine disorders effectively. In the context of the NCLEX exam, being able to differentiate between the functions of different glands can help in selecting the correct answer choice and demonstrating a solid understanding of endocrine physiology.

Correct Answer: D

Rationale: In this scenario, the best treatment option is D) Levothyroxine. Levothyroxine is a synthetic form of T4, the main hormone produced by the thyroid gland. In the case of low levels of free T3 and T4, administering levothyroxine can help to supplement the deficient thyroid hormones and restore normal thyroid function. Option A) IV infusion of TSH is incorrect because administering more thyroid-stimulating hormone (TSH) would not address the underlying issue of low T3 and T4 levels. TSH stimulates the thyroid gland to produce T3 and T4, but in this case, the thyroid gland is already enlarged and likely unable to produce sufficient hormones. Option B) Propranolol is a beta-blocker that can help manage symptoms of hyperthyroidism such as rapid heart rate and tremors, but it does not address the root cause of low T3 and T4 levels seen in a simple adenomatous goiter. Option C) Propylthiouracil is an antithyroid medication used to treat hyperthyroidism by inhibiting the production of thyroid hormones. However, in the case of low T3 and T4 levels due to a simple adenomatous goiter, propylthiouracil would not be the appropriate treatment. In an educational context, understanding the appropriate treatment for thyroid disorders is crucial for healthcare providers to effectively manage patients presenting with thyroid abnormalities. Knowledge of how different medications work and their specific indications is essential for providing safe and evidence-based care to patients with thyroid conditions.

Correct Answer: A

Rationale: In this scenario, the most likely side effect the 42-year-old man will experience after being prescribed a second-generation sulfonylurea agent for diabetes mellitus is hypoglycemia. Sulfonylureas work by stimulating insulin release from the pancreas, which can lead to a rapid decrease in blood sugar levels. A) Hypoglycemia is the correct answer because sulfonylureas can cause blood sugar levels to drop too low, resulting in symptoms like sweating, dizziness, confusion, and even loss of consciousness. B) Lactic acidosis is a potential side effect of biguanides like metformin, not sulfonylureas. C) Myositis is not a common side effect associated with sulfonylureas. It is more commonly seen with statins, which are used to lower cholesterol levels. D) Pruritus (itching) is not a typical side effect of sulfonylureas. It is often associated with allergic reactions or skin conditions. Educationally, understanding the side effects of different classes of medications used to manage diabetes is crucial for healthcare professionals to provide safe and effective care to patients. Recognizing the potential side effects of sulfonylureas, like hypoglycemia, can help healthcare providers monitor and manage patients appropriately to prevent complications.

Correct Answer: D

Rationale: In the treatment of congenital adrenal hyperplasia (CAH), which involves excess production of cortisol precursor due to enzymatic deficiencies, the administration of synthetic glucocorticoids serves the purpose of suppressing ACTH secretion. ACTH (adrenocorticotropic hormone) is responsible for stimulating the adrenal glands to produce cortisol. By providing exogenous glucocorticoids, the negative feedback mechanism is triggered, leading to a decrease in ACTH production from the pituitary gland. This, in turn, reduces the stimulation of the adrenal glands, thereby decreasing the production of excessive cortisol precursors. Option A, inhibition of aldosterone secretion, is incorrect because glucocorticoids primarily affect cortisol production, not aldosterone, which is regulated by the renin-angiotensin-aldosterone system. Option B, normalization of renal function, is incorrect as the primary goal of glucocorticoid administration in CAH is to address the hormonal imbalance, not specifically to target renal function. Option C, recovery of normal immune function, is incorrect because while glucocorticoids have immunosuppressive effects, in the context of CAH treatment, the primary aim is to regulate cortisol levels and not specifically to address immune function. Understanding the rationale behind the choice of the correct answer is vital for nursing students preparing for the NCLEX exam. It demonstrates the importance of recognizing the pathophysiology of CAH and the mechanism of action of glucocorticoid therapy in managing this condition. By grasping this concept, nurses can provide effective care to patients with CAH and other endocrine disorders, ensuring optimal outcomes.

Correct Answer: A

Rationale: DES, a synthetic estrogen, causes deep vein thrombosis (choice A), feminization of male offspring (choice B), and miscarriages (choice C) in pregnancy, linked to historical congenital anomalies (e.g., vaginal adenocarcinoma). Virilization of female offspring (choice D) isn't reported; DES mimics estrogen, not androgens. This exception highlights its teratogenic risks, banning its use in pregnancy.