foundations
The organized system of worship, practices, and codes of conduct related to a higher power is known as what?
What is religion?
The personal, universal human experience connecting one to something greater than self is called what?
What is spirituality?
A woman in labor experiences increasing uterine contractions until delivery. Identify the hormone involved and type of feedback loop.
Oxytocin; positive feedback loop terminated by childbirth
The nurse is assessing a patient with Cushing syndrome. Which finding requires the most immediate follow-up?
A. Facial fullness and purple abdominal striae
B. Fasting glucose of 198 mg/dL
C. 3+ pitting edema in the legs
D. Crackles in the lungs and shortness of breath
Answer: D. Crackles in the lungs and shortness of breath
Rationale: Fluid retention and cardiac workload can cause pulmonary edema—priority due to impaired gas exchange. The other findings are typical of Cushing syndrome.
Which condition results from autoantibodies stimulating the TSH receptor, producing excess T3 and T4? and name the hallmark finding for this disease
Graves disease (hyperthyroidism); Exophthalmos
A nurse observes that a patient with terminal cancer expresses anger toward God. What is the best initial response?
A) Offer to pray for them immediately
B) Acknowledge their feelings and listen
C) Tell them anger is normal but temporary
D) Redirect conversation to treatment
B. Acknowledge their feelings and listen.
Which scenario demonstrates cultural humility by the nurse?
A. The nurse assumes a Hispanic family prefers folk remedies.
B. The nurse shares personal beliefs to connect with the patient.
C. The nurse asks open-ended questions about the family’s healing traditions.
D. The nurse corrects misconceptions about Western medicine.
Correct Answer: C
Rationale: Cultural humility emphasizes openness, self-awareness, and respectful curiosity about the patient’s worldview
The nurse reviews labs for a patient with suspected SIADH. Which combination supports this diagnosis?
A. High urine output, high serum sodium, low urine osmolality
B. Low urine output, low serum sodium, high urine osmolality
C. High urine output, low serum sodium, low urine osmolality
D. Low urine output, high serum sodium, high urine osmolality
Answer: B. Low urine output, low serum sodium, high urine osmolality
Rationale: SIADH → water retention → hyponatremia + concentrated urine.
Which pancreatic cells produce insulin, and what do alpha cells secrete?
Beta cells = insulin; Alpha cells = glucagon
A patient presents with coarse hair, constipation, and non-pitting facial edema. Identify the disorder and risk if untreated.
Severe hypothyroidism → myxedema coma (hypoglycemia, hypothermia)
The nurse prepares to care for a patient who refuses pain medication, stating, “Pain is something I must endure to restore balance.” Which nursing action best demonstrates cultural competence?
A. Explain that unrelieved pain delays recovery and insist on analgesics.
B. Document the refusal and offer medication again in four hours.
C. Explore the patient’s belief system to plan acceptable comfort strategies.
D. Ask the family to convince the patient to take the medication.
Correct Answer: C
Rationale: Cultural competence requires integrating the patient’s beliefs into care. Pain expression and management vary by culture; the nurse explores the meaning of pain before intervening
A nurse using the HOPE tool for spiritual assessment asks, “What personal spiritual practices give your life meaning?” Which domain of the tool does this assess?
A. H – Sources of hope
B. O – Organized religion
C. P – Personal spirituality and practices
D. E – Effects on medical care
Correct Answer: C
Rationale: “P” = Personal spirituality and practices, exploring how a patient finds purpose beyond organized religion
Distinguish the key difference between DKA and HHNK.
DKA = ketone acidosis (Type 1); HHNK = no ketones (Type 2) but severe dehydration
A patient asks why exercise is important for managing Type 2 diabetes. Which nurse response is best?
A. “It decreases insulin resistance by helping cells use glucose more effectively.”
B. “It replaces the need for oral diabetic medication.”
C. “It helps your pancreas produce more insulin.”
D. “It prevents the body from storing glucose as glycogen.”
Answer: A. “It decreases insulin resistance by helping cells use glucose more effectively.”
Rationale: Exercise enhances cellular glucose uptake and reduces insulin resistance, improving glycemic control.
A patient with puffy face, dry skin, and coarse hair has TSH ↑, T3/T4 ↓. Name the condition
Primary hypothyroidism (Hashimoto’s)
When using the SPIRIT tool, what does the “R” represent?
What is ritual practices and restrictions?
A nurse plans care for a newly admitted patient who identifies as a Jehovah’s Witness. Which order requires clarification?
A. Administer blood transfusion for hemoglobin 6.8 g/dL.
B. Offer dietary options consistent with patient’s beliefs.
C. Encourage patient to bring personal religious materials.
D. Notify the hospital chaplain of patient’s faith preference.
Correct Answer: A
Rationale: Jehovah’s Witnesses generally decline blood transfusions for spiritual reasons; administering blood violates religious freedom
A nurse is teaching about negative feedback regulation. Which example best demonstrates this mechanism?
A. Oxytocin causing stronger contractions during labor
B. Estrogen surge stimulating the LH peak before ovulation
C. Insulin release decreasing blood glucose after a meal
D. Platelet activation promoting additional clot formation
Answer: C. Insulin release decreasing blood glucose after a meal
Rationale: This reverses the stimulus (high glucose), restoring homeostasis. The others are positive feedback loops.
Darkened skin, dehydration, and low blood pressure occur with what endocrine deficit?
Addison disease — ↓cortisol and ↓aldosterone.
A post-thyroidectomy patient has muscle twitching and tingling around the mouth. Which complication and electrolyte imbalance should the nurse suspect?
Hypocalcemia
The nurse uses the HOPE tool during assessment. Which question addresses the “P” component?
A. “Do you have sources of hope or comfort?”
B. “Are you part of an organized religion?”
C. “What personal spiritual practices give your life meaning?”
D. “How do your beliefs influence medical decisions?”
Correct Answer: C
Rationale: In the HOPE framework, P = personal spirituality and practices; this explores individualized belief systems
What distinguishes spiritual distress from spiritual health? Give one behavioral example of each
Distress = hopelessness/anger (“God abandoned me”); Health = peace/acceptance of meaning.
Differentiate the major insulin-related defect in Type 2 diabetes from Type 1.
Type 2 = insulin resistance; Type 1 = autoimmune β-cell destruction.
A patient with SIADH shows serum Na⁺ 120 mEq/L and concentrated urine. Which nursing action is priority?
Restrict fluids and monitor neuro status (seizure precautions)
Which insulin regimen requires the nurse to ensure the patient eats immediately after administration?
A. NPH insulin
B. Regular insulin
C. Insulin glargine (Lantus)
D. Insulin lispro (Humalog)
Answer: D. Insulin lispro (Humalog)
Rationale: Lispro is rapid-acting (onset < 15 min). Give with food to prevent hypoglycemia.