The nurse determines that a patient with a 2-hour OGTT of 152 mg/dL has

Correct Answer: D

Rationale: In this scenario, the correct answer is D) impaired glucose tolerance. Impaired glucose tolerance (IGT) is diagnosed when the 2-hour Oral Glucose Tolerance Test (OGTT) result falls between 140-199 mg/dL. This indicates that the patient's blood sugar levels are elevated after consuming a glucose load, but not high enough to meet the criteria for diabetes. Option A) diabetes is not the correct answer because a 2-hour OGTT of 152 mg/dL does not meet the diagnostic criteria for diabetes (200 mg/dL or above). Option B) impaired fasting glucose refers to elevated fasting blood sugar levels, not the result of an OGTT. Option C) elevated A1C is a marker for long-term blood glucose control and is not directly related to the OGTT result. In an educational context, understanding the diagnostic criteria for diabetes and its precursor states like impaired glucose tolerance is crucial for nurses caring for patients at risk for or with diabetes. By knowing the specific values that indicate different glucose abnormalities, nurses can provide appropriate education, monitoring, and support to help patients manage their condition effectively.

Correct Answer: A

Rationale: In a patient with a prolactinoma, which is a benign tumor of the pituitary gland that produces excess prolactin, the most common findings include gynecomastia in men. The rationale for this is that prolactin inhibits the secretion of gonadotropin-releasing hormone (GnRH), leading to decreased levels of testosterone in men, which can result in the development of breast tissue (gynecomastia). Option B, profuse menstruation in women, is incorrect because prolactinomas typically cause irregular or absent menstruation due to the suppression of gonadotropin hormones. Option C, excess FSH and LH, is also incorrect because prolactinomas do not directly affect the levels of these hormones. Option D, signs of increased intracranial pressure, including headache, nausea, and vomiting, is more commonly associated with other types of pituitary tumors, such as craniopharyngiomas or pituitary adenomas that cause mass effect. In an educational context, understanding the clinical manifestations of prolactinomas is crucial for nurses caring for patients with endocrine disorders. Recognizing these signs and symptoms can help in early detection, appropriate management, and improved patient outcomes. Nurses play a vital role in educating patients about their condition, treatment options, and potential complications, making it essential for them to have a comprehensive understanding of endocrine disorders like prolactinomas.

Correct Answer: A

Rationale: Rationale: The correct answer is A) Tracheostomy tray. During a thyroidectomy surgery, there is a risk of damaging the recurrent laryngeal nerve, which can lead to vocal cord paralysis and airway compromise. In case of emergency situations like difficulty breathing due to vocal cord paralysis, having a tracheostomy tray readily available in the room is crucial. A tracheostomy tray contains the necessary equipment to perform an emergency tracheostomy, providing an alternative airway when upper airway obstruction occurs. Option B) IV calcium gluconate is used to manage hypocalcemia, a common complication after thyroidectomy due to inadvertent removal or damage to the parathyroid glands. While important for managing hypocalcemia, it is not directly related to managing an emergency airway situation caused by vocal cord paralysis. Option C) Oxygen equipment is important for respiratory support in various situations, but in the context of vocal cord paralysis leading to airway compromise, oxygen alone may not be sufficient to manage the emergency. A definitive airway intervention like a tracheostomy would be needed. Option D) Paper and pencil for communication may be useful for aiding communication with a patient who cannot speak but is not directly related to managing a compromised airway due to vocal cord paralysis. In an educational context, understanding the potential complications of thyroidectomy, such as damage to the recurrent laryngeal nerve and subsequent vocal cord paralysis, is crucial for nursing practice. Knowing the appropriate emergency equipment needed in such situations and being prepared to act swiftly can significantly impact patient outcomes and safety during and post-surgery. This question reinforces the importance of preparedness and quick decision-making in managing surgical complications.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Alendronate (Fosamax). The rationale behind this is that Alendronate is a bisphosphonate medication commonly used in patients on corticosteroid therapy to prevent corticosteroid-induced osteoporosis. Corticosteroids can lead to bone loss by interfering with calcium absorption and increasing bone resorption, making patients more prone to osteoporosis. Option A) Potassium is not used to prevent corticosteroid-induced osteoporosis. Potassium is an electrolyte that is important for nerve and muscle function, but it is not directly involved in preventing bone loss associated with corticosteroid use. Option C) Furosemide (Lasix) is a diuretic medication used to treat fluid retention and high blood pressure. It is not indicated for preventing corticosteroid-induced osteoporosis. Option D) Pantoprazole (Protonix) is a proton pump inhibitor commonly used to reduce stomach acid production and treat conditions like gastroesophageal reflux disease (GERD) and ulcers. It is not used specifically to prevent corticosteroid-induced osteoporosis. In an educational context, it is crucial for nursing students to understand the adverse effects of corticosteroid therapy, such as osteoporosis, and the importance of preventive measures like using bisphosphonates. This knowledge helps nurses provide comprehensive care to patients on corticosteroid therapy, ensuring their overall well-being and quality of life.

Correct Answer: C

Rationale: Rationale: The correct answer is C) Insulin reaction. When a patient like Jane Doe receives NPH insulin but delays eating for an extended period, they are at risk for an insulin reaction (hypoglycemia). NPH insulin has an onset of action around 1-2 hours after administration, so if a patient doesn't eat within a reasonable timeframe, their blood sugar levels can drop dangerously low, leading to symptoms like dizziness, confusion, sweating, and even loss of consciousness. Option A) Dehydration is incorrect because it is not directly related to the scenario described. Option B) Ketoacidotic coma is unlikely in this case because NPH insulin does not typically cause ketoacidosis, which is more common in type 1 diabetes or during periods of severe insulin deficiency. Option D) Hyperosmolar hyperglycemic coma is also less likely as NPH insulin is a shorter-acting insulin and typically does not lead to extreme hyperglycemia that would result in a hyperosmolar state. Educational Context: This question highlights the importance of timely administration of insulin in relation to meals to prevent hypoglycemia. It also underscores the need for healthcare providers to educate patients on the timing of insulin injections in coordination with meals to maintain optimal blood sugar levels and prevent complications. Understanding insulin action, patient education, and timely interventions are crucial aspects of nursing care in managing diabetes effectively.