A patient has been prescribed mifepristone (RU-486) to terminate a pregnancy. How does this drug achieve its therapeutic effect?
- A. By inhibiting the action of progesterone, which is necessary to maintain pregnancy.
- B. By increasing estrogen levels, which induce uterine contractions.
- C. By altering the uterine lining, preventing implantation.
- D. By stimulating uterine contractions, which expel the embryo.
Correct Answer: A
Rationale: Mifepristone (RU-486) functions by inhibiting the action of progesterone, a hormone crucial for maintaining pregnancy. By blocking progesterone, mifepristone disrupts the uterine environment necessary for pregnancy continuation, ultimately leading to termination. Choice B is incorrect because mifepristone does not increase estrogen levels; instead, it acts on progesterone. Choice C is incorrect as mifepristone's mechanism does not involve altering the uterine lining to prevent implantation. Choice D is incorrect because mifepristone does not directly stimulate uterine contractions; its primary action is through progesterone inhibition.
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Cushing syndrome is characterized by which disorder?
- A. Hypocortisolism
- B. Exophthalmos
- C. Hypercortisolism
- D. Hyperpigmentation
Correct Answer: C
Rationale: Cushing syndrome is characterized by hypercortisolism, which is an excessive amount of cortisol in the body. Choice A, 'Hypocortisolism,' is incorrect as Cushing syndrome is associated with elevated cortisol levels. Choice B, 'Exophthalmos,' refers to bulging eyes and is not a characteristic feature of Cushing syndrome. Hyperpigmentation, as mentioned in choice D, can be present in Cushing syndrome due to increased ACTH levels stimulating melanocytes, but it is not the defining characteristic of the syndrome.
A client with chronic obstructive pulmonary disease (COPD) is admitted to the hospital for pneumonia. Which intervention should the nurse prioritize?
- A. Administer bronchodilators as prescribed.
- B. Monitor oxygen saturation levels continuously.
- C. Administer intravenous antibiotics as prescribed.
- D. Provide respiratory therapy treatments as needed.
Correct Answer: C
Rationale: Administering IV antibiotics is crucial for treating pneumonia in a client with COPD. Pneumonia is an infection of the lungs that requires prompt antibiotic therapy to prevent complications and improve outcomes. While bronchodilators may help with COPD symptoms, in the case of pneumonia, addressing the infection is the priority. Continuous monitoring of oxygen saturation is important, but administering antibiotics to treat the underlying infection takes precedence. Respiratory therapy treatments can be beneficial, but they are not the initial priority when managing pneumonia in a client with COPD.
A patient with a history of venous thromboembolism is prescribed hormone replacement therapy (HRT). What should the nurse discuss with the patient regarding the risks of HRT?
- A. HRT is associated with an increased risk of venous thromboembolism, so the patient should be aware of the signs and symptoms of blood clots.
- B. HRT can decrease the risk of osteoporosis, but the patient should also be aware of the increased risk of venous thromboembolism.
- C. HRT may increase the risk of breast cancer, so the patient should undergo regular breast exams.
- D. HRT can improve mood and energy levels, but it also carries a risk of cardiovascular events.
Correct Answer: A
Rationale: The correct answer is A. Hormone replacement therapy (HRT) is indeed associated with an increased risk of venous thromboembolism. Therefore, patients should be educated about the signs and symptoms of blood clots and advised to seek immediate medical attention if they occur. Choice B is incorrect because although HRT may decrease the risk of osteoporosis, the focus of concern in this case is the increased risk of venous thromboembolism. Choice C is incorrect as it mentions the risk of breast cancer, which is not the primary concern when discussing HRT with a patient with a history of venous thromboembolism. Choice D is also incorrect as it mentions cardiovascular events, which are not the main focus of risk associated with HRT in this scenario.
What is the primary function of the kidneys in acid-base balance?
- A. The kidneys remove hydrogen ions and retain bicarbonate ions.
- B. The kidneys convert ammonia into urea, which is excreted in the urine.
- C. The kidneys produce aldosterone to regulate sodium levels.
- D. The kidneys secrete renin to regulate blood pressure.
Correct Answer: A
Rationale: The correct answer is A. The kidneys are crucial in maintaining acid-base balance by removing hydrogen ions to decrease acidity and retaining bicarbonate ions to increase alkalinity. Choice B is incorrect because the conversion of ammonia into urea is related to nitrogen waste excretion, not acid-base balance. Choice C is incorrect as aldosterone regulates sodium levels, not acid-base balance. Choice D is also incorrect as renin is involved in regulating blood pressure, not acid-base balance.
What property is found in clients with metastatic cancer?
- A. Tumors that are well encapsulated
- B. Tumors with slow, stable growth
- C. Cells that are genetically stable
- D. Cells invading local tissue and overrunning neighboring cells
Correct Answer: D
Rationale: Metastatic cancer is characterized by cells that invade local tissue and overrun neighboring cells. Therefore, the correct answer is D. Choices A, B, and C are incorrect because metastatic cancer is associated with aggressive behavior where cells invade and spread to other parts of the body, rather than being well encapsulated, growing slowly, or being genetically stable.