Nokea
A patient with severe peripheral vascular disease has developed signs of dry gangrene on the great toe of one foot. Which of the following pathophysiologic processes most likely contributed to this diagnosis?
- A. Inappropriate activation of apoptosis
- B. Bacterial invasion
- C. Impaired arterial blood supply
- D. Metaplastic cellular changes
Correct Answer: C
Rationale: The correct answer is C: Impaired arterial blood supply. Dry gangrene is typically caused by impaired arterial blood supply, leading to tissue death without bacterial infection. Choices A, B, and D are incorrect. Inappropriate activation of apoptosis is not a common cause of dry gangrene. Bacterial invasion usually leads to wet gangrene, not dry gangrene. Metaplastic cellular changes are not directly associated with the development of dry gangrene.
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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.
While planning care for an elderly patient, the nurse remembers that increased age is associated with:
- A. Increased T cell function
- B. Increased immune function
- C. Increased production of antibodies
- D. Increased levels of circulating autoantibodies
Correct Answer: D
Rationale: As individuals age, their immune function tends to decrease, making them more susceptible to infections and diseases. Additionally, increased age is associated with higher levels of circulating autoantibodies, which can lead to autoimmune conditions. Choice A is incorrect as aging is not typically associated with increased T cell function. Choice C is also incorrect as aging does not necessarily result in increased production of antibodies. Therefore, the correct answers are B (Decreased immune function) and D (Increased levels of circulating autoantibodies).
A client is brought to the emergency department after a motor vehicle accident in which she suffered a spinal cord injury at the level of C5. Which of the following assessments should be the priority?
- A. Monitoring urinary output
- B. Monitoring heart rate and rhythm
- C. Monitoring respiratory rate
- D. Monitoring the client's pain levels
Correct Answer: B
Rationale: The correct answer is monitoring heart rate and rhythm. With a C5 spinal cord injury, monitoring heart rate and rhythm is crucial as it can impact autonomic regulation. This level of injury can affect cardiac function due to the disruption of sympathetic nerve fibers. Monitoring urinary output may be important to assess for urinary retention, but it is not the priority in this scenario. While monitoring respiratory rate is essential in all patients, in this case, cardiovascular stability takes precedence. Pain management is important but is not the priority when assessing a client with a C5 spinal cord injury.
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.
Which of the following are risk factors for hypertension (HTN)?
- A. High sugar, low-fat diet
- B. Increased physical activity
- C. Tobacco use
- D. Low-fat diet
Correct Answer: C
Rationale: Tobacco use is a well-established risk factor for hypertension (HTN) as it can lead to increased blood pressure. High sugar intake and low-fat diets, as well as increased physical activity, are not directly associated with hypertension. While low-fat diets are generally recommended for overall health, they are not specifically linked to hypertension risk.