Jan, an insulin-dependent diabetic, was admitted to the emergency room with hypoglycemia after playing tennis all afternoon. The probable cause of this reaction was

Correct Answer: A

Rationale: In this scenario, the correct answer is A) increased exercise level. When someone with diabetes engages in physical activity like playing tennis, their body uses up glucose for energy. This increased demand for glucose, coupled with the effects of insulin that is already present in the body, can lead to hypoglycemia if the individual does not adjust their insulin dosage or food intake accordingly. Option B) insufficient insulin dosage is incorrect because in this case, the individual's insulin dosage would have been sufficient for their usual activity level but became excessive due to the additional glucose utilization during exercise. Option C) increased food intake is incorrect because consuming more food would actually help prevent hypoglycemia by providing more glucose for the body to use during exercise. Option D) increased glucagon production is incorrect because glucagon is released by the body to raise blood sugar levels when they are low, so increased glucagon production would actually help counteract hypoglycemia. Educationally, this question highlights the importance of monitoring blood sugar levels and adjusting insulin dosage and food intake based on physical activity levels for individuals with diabetes. It underscores the need for proactive management of blood sugar levels to prevent complications like hypoglycemia during exercise. This knowledge is crucial for healthcare professionals, caregivers, and individuals with diabetes to ensure safe and effective management of the condition.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) FSH and LH. The rationale behind this is that FSH (Follicle-Stimulating Hormone) and LH (Luteinizing Hormone) are both gonadotropins secreted by the pituitary gland. These hormones play crucial roles in regulating reproductive functions. In Annabelle's case, the symptoms of infertility, hypogonadism, and delayed puberty point towards a deficiency in FSH and LH, which are essential for proper ovarian and testicular function, as well as the onset of puberty. Option B) ACTH (Adrenocorticotropic Hormone) is responsible for stimulating the adrenal glands to produce cortisol and is not directly related to the symptoms described in the case of Annabelle. Option C) TSH (Thyroid-Stimulating Hormone) regulates thyroid function and is not associated with the symptoms of infertility, hypogonadism, or delayed puberty. Option D) Growth hormone primarily regulates growth, metabolism, and body composition, and its deficiency would typically manifest as growth retardation rather than the specific symptoms described for Annabelle. Educationally, understanding the roles of different pituitary hormones is crucial in diagnosing and treating endocrine disorders. This question highlights the importance of recognizing the specific hormonal deficiencies that can lead to reproductive issues in individuals like Annabelle, emphasizing the interconnectedness of the endocrine system and the diverse functions of its hormones.

Correct Answer: C

Rationale: In the context of a client with diabetes insipidus, the correct advice is to emphasize compliance with drug therapy (Option C). This is because diabetes insipidus is a condition characterized by the inability of the body to properly regulate fluid balance due to insufficient antidiuretic hormone (ADH) production or response. Medications like desmopressin are commonly used to manage this condition by replacing the deficient ADH. Option A, remaining in air-conditioned areas during hot and humid weather, may help reduce fluid loss to some extent by minimizing excessive sweating, but it does not address the underlying cause of the condition or provide a comprehensive solution like drug therapy does. Option B, avoiding any activity, is not a practical or healthy recommendation as physical activity is important for overall health and well-being. Complete avoidance of activity is not necessary for managing diabetes insipidus. Option D, avoiding a high-protein diet, is unrelated to managing fluid loss in diabetes insipidus. Protein intake does not significantly impact fluid balance in the same way that the presence or absence of ADH does. In an educational context, understanding the rationale behind the correct answer helps healthcare providers and patients make informed decisions about managing diabetes insipidus effectively. Emphasizing compliance with drug therapy is crucial in controlling symptoms and improving the client's quality of life by addressing the root cause of the condition. It also highlights the importance of individualized treatment plans and the role of healthcare professionals in guiding patients towards optimal management strategies.

Correct Answer: D

Rationale: In a patient with Cushing's disease, excessive cortisol levels can lead to fluid retention and increased susceptibility to infections. Crackles heard bilaterally in the lower lobes of the lungs suggest the presence of pulmonary edema, a potential complication of Cushing's due to fluid overload, which can progress rapidly to respiratory distress. Therefore, notifying the physician immediately is crucial for timely intervention to prevent respiratory compromise. Option A, purple striae on the abdomen and thighs, is a common physical manifestation of Cushing's disease due to the weakening of the skin's connective tissue, but it does not require immediate physician notification as it is a chronic finding. Option B, a 1-pound weight gain since the previous day, while potentially concerning in the context of fluid retention, is not as urgent as the presence of crackles indicating acute respiratory distress. Option C, the error option, is obviously incorrect. This question provides an opportunity for learners to understand the acute complications of Cushing's disease and the importance of recognizing and responding promptly to signs of respiratory distress in patients with endocrine disorders. It reinforces the concept of prioritizing assessments based on the urgency of the patient's condition, a critical skill in clinical practice.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) The RN encourages the patient to drink orange juice. This response requires immediate intervention because the patient is showing signs of diabetic ketoacidosis (DKA), a serious complication of diabetes. Encouraging the patient to drink orange juice is not appropriate as DKA is characterized by hyperglycemia, dehydration, and metabolic acidosis. Option A is incorrect because checking the patient's fingerstick glucose may be important for monitoring blood sugar levels but is not the most urgent task given the patient's presentation. Option C is also incorrect as checking the patient's order for sliding scale insulin is not the immediate priority in this critical situation. Option D, assessing the patient's vital signs every 15 minutes, is important but does not address the immediate need to correct the patient's metabolic imbalance. From an educational perspective, this question highlights the importance of recognizing and responding to critical situations promptly in patients with diabetes. It emphasizes the significance of understanding the signs and symptoms of DKA and the appropriate interventions required in such cases. Educating healthcare providers on the prioritization of care in emergencies like DKA is crucial for patient safety and optimal outcomes.