pharm hesi v1 315 What hormone stimulates the release of the follicle -stimulating hormone (FSH) from both male and female glands? A)Growth hormone -releasing hormone (GHRH) B)Thyrotropin -releasing hormone (TRH) C)Gonadotropin -releasing hormone (GnRH) D)Prolactin -releasing hormone (PRH) - correct answer c The male and female glands respond to luteinizing hormone (LH) and FSH, which are released from the anterior pituitary in response to stimulation from GnRH that is released from the hypothalamus. GHRH stimulates the release of the growth hormone, which tar gets cell growth. TRH stimulates the thyroid -
stimulating hormone, which targets the thyroid gland. PRH stimulates the release of prolactin, which is necessary for milk production. A nurse is providing patient education to a patient as part of her work in a fertility clinic. The nurse explains possible reasons for infertility. When explaining how the ovaries are involved in conception, what will the nurse stress? A)Ova quickly degenerate and most are absorbed in the body before the age of 12. B)The ovaries at birth contain all of the ova that a woman will have. C)Ova aggregate, causing millions to be contained in a storage site called a follicle. D)Follicles produce only estrogen; the uterus produces progesterone. - correct answer b It would be important to explain that the woman's ova do not increase or decrease from birth to childbearing years. The nurse will stress that all the ova that a woman will have will be present at birth. The patient should understand that if she does not o vulate 1 month or for several months, it is not because she has done something to her body to cause this. Ova slowly degenerate over a lifetime or they are released once a month until menopause is complete. Each ovum is contained in a storage site called a follicle, which produces the female sex hormones, estrogen and progesterone. The nursing instructor is discussing the physiology of pregnancy with her clinical group. What hormone, produced during pregnancy, would the instructor tell the students helps to maintain the pregnancy until birth of the fetus? A)High levels of estrogen only B)High levels of estrogen, low levels of progesterone C)Low levels of estrogen, high levels of progesterone D)High levels of estrogen and progesterone - correct answer D Feedback: In a pregnant woman, both estrogen and progesterone hormones have specific functions. High levels of both hormones are needed for the maintenance of pregnancy. The nursing instructor is talking with her class of students about the female reproductive system. A student is trying to understand the role of progesterone in the body. What nonreproductive affect does progesterone have on the body? A)Decreased body temperature B)Decreased appetite C)Anti -insulinD)Increased uterine motility - correct answer C Feedback: Progesterone has an anti -insulin effect to generate a higher blood glucose concentration to allow for rapid diffusion of glucose to the developing embryo. Body temperature and appetite are increased by progesterone. Uterine motility is decreased to provide increased chance that implantation can occur. What hormone causes ovulation to occur? A)Adrenocorticotropic hormone (ACTH) B)Luteinizing hormone (LH) C)Prolactin D)Follicle -stimulating hormone (FSH) - correct answer B Feedback: When the circulating estrogen level rises high enough, it stimulates a massive release of LH from the anterior pituitary causing one of the developing follicles to burst and release the ovum with its stored hormones into the system. ACTH targets the adrena l corticosteroid hormone, which helps prepare the body for the "fight or flight" response. Prolactin is responsible for milk production and FSH in combination with LH stimulate follicles on the outer surface of the uterus to grow and develop and also stimu lates the release of estrogen and progesterone. A 16 -year -old girl comes to the clinic complaining of severe menstrual cramps. The girl is concerned about the pain and worried that "something is wrong." The nurse explains to the patient that she has cramping during her menstrual period because of what? A)An increase in the levels of estrogen and progesterone, which cause uterine contractions B)Low levels of plasminogen in the uterus that cause the shedding of the lining of the uterus C)Prostaglandins in the uterus, which stimulate uterine contractions to clamp off vessels as the lining of her uterus sheds D)An increase in progesterone and a decrease of estrogen cause the lining of the uterus to slough away - correct answer C Feedback: Prostaglandins in the uterus stimulate uterine contractions to clamp off vessels in the lining of the uterus, which is the cause of the cramping. The decrease of estrogen and progesterone after the involution of the corpus luteum triggers the release of fo llicle - stimulating hormone (FSH) and luteinizing hormone (LH). The decreased levels of FSH and LH cause the inner lining of the uterus to slough off because the vascular system is no longer being stimulated. High, not low, levels of plasminogen in the uterus prevent clotting of the lining as the vessels shear off. What drug would the nurse expect to administer if beta -specific adrenergic agonist effects are desired to prevent bronchospasm during anesthesia? A)Dobutamine (Dobutrex) B)Ephedrine (generic) C)Isoproterenol (Isuprel) D)Phenylephrine (Neo -
Synephrine) - correct answer C Isoproterenol is a beta -specific adrenergic agonist used to prevent bronchospasm during anesthesia. Phenylephrine is an alpha -specific adrenergic agonist. Both dobutamine and ephedrine are alpha - and beta -adrenergic agonists. The nurse is preparing discharge teaching for four patients. Which patient should be advised by the nurse that over -the-counter cold and allergy preparations contain phenylephrine and should be avoided? A)A 47 -year -old woman with hypertensionB)A 52 -year -old man with adult onset diabetes C)A 17 -year -old girl with symptoms of an upper respiratory infection D)A 62 -year -old man with gout - correct answer A Feedback: Phenylephrine, a potent vasoconstrictor and alpha1 -agonist with little or no effect on the heart or bronchi, is used in many combination cold and allergy products. Patients with hypertension should avoid these drugs because serious increases in blood press ure could occur. Use of this drug in patients with diabetes and gout are not contraindicated. An upper respiratory infection may be an indication for the drug. The nurse is writing a plan of care for a patient receiving an alpha -specific adrenergic agonist. What should this plan of care include? A)Monitoring the patient for diarrhea B)Monitoring blood pressure and heart rate every 2 to 4 hours C)Assessing skin turgor for dehydration D)Assessing for fatigue and lethargy - correct answer B Sympathetic stimulation will cause hypertension and increased heart rate so it is important these be monitored. Sympathetic stimulation will also result in increased sweating, decreased gastrointestinal activity, and a sense of anxiety and heightened aware ness. Diarrhea, dehydration, fatigue, and lethargy would not be expected. A nurse receives an order for clonidine (Catapres) for a 25 -year -old pregnant woman. What is the nurse's priority action? A)Weigh the patient to obtain correct dose/kg/day. B)Have a second nurse check the dose before administering the drug. C)Consult with the physician about the order. D)Make sure the patient is wearing a fetal monitor. - correct answer Ans:C Feedback: The nurse would consult with the physician to ensure awareness of the pregnancy and desire to administer this drug. There are no adequate studies about use during pregnancy and lactation, so use should be reserved for situations in which the benefit to the mother outweighs any potential risk to the fetus or neonate. The nurse should question the prescriber regarding this order. It would not be necessary to implement the other options. The nursing students are studying sympathomimetic drugs. How do these drugs act on the body? A)Stimulate beta receptors and block alpha - receptors B)Stimulate alpha -receptors and block beta - receptors C)Block adrenergic receptorsD)Stimulate both alpha and beta -receptors - correct answer Ans:D Drugs that are generally sympathomimetic are called alpha -agonists (stimulate alpha - receptors) and beta -agonists (stimulate beta - receptors). These agonists stimulate all of the adrenergic receptors; that is they affect both alpha and beta -receptors. How does ephedrine act on the body? A)Stimulates the release of norepinephrine
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