The patient with pheochromocytoma had surgery to remove his adrenal glands. Which nursing intervention should you delegate to the nursing assistant?

Correct Answer: D

Rationale: In this scenario, the correct answer is option D - "Monitor lying and standing blood pressure every 4 hours with cuff placed on the same arm." This task can be appropriately delegated to a nursing assistant because it involves routine monitoring that does not require specialized nursing judgment. Monitoring blood pressure in different positions is crucial in assessing for orthostatic hypotension, a common complication post-adrenalectomy in patients with pheochromocytoma. Option A is incorrect because adding strategies to provide a calm and restful environment post-operatively requires nursing knowledge and critical thinking to individualize care based on the patient's condition and needs. Option B is incorrect as warning the patient to avoid smoking and caffeinated beverages involves patient education and counseling, which should be done by a licensed healthcare provider. Option C is also incorrect as monitoring the patient's skin and mucous membranes for signs of hydration requires assessment skills to interpret the findings correctly. Educationally, it is important to understand the principles of delegation in nursing practice. Delegating tasks appropriately ensures efficient patient care while promoting the professional growth and development of all team members. Understanding which tasks can be delegated to nursing assistants versus those that require a higher level of expertise is essential for providing safe and effective care to patients.

Correct Answer: C

Rationale: The correct answer to the question, "Which endocrine gland secretes cortisol?" is option C) Adrenal cortex. Educational Rationale: 1. Adrenal Cortex (Option C) - This is the correct answer because the adrenal cortex, which is the outer portion of the adrenal gland, is responsible for secreting cortisol. Cortisol is a steroid hormone that plays a crucial role in regulating metabolism, immune response, and stress response in the body. 2. Ovaries (Option A) - The ovaries are not responsible for secreting cortisol. Instead, they produce hormones like estrogen and progesterone, which are involved in the reproductive system and menstrual cycle. 3. Thyroid (Option B) - The thyroid gland secretes hormones like thyroxine (T4) and triiodothyronine (T3) that regulate metabolism. It is not involved in the production of cortisol. 4. Adrenal Medulla (Option D) - The adrenal medulla is the inner portion of the adrenal gland and is responsible for secreting hormones like adrenaline and noradrenaline, which are involved in the body's fight-or-flight response. It does not produce cortisol. Educational Context: Understanding the endocrine system and the glands responsible for secreting specific hormones is crucial in the field of biology, physiology, and healthcare. Knowing which gland produces cortisol is important for understanding how the body responds to stress and maintains homeostasis. This knowledge is also essential for healthcare professionals when diagnosing and treating endocrine disorders related to cortisol production.

Correct Answer: A

Rationale: In teaching a patient with type 1 diabetes about the major advantage of using an insulin pump, emphasizing the option A) Tight glycemic control can be maintained is crucial. Insulin pumps deliver insulin continuously, mimicking the body's natural insulin release more closely than manual injections. This continuous delivery helps in maintaining stable blood glucose levels throughout the day, leading to better glycemic control. Option B) Errors in insulin dosing are less likely to occur is incorrect because while insulin pumps can reduce dosing errors related to manual injections, they can still occur due to factors like incorrect programming or pump malfunctions. Option C) Complications of insulin therapy are prevented is incorrect because while insulin pumps can help in better managing blood sugar levels, they do not prevent all complications associated with insulin therapy, such as hypoglycemia or skin irritation at the infusion site. Option D) Frequent blood glucose monitoring is unnecessary is incorrect because even with an insulin pump, regular blood glucose monitoring is still necessary to ensure the pump is delivering the right amount of insulin and to make any necessary adjustments in insulin doses based on blood sugar levels. In an educational context, it is important to emphasize to students or patients that while insulin pumps offer advantages in glycemic control, they are not a cure for diabetes and require proper education, monitoring, and management to be effective in diabetes care. Understanding the benefits and limitations of insulin pump therapy is essential for individuals with type 1 diabetes to make informed decisions about their treatment options.

Correct Answer: A

Rationale: The correct response is option A) "That is a good range for your glucose levels." This response is the best choice because a blood glucose level between 80-90 mg/dL is within the normal range and indicates good control of blood sugar following a hypoglycemic episode. It shows that the patient's glucose levels have stabilized and are not excessively low or high. Option B is incorrect because suggesting an increase in insulin without assessing the patient's current condition could lead to hypoglycemia. Option C is incorrect as advising the patient to increase food intake without proper assessment could potentially lead to hyperglycemia. Option D is incorrect as reducing insulin dosage without proper guidance from a healthcare provider can also lead to fluctuations in blood sugar levels. In an educational context, it's crucial for nurses to understand the management of blood glucose levels post-hypoglycemic episode and to support patients in maintaining stable levels within the target range. Providing accurate information and guidance empowers patients to manage their condition effectively and prevent complications related to blood sugar control.

Correct Answer: C

Rationale: In caring for a patient with nephrogenic diabetes insipidus, the treatment typically includes thiazide diuretics (Option C) because they can paradoxically decrease urine output by enhancing water reabsorption in the kidneys. Thiazides reduce the amount of urine produced, helping to manage the excessive urination characteristic of diabetes insipidus. Option A, fluid restriction, is not the primary treatment for nephrogenic diabetes insipidus because it can lead to dehydration without addressing the underlying issue of impaired kidney response to antidiuretic hormone. Option B, a high-sodium diet, would exacerbate the symptoms of diabetes insipidus by increasing urine output due to sodium's osmotic effect. Option D, chlorpropamide (Diabinese), is a sulfonylurea used to treat diabetes mellitus, not diabetes insipidus. In an educational context, understanding the appropriate treatment for nephrogenic diabetes insipidus is crucial for nursing students as it demonstrates the importance of differentiating between various types of diabetes and the tailored interventions required for each condition to ensure optimal patient outcomes. By grasping the rationale behind using thiazide diuretics in this scenario, students can apply this knowledge to clinical practice when caring for patients with similar conditions.