At what time should the nurse administer the patient’s sliding scale Insulin Aspart?

Correct Answer: A

Rationale: The correct answer is A: 1 hour before the meal tray arrives. This timing allows the insulin to start working before the patient starts eating, preventing blood sugar spikes. Choice B is too early, leading to potential hypoglycemia. Choice C (1215) and D are specific times without considering the patient's meal schedule. Timing insulin administration is crucial to match peak action with meal consumption, making choice A the most appropriate option.

Correct Answer: D

Rationale: The correct answer is D: Nafarelin. Nafarelin is a gonadotropin-releasing hormone agonist used for conditions like endometriosis and precocious puberty, not for acromegaly. A: Bromocriptine and B: Somatostatin analogs (e.g., C: Octreotide) are used to suppress growth hormone release in acromegaly by targeting the pituitary gland.

Correct Answer: C

Rationale: The correct answer is C: Bromocriptine. Gynaecomastia is often caused by hormonal imbalances, specifically increased estrogen levels relative to testosterone. Bromocriptine is a dopamine agonist that inhibits prolactin secretion, which can help restore hormonal balance and reduce gynaecomastia. Chlorpromazine (A) is an antipsychotic with no direct effect on hormonal levels. Cimetidine (B) is a histamine H2 receptor antagonist used for acid reflux and ulcers, not for gynaecomastia. Metoclopramide (D) is a dopamine receptor antagonist that can actually exacerbate gynaecomastia by increasing prolactin levels.

Correct Answer: D

Rationale: The correct answer is D because adrenocorticotropic hormone (ACTH) is primarily used for diagnosing pituitary-adrenal axis disorders. ACTH stimulates the adrenal glands to produce cortisol, so measuring cortisol levels after administering ACTH helps identify disorders like Cushing's syndrome or adrenal insufficiency. Choices A, B, and C are incorrect because ACTH is not used to treat Addison's disease, congenital adrenal hyperplasia, or autoimmune diseases. Instead, these conditions may require cortisol replacement therapy, specific enzyme inhibitors, or immunosuppressants, respectively.

Correct Answer: A

Rationale: The correct answer is A. Auricular fibrillation is not a complication of overtreatment with thyroxine. Thyroxine is a thyroid hormone that can increase heart rate and cardiac output, potentially leading to complications such as angina pectoris, congestive heart failure, and acceleration of atherosclerosis. However, auricular fibrillation, also known as atrial fibrillation, is not directly caused by thyroxine over-treatment. It is important to differentiate between the potential complications of thyroxine therapy to ensure proper management and avoid unnecessary risks to the patient's health.