A nurse is caring for a patient with a diagnosis of sepsis who is on a ventilator in the intensive care unit. To reduce the risk of developing a physiologic stress ulcer, the nurse should anticipate an order to administer which medication?

Methylprednisolone

Enoxaparin

Pantoprazole

Ibuprofen

Answer and Explanation

The Correct Answer is C

A.   Methylprednisolone is a corticosteroid used to reduce inflammation and suppress the immune system. While corticosteroids are sometimes used in critical care settings, they are not specifically used to prevent stress ulcers. In fact, corticosteroids can increase the risk of gastrointestinal bleeding and may require additional measures to protect the stomach lining.
B.   Enoxaparin is a low molecular weight heparin (LMWH) used primarily for the prevention of deep vein thrombosis (DVT) and pulmonary embolism (PE). It works as an anticoagulant, preventing blood clots. While enoxaparin is important for preventing thromboembolic events in critically ill patients, it does not specifically address the prevention of stress ulcers.
C.   Pantoprazole is a proton pump inhibitor (PPI) that reduces gastric acid production by inhibiting the proton pumps in the stomach lining. PPIs are commonly used to prevent and treat stress ulcers because they help decrease gastric acid secretion, thereby reducing the risk of ulcer formation and bleeding. This makes pantoprazole the appropriate medication to administer to prevent physiologic stress ulcers in a patient with sepsis on a ventilator.
D.   Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that is used for pain relief and inflammation. NSAIDs can actually increase the risk of gastrointestinal bleeding and ulceration, especially in critically ill patients.

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Correct Answer is C

Explanation

A. Raw vegetables can be challenging for individuals with myasthenia gravis because they require significant chewing and can lead to fatigue of the jaw muscles. Additionally, raw vegetables can be difficult to swallow if there is significant weakness.
B. Granola bars can be hard and require extensive chewing. For a person with myasthenia gravis, the effort needed to chew and swallow these bars can lead to increased fatigue and difficulty managing meals.
C. Macaroni and cheese is a softer food that requires less chewing compared to raw vegetables or granola bars. It can be easier for individuals with myasthenia gravis to manage because it is soft and less likely to cause fatigue. Additionally, it can be enriched with nutrients and is easier to swallow, making it a more appropriate choice for a nutritional plan for someone with MG.
D. Dried fruit is typically tough and chewy, which can be difficult for someone with myasthenia gravis to handle. The chewing effort required can lead to muscle fatigue and discomfort.

A. "It is caused by the overproduction of T3, T4, and calcitonin by the thyroid gland." B. "It is caused by the lack of production of adrenocorticotropic hormone by the pituitary gland." C. "It is caused by the lack of production of thyroid stimulating hormone by the pituitary gland." D. "It is caused by the lack of production of aldosterone by the adrenal gland."

Correct Answer is C

Explanation

A. Secondary hypothyroidism is characterized by insufficient production of thyroid hormones (T3 and T4) due to inadequate stimulation from the pituitary gland, not due to overproduction. Overproduction of thyroid hormones would typically be associated with hyperthyroidism, not hypothyroidism.
B. Adrenocorticotropic hormone (ACTH) stimulates the adrenal glands to produce cortisol. A deficiency in ACTH would lead to adrenal insufficiency or Addison's disease, not secondary hypothyroidism.
Secondary hypothyroidism specifically involves a deficiency in thyroid-stimulating hormone (TSH), not ACTH.
C. Secondary hypothyroidism is caused by inadequate production of thyroid-stimulating hormone (TSH) by the pituitary gland. TSH is necessary for stimulating the thyroid gland to produce thyroid hormones (T3 and T4). When the pituitary gland does not produce enough TSH, the thyroid gland is not adequately stimulated, leading to low levels of thyroid hormones in the blood.
D. Aldosterone is a hormone produced by the adrenal glands that helps regulate sodium and potassium levels, as well as blood pressure. A deficiency in aldosterone is associated with conditions such as
Addison’s disease or primary adrenal insufficiency, not secondary hypothyroidism. Secondary
hypothyroidism specifically relates to issues with TSH production, not aldosterone.

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A nurse is caring for a patient with a diagnosis of sepsis who is on a ventilator in the intensive care unit. To reduce the risk of developing a physiologic stress ulcer, the nurse should anticipate an order to administer which medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has a diagnosis of myasthenia gravis. When creating the nutritional plan of care for the client, which of the following foods would be appropriate to include?

Correct Answer is C

Explanation

A staff nurse is teaching a client who has secondary hypothyroidism about the disease process. The client asks the nurse what causes secondary hypothyroidism. Which of the following responses should the nurse make?

Correct Answer is C

Explanation

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