Endocrine Nursing

Why C is the answer

The posterior lobe makes nothing. Both hormones are built in the hypothalamus, travel down nerve fibers and wait there until a signal releases them. Calling it a factory misplaces the organ that actually fails.

Why the other options are not the answer

• A — "Its two hormones travel down nerve fibers and sit stored inside it until they are released": Accurate: they are carried along axons and stored there.
• B — "Its antidiuretic hormone starts in the supraoptic nuclei and its oxytocin in the paraventricular nuclei": Accurate: those are the two nuclei that build them.
• D — "The anterior lobe, unlike this one, does not store the hormones that it produces": The contrast is correct, though the anterior lobe is the unusual one: it releases what it makes without a store.

Why C is correct

In diabetic ketoacidosis serum potassium often appears normal or high despite a large total-body deficit, and starting insulin drives potassium into cells, so the level can drop precipitously and must be monitored and replaced as it falls.

Why the other options are wrong

• A — Withhold insulin until potassium falls below normal: The danger is hypokalemia after treatment begins, not before, and insulin is needed to reverse the acidosis.
• B — High-normal potassium means total body potassium is excessive: The high-normal level reflects a shift out of cells during acidosis, not true total-body excess, since total-body potassium is actually depleted.
• D — Potassium replacement should begin after acidosis fully resolves: Waiting for full resolution delays replacement past the point where insulin has already begun driving potassium into cells, risking dangerous hypokalemia.

Why C is correct

After a treated low, she stays at higher risk of another low for about the next 24 hours, so the nurse watches her closely. A low, or hypoglycemia, is a blood sugar that is too low.

Why the other options are wrong

• A — "A high sugar from the juice she was given": A high sugar is not the main risk, since her reading is back in range.
• B — "A falling potassium level": A treated low does not put her potassium at risk.
• D — "Lasting confusion from the low": Lasting harm is not expected after a low treated quickly. Brain injury is a serious risk of a low left untreated, but hers was treated early and she is now eating.

Why A is correct

Calcitonin acts on the bone-dissolving cell, so the skeleton releases less calcium and more of it leaves in the urine. That brings the level down faster than anything else here, so it runs alongside the fluids rather than in place of them. Its effect is brisk but short.

Why the other options are wrong

• B — "It cancels the parathyroid hormone already in his blood, so it stops acting on his bones": Calcitonin is the counterweight to parathyroid hormone, but it works on the bone cell rather than by cancelling the hormone.
• C — "It blocks the calcium in his meals from being taken up, so less of it reaches his blood": His trouble is calcium leaving his own skeleton, and a meal-by-meal block is far too slow.
• D — "It hardens the bone against further calcium loss over the weeks ahead while the fluids continue": That describes the slow bone agents. This injection is chosen because it acts within hours.

Why D is the answer

Her round face and bruising are prednisone effects, not worsening lupus, which is well controlled. The nurse explains these cushingoid changes, the round face and body changes caused by too much steroid medicine, as drug effects to watch and report.

Why the other options are not the answer

• A — "The goal is the lowest dose that still controls her lupus": This is accurate. The lowest dose that controls the disease limits these side effects.
• B — "Her dose will be lowered slowly rather than stopped at once": This is accurate too. Stopping a drug that causes these changes is a reasonable aim, but after months of use it comes down step by step.
• C — "She should report new swelling, bone pain or sores that do not heal": This is also accurate. These are steroid side effects to report.