Nursing Elites

1. The nurse is aware that norepinephrine is secreted by which endocrine gland?

• A. The pancreas
• B. The adrenal cortex
• C. The adrenal medulla
• D. The anterior pituitary gland

Correct answer: C

Rationale: The correct answer is C: The adrenal medulla. Norepinephrine is secreted by the adrenal medulla and is involved in the body's 'fight or flight' response. The pancreas (choice A) secretes insulin and glucagon, not norepinephrine. The adrenal cortex (choice B) secretes hormones like cortisol and aldosterone, but not norepinephrine. The anterior pituitary gland (choice D) secretes various hormones like growth hormone and thyroid-stimulating hormone, but not norepinephrine.

2. The nurse administers 2 units of salt-poor albumin to a client with portal hypertension and ascites. The nurse explains to the client that this is administered to:

• A. Provide nutrients
• B. Increase protein stores
• C. Elevate the circulating blood volume
• D. Divert blood flow away from the liver temporarily

Correct answer: C

Rationale: The correct answer is C: Elevate the circulating blood volume. Salt-poor albumin is given to increase the circulating blood volume, which helps reduce ascites by improving fluid distribution within the body. Choices A, B, and D are incorrect because salt-poor albumin is not administered to provide nutrients, increase protein stores, or divert blood flow away from the liver.

3. Listed below are five categories that identify the responsibilities of the practical nurse manager in personnel management. Which of these categories is most appropriate for the task 'Ensure that personnel are utilized in their designated roles'?

• A. Accountability
• B. Personal/professional development
• C. Individual training
• D. Military appearance/physical condition

Correct answer: A

Rationale: The correct answer is 'Accountability'. Accountability in personnel management ensures that individuals are utilized in their designated roles, such as ensuring that soldiers are utilized in their Military Occupational Specialty (MOS). This category focuses on ensuring that personnel are assigned and performing their duties as required. The other choices, personal/professional development, individual training, and military appearance/physical condition, do not directly relate to the specific task of ensuring individuals are utilized in their designated roles.

4. The nurse is caring for clients on a cardiac floor. Which client should the nurse assess first?

• A. The client with three (3) unifocal PVCs in a minute
• B. The client diagnosed with coronary artery disease who wants to ambulate
• C. The client diagnosed with mitral valve prolapse with an audible S3
• D. The client diagnosed with pericarditis who is in normal sinus rhythm

Correct answer: C

Rationale: The correct answer is C because an audible S3 in a client with mitral valve prolapse could indicate heart failure, which requires immediate assessment. Choice A is less urgent as occasional unifocal PVCs are common. Choice B is important but can be addressed after the client with an audible S3. Choice D, a client with pericarditis in normal sinus rhythm, is stable compared to a client with potential heart failure symptoms.

5. Which endocrine disorder would the nurse assess for in the client who has a closed head injury with increased intracranial pressure?

• A. Pheochromocytoma
• B. Diabetes insipidus
• C. Hashimoto's disease
• D. Gynecomastia

Correct answer: B

Rationale: The correct answer is B, Diabetes insipidus. Diabetes insipidus can develop after a head injury due to damage to the hypothalamus or pituitary gland, leading to a deficiency in antidiuretic hormone (ADH). Pheochromocytoma (Choice A) is a tumor of the adrenal gland that causes excessive release of catecholamines, leading to hypertension. Hashimoto's disease (Choice C) is an autoimmune condition affecting the thyroid gland. Gynecomastia (Choice D) refers to the enlargement of breast tissue in males and is not directly related to a closed head injury with increased intracranial pressure.

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