When teaching a young woman about the use of hormonal contraceptives, a nurse should emphasize that these drugs are most effective when taken:
- A. Immediately after sexual intercourse.
- B. At the same time each day.
- C. Before going to bed at night.
- D. On an empty stomach.
Correct Answer: B
Rationale: The correct answer is B: 'At the same time each day.' Hormonal contraceptives should be taken consistently at the same time each day to maintain stable hormone levels, which is crucial for their effectiveness. Taking them at random times can increase the risk of contraceptive failure. Choices A, C, and D are incorrect because taking hormonal contraceptives immediately after sexual intercourse, before going to bed at night, or on an empty stomach does not align with the recommended usage instructions for these drugs.
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Which of the following accurately describes the pathophysiology of asthma?
- A. Chronic inflammation of the bronchial lining
- B. Narrowing of the airway due to bronchoconstriction
- C. Damage to alveoli reducing lung elasticity
- D. Overproduction of mucus by the goblet cells
Correct Answer: B
Rationale: The correct answer is B: "Narrowing of the airway due to bronchoconstriction." In asthma, there is an inflammatory response that leads to bronchoconstriction, causing the airways to narrow and making it difficult to breathe. Choice A is incorrect as chronic inflammation is a feature of asthma but not the primary pathophysiological mechanism. Choice C is incorrect as damage to alveoli is more characteristic of conditions like emphysema. Choice D is incorrect as overproduction of mucus is a feature of chronic bronchitis, not asthma.
A patient has been diagnosed with chronic renal failure. Which of the following agents will assist in raising the patient's hemoglobin levels?
- A. Epoetin alfa (Epogen, Procrit)
- B. Pentoxifylline (Pentoxil)
- C. Estazolam (ProSom)
- D. Dextromethorphan hydrobromide
Correct Answer: A
Rationale: The correct answer is A: Epoetin alfa (Epogen, Procrit). Epoetin alfa is a synthetic form of erythropoietin that stimulates red blood cell production and is commonly used to treat anemia in patients with chronic renal failure. By increasing red blood cell production, epoetin alfa helps raise hemoglobin levels in these patients. Pentoxifylline (Choice B) is not indicated for raising hemoglobin levels in chronic renal failure patients; it is a peripheral vasodilator used to improve blood flow. Estazolam (Choice C) is a benzodiazepine used for treating insomnia and has no role in raising hemoglobin levels. Dextromethorphan hydrobromide (Choice D) is a cough suppressant and is not used to raise hemoglobin levels in patients with chronic renal failure.
A client on an acute medicine unit of a hospital with a diagnosis of small bowel obstruction is reporting intense, diffuse pain in her abdomen. Which physiologic phenomenon is most likely contributing to her complaint?
- A. Somatic pain resulting from pressure on the parietal peritoneum
- B. Referred pain from her small bowel
- C. Visceral pain resulting from distension and ischemia
- D. Neuropathic pain resulting from autonomic dysfunction
Correct Answer: C
Rationale: Visceral pain is associated with distension, ischemia, and inflammation of internal organs. In the case of a small bowel obstruction, the intense, diffuse pain reported by the client is likely due to the distension and ischemia of the small bowel. Somatic pain (Choice A) would be more localized and sharp, typically arising from the parietal peritoneum. Referred pain (Choice B) is pain perceived at a site distant from the actual pathology. Neuropathic pain (Choice D) involves dysfunction or damage to the nervous system and is not typically associated with the described physiologic phenomenon of distension and ischemia in the context of a small bowel obstruction.
A nurse is providing care for a 44-year-old male client who is admitted with a diagnosis of fever of unknown origin (FUO). Which characteristic of the client's history is most likely to have a bearing on his current diagnosis?
- A. The client is a smoker.
- B. The client has a history of IV drug use.
- C. The client was treated for an STD 2 years ago.
- D. The client has a family history of cardiac disease.
Correct Answer: B
Rationale: A history of IV drug use is significant in cases of fever of unknown origin, as it increases the risk of infections like endocarditis, which can present with persistent fever. Smoking (Choice A) is not directly linked to FUO. While a history of STD treatment (Choice C) may be relevant, it is less likely to be associated with FUO compared to IV drug use. Family history of cardiac disease (Choice D) is not typically a primary factor in the diagnosis of FUO.
Although stress exposure initiates integrated responses by multiple systems, which system first activates the most important changes?
- A. Pulmonary
- B. Gastrointestinal
- C. Neuroendocrine
- D. Cardiovascular
Correct Answer: C
Rationale: The correct answer is C, the Neuroendocrine system. When the body is exposed to stress, the neuroendocrine system plays a crucial role in initiating the body's response. This system, particularly through the hypothalamic-pituitary-adrenal axis, triggers a cascade of physiological responses to stress. Choices A, B, and D are incorrect because while other systems like the cardiovascular and gastrointestinal systems also respond to stress, the neuroendocrine system is primarily responsible for the initial and significant changes in the body's stress response.