When teaching about hypoglycemia, the nurse will make sure that the patient is aware of the early signs of hypoglycemia, including:

Correct Answer: D

Rationale: The correct answer is D because confusion and sweating are classic early signs of hypoglycemia. Confusion occurs due to the brain not receiving enough glucose, while sweating is the body's response to low blood sugar levels. Choice A, hypothermia and seizures, are not typical early signs of hypoglycemia. Hypothermia is a severe condition and seizures usually occur in more advanced stages. Choice B, nausea and diarrhea, are not common early signs of hypoglycemia. They may occur in some cases but are not the primary indicators. Choice C is incomplete, and therefore, cannot be considered a valid option.

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, 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.