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What is the major effect of filgrastim (Neupogen) in a patient with chronic renal failure?
- A. Decreases neutropenia related to chemotherapy
- B. Decreases white blood cells related to infection
- C. Decreases growth of blood vessels due to ischemia
- D. Decreases platelet count related to bleeding
Correct Answer: A
Rationale: The major effect of filgrastim (Neupogen) is to stimulate the production of neutrophils, thereby decreasing neutropenia in patients undergoing chemotherapy. This medication helps the bone marrow produce more white blood cells, specifically neutrophils, to reduce the risk of infections associated with low neutrophil counts. Choices B, C, and D are incorrect because filgrastim does not decrease white blood cells related to infection, growth of blood vessels, or platelet count related to bleeding.
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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.
What does a client's symptoms of headache, vomiting, blurred vision, and loss of consciousness following a concussion indicate?
- A. Increased intracranial pressure
- B. Lower extremity compartment syndrome
- C. Consuming too much food at once
- D. Improved kidney function
Correct Answer: A
Rationale: The symptoms of headache, vomiting, blurred vision, and loss of consciousness following a concussion are indicative of increased intracranial pressure. These symptoms suggest a serious condition that can occur after head trauma, requiring immediate medical attention. Lower extremity compartment syndrome presents with symptoms related to pressure build-up in the muscles of the legs, not the head. Consuming too much food at once does not manifest with these neurological symptoms. Improved kidney function would not present with symptoms such as headache, vomiting, blurred vision, and loss of consciousness.
What best describes sepsis?
- A. An overwhelming allergic reaction
- B. Severe inflammatory response to a pathogen's endotoxins
- C. Unknown causes resulting in hypertension
- D. Poor nursing and health care provider interventions
Correct Answer: B
Rationale: The correct answer is B. Sepsis is a severe inflammatory response to a pathogen's endotoxins, leading to widespread infection and organ dysfunction. Choice A is incorrect as sepsis is not primarily an allergic reaction. Choice C is incorrect as sepsis is not characterized by unknown causes resulting in hypertension. Choice D is incorrect as sepsis is a medical condition and not solely caused by poor nursing or healthcare provider interventions.
When administering azoles in the home setting, the home health nurse should prioritize educational interventions that address what nursing diagnosis?
- A. Risk for injury related to antifungal therapy
- B. Risk for acute confusion related to antifungal therapy
- C. Risk for infection related to antifungal therapy
- D. Risk for falls related to antifungal therapy
Correct Answer: A
Rationale: The correct answer is A: Risk for injury related to antifungal therapy. When administering azoles, the priority is to educate patients and caregivers about potential side effects that could lead to injury, such as hepatotoxicity or allergic reactions. Choices B, C, and D are incorrect because acute confusion, infection, and falls are not typically associated with azole therapy.
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.