The nurse is reviewing instructions for a patient with type 2 diabetes who also takes insulin injections as part of the therapy. The nurse asks the patient, What should you do if your fasting blood glucose is 47 mg/dL? Which response by the patient reflects a correct understanding of insulin therapy?

Correct Answer: B

Rationale: Correct Answer: B - "I will give myself the regular insulin." Rationale: 1. Correct response as the patient has low blood glucose (47 mg/dL). 2. Regular insulin helps lower blood glucose levels efficiently. 3. Immediate action needed to prevent hypoglycemia. 4. Calling the doctor (choice A) delays treatment. Taking an oral form of glucose (choice C) may not act fast enough.

Correct Answer: D

Rationale: The correct answer is D, Insulin like growth factor-1 (IGF-1). Growth hormone stimulates the production of IGF-1 in the liver, which mediates many of its growth-promoting effects. IGF-1 acts on target tissues to promote cell growth and division. A is incorrect because growth hormone does not directly act through cyclic AMP. B is incorrect as cyclic GMP is not a major mediator of growth hormone actions. C, somatostatin, is a hormone that inhibits growth hormone release and does not play a direct role in mediating growth hormone effects. In summary, the correct answer, D, is supported by the fact that IGF-1 is a key downstream mediator of growth hormone actions.

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.