A middle-aged male walks into the emergency department ...

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A middle-aged male walks into the emergency department complaining of chest pain radiating to the neck, shortness of breath, and nausea.
 
  His heart rate is 120 and BP is 94/60. The ED physician recognizes the patient is having an acute MI with decreased cardiac output. The nurse identifies the nausea to be in response to
  A)
  the patient not having a very high pain tolerance.
  B)
  hypoxia exerting a direct effect on the chemoreceptor trigger zone.
  C)
  the patient not having digested his meal completely.
  D)
  fear of having to make major lifestyle changes.

Question 2

A dietitian is working with a morbidly obese client in an effort to facilitate weight loss. Which of the dietitian's following teaching points about the nature of adipose tissue should be included in the client education?
 
  A)
  Our ultimate goal is going to be eventually rid your body of adipose tissue or fat.
  B)
  Your fat cells can be considered to be one large energy storage organ that also has a role in hormone production.
  C)
  We ideally would like to maximize your levels of brown fat and minimize those of white fat.
  D)
  Obesity is normally the result of the number of 'pre-fat' cells an individual is born with.

[tjayeee]

Answer to Question 1

Ans:
B

Feedback:

Hypoxia exerts a direct effect on the vomiting center (chemoreceptor trigger zone), producing nausea and vomiting. This direct effect probably accounts for the vomiting that occurs during periods of decreased cardiac output, shock, and environmental hypoxia. We are given no information about the patient's pain tolerance, when he last had a meal, or his routine lifestyle. This patient is going into shock (rapid pulse, low BP) that can result in shunting of blood away from the gut and other organs. During shock, the priority organs for oxygenation include the heart, brain, lungs, and kidneys.

Answer to Question 2

Ans:
B

Feedback:

Fat cells are collectively considered a large body organ that is metabolically active in the uptake, synthesis, storage, and mobilization of lipids, which are the main source of stored fuel for the body; the role of adipose tissue as an endocrine organ has also been recently elucidated. It is neither a desirable nor reasonable goal to entirely rid the body of fat, given the key roles it plays in homeostasis, and brown fat is not common in postnatal life. Preadipocytes have been shown to play a role in obesity, but the condition is still primarily a consequence of energy intake exceeding output.