Nursing Elites

1. 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.

2. When arterial blood pressure declines, the kidneys secrete a hormone to increase blood pressure and peripheral resistance. What is this hormone called?

• A. Renin
• B. Antidiuretic hormone
• C. Atrial natriuretic
• D. Insulin

Correct answer: A

Rationale: Renin is the correct answer. When arterial blood pressure decreases, the kidneys release renin, which triggers a series of reactions ultimately leading to an increase in blood pressure and peripheral resistance. Antidiuretic hormone (choice B) is involved in water retention, atrial natriuretic hormone (choice C) promotes sodium excretion and lowers blood pressure, and insulin (choice D) regulates glucose metabolism, not blood pressure.

3. A patient with an 18 pack per year history presents to a family practice clinic complaining of painless hoarseness and inability to clear mucus. A biopsy of respiratory tract cells is taken and shows that these cells have been replaced by less mature squamous epithelium cells. The nurse knows this type of change is referred to as:

• A. Dysplasia
• B. Metaplasia
• C. Hyperplasia
• D. Coagulation

Correct answer: B

Rationale: Metaplasia is the replacement of one type of cell with another, which can occur in response to chronic irritation, such as from smoking. In this case, the respiratory tract cells being replaced by less mature squamous epithelium cells indicate metaplasia. Dysplasia refers to abnormal development or growth of cells, not replacement; hyperplasia is an increase in the number of cells, not a replacement; and coagulation is a process related to blood clotting, not cell replacement.

4. A patient is starting on atorvastatin (Lipitor) for hyperlipidemia. What important instruction should the nurse provide?

• A. Take the medication at night to reduce the risk of muscle pain.
• B. Avoid consuming grapefruit juice while taking this medication.
• C. Take the medication in the morning with breakfast.
• D. Avoid taking the medication with alcohol to reduce the risk of liver damage.

Correct answer: A

Rationale: The correct answer is A. Atorvastatin should be taken at night to reduce the risk of muscle pain and other side effects. Taking it at night aligns with the body's natural rhythm of cholesterol production, optimizing its effectiveness. Choice B is incorrect because grapefruit juice can increase the risk of side effects by affecting the metabolism of atorvastatin. Choice C is incorrect as taking atorvastatin in the morning does not maximize its effectiveness. Choice D is incorrect because alcohol consumption can increase the risk of liver damage when combined with atorvastatin.

5. A patient is diagnosed with type 2 diabetes mellitus. Which of the following is a common initial treatment strategy?

• A. Insulin therapy
• B. Lifestyle modification and metformin
• C. Sulfonylureas
• D. Thiazolidinediones

Correct answer: B

Rationale: The correct answer is B: Lifestyle modification and metformin. When managing type 2 diabetes mellitus, initial treatment often involves lifestyle changes such as adopting a healthy diet and increasing physical activity, along with the oral medication metformin. Insulin therapy (choice A) is usually reserved for cases where lifestyle changes and oral medications are not sufficient to control blood sugar levels. Sulfonylureas (choice C) and thiazolidinediones (choice D) are also oral medications used in diabetes management, but they are not typically recommended as first-line treatments due to various side effects and considerations in type 2 diabetes management.

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