Nursing Elites

1. A patient is prescribed raloxifene (Evista) for osteoporosis. What is the primary therapeutic action of this medication?

• A. It stimulates the formation of new bone.
• B. It decreases bone resorption and increases bone density.
• C. It increases calcium absorption in the intestines.
• D. It increases the excretion of calcium through the kidneys.

Correct answer: B

Rationale: The correct answer is B. Raloxifene works by decreasing bone resorption and increasing bone density, which helps in the prevention and treatment of osteoporosis. Choice A is incorrect as raloxifene does not directly stimulate the formation of new bone. Choice C is incorrect because raloxifene does not primarily affect calcium absorption in the intestines. Choice D is incorrect as raloxifene does not increase the excretion of calcium through the kidneys.

2. Which of the following is NOT an example of clinical manifestations of leukemia and lymphoma?

• A. Fatigue
• B. Increased risk of bleeding
• C. Increased risk of infections
• D. Increased energy and strength

Correct answer: D

Rationale: The correct answer is D: Increased energy and strength. Leukemia and lymphoma typically present with symptoms such as fatigue, weakness, increased risk of bleeding, and increased risk of infections. Patients with these conditions often experience a lack of energy and strength due to the disease's impact on the body. Therefore, increased energy and strength are not typical manifestations of leukemia and lymphoma.

3. 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.

4. A healthcare professional is assessing a client with suspected myasthenia gravis. Which symptom would the healthcare professional expect to find?

• A. Muscle atrophy
• B. Facial weakness
• C. Ptosis and diplopia
• D. Increased muscle tone

Correct answer: C

Rationale: Ptosis (drooping eyelid) and diplopia (double vision) are classic symptoms of myasthenia gravis. Muscle atrophy (Choice A) is not a typical early manifestation of myasthenia gravis. While facial weakness (Choice B) can occur, it is not as specific as ptosis and diplopia. Increased muscle tone (Choice D) is more indicative of conditions like spasticity, not myasthenia gravis.

5. Which pathophysiologic process causes the decreased glomerular filtration rate in a patient with acute glomerulonephritis?

• A. Decreased renal-induced constriction of the renal arteries
• B. Immune complex deposition, increased capillary permeability, and cellular proliferation
• C. Necrosis of 70% or more of the nephrons secondary to increased kidney interstitial hydrostatic pressure
• D. Scar tissue formation throughout the proximal convoluted tubule secondary to toxin-induced collagen synthesis

Correct answer: B

Rationale: The correct answer is B: Immune complex deposition, increased capillary permeability, and cellular proliferation. In acute glomerulonephritis, immune complexes deposit in the glomerulus, leading to inflammation, increased capillary permeability, and cellular proliferation. These processes collectively reduce the glomerular filtration rate. Choices A, C, and D do not accurately describe the pathophysiologic process in acute glomerulonephritis. Decreased renal-induced constriction of the renal arteries, necrosis of nephrons due to increased kidney interstitial hydrostatic pressure, and scar tissue formation in the proximal convoluted tubule are not the primary mechanisms responsible for the decreased filtration rate in this condition.

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