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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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.
Following a spinal cord injury suffered in a motor vehicle accident, a 22-year-old male has lost fine motor function of his finger and thumb, but is still able to perform gross motor movements of his hand and arm. Which component of his 'white matter' has most likely been damaged?
- A. The inner layer (archilayer)
- B. The middle layer (paleolayer)
- C. The outer layer (neolayer)
- D. The reticular formation
Correct Answer: C
Rationale: The correct answer is C: The outer layer (neolayer). The white matter of the spinal cord consists of three layers: the outer layer (neolayer), the middle layer (paleolayer), and the inner layer (archilayer). Damage to the outer layer (neolayer) is likely to affect fine motor skills, explaining the loss of fine motor function in the finger and thumb while gross motor movements remain intact. Choices A, B, and D are incorrect as they do not correspond to the specific layer of the white matter that is typically associated with fine motor control.
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.
Which of the following might result from severe diarrhea?
- A. Respiratory acidosis
- B. Metabolic alkalosis
- C. Respiratory alkalosis
- D. Metabolic acidosis
Correct Answer: D
Rationale: The correct answer is D: Metabolic acidosis. Severe diarrhea can lead to metabolic acidosis because the loss of bicarbonate ions in the stool results in an overall decrease in the body's bicarbonate levels. Respiratory acidosis (choice A) is caused by retention of carbon dioxide, usually due to inadequate alveolar ventilation. Metabolic alkalosis (choice B) is characterized by elevated pH and bicarbonate levels, usually caused by conditions like vomiting. Respiratory alkalosis (choice C) is a condition of low blood carbon dioxide levels and high pH, often due to hyperventilation.
A 30-year-old woman is taking an oral contraceptive and is concerned about the potential side effects. What should the nurse include in the patient education?
- A. Oral contraceptives can cause weight loss and increased energy levels.
- B. Oral contraceptives can cause increased appetite and weight gain.
- C. Oral contraceptives can cause headaches and breast tenderness.
- D. Oral contraceptives have no side effects.
Correct Answer: C
Rationale: The correct answer is C: 'Oral contraceptives can cause headaches and breast tenderness.' It is essential for the nurse to educate the patient about common side effects of oral contraceptives, such as headaches and breast tenderness. Choices A, B, and D are incorrect. Weight loss and increased energy levels (Choice A) are not common side effects of oral contraceptives. Similarly, increased appetite and weight gain (Choice B) are not typical side effects. Finally, stating that oral contraceptives have no side effects (Choice D) is inaccurate as they can have various side effects, albeit usually mild and manageable.
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