A 48-year-old woman with 2-year history of rheumatoid arthritis has not had sufficient relief with methotrexate alone. Her physician prescribes etanercept to help control her symptoms. How does etanercept work?

Correct Answer: D

Rationale: In this question, the correct answer is D) Inhibition of TNF-α signaling. Etanercept is a TNF-α inhibitor used in the treatment of autoimmune diseases like rheumatoid arthritis. TNF-α is a pro-inflammatory cytokine that plays a key role in the pathogenesis of rheumatoid arthritis by promoting inflammation and joint destruction. By inhibiting TNF-α signaling, etanercept helps to reduce inflammation, relieve symptoms, and slow down disease progression in patients with rheumatoid arthritis. Option A) Depleting substance P is incorrect because substance P is a neurotransmitter involved in pain perception, not in the inflammatory process targeted by etanercept. Option B) Inhibition of COX enzymes is incorrect as COX enzymes are targeted by nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, not by etanercept. Option C) Inhibition of leukocyte chemotaxis is incorrect because this mechanism is not specific to etanercept; it is more commonly associated with drugs like corticosteroids. From an educational context, understanding the mechanism of action of different medications is crucial for healthcare professionals to make informed decisions about treatment options for their patients. Knowing how etanercept works allows healthcare providers to explain the rationale behind its use, anticipate potential side effects, and monitor for therapeutic efficacy in patients with rheumatoid arthritis.

Correct Answer: C

Rationale: Prostate cancer is androgen-dependent, relying on testosterone and other androgens for growth. Estrogen therapy suppresses pituitary secretion of luteinizing hormone, reducing testicular androgen production, effectively starving the cancer. This hormonal manipulation is a standard approach. Choice A inaccurately suggests direct cell death, not estrogen's mechanism. Choice B overstates testosterone elimination; it's reduced, not eradicated. Choice D misattributes nutrient blockade, unrelated to estrogen's action. The nurse's best response (C) clarifies estrogen's role in androgen suppression, addressing the client's confusion with precision and relevance to his treatment.

Correct Answer: B

Rationale: The correct answer is B) Enteric-coated capsules are available to reduce GI side effects. This is the accurate statement concerning the use of aspirin (ASA) to treat pain because aspirin has the potential to cause gastrointestinal irritation and ulcers. Enteric-coated capsules are designed to dissolve in the small intestine rather than the stomach, which can help reduce these GI side effects by minimizing direct contact between the medication and the stomach lining. Option A is incorrect because high doses of aspirin are not primarily used for anticoagulant effects; they may be used for anti-inflammatory and analgesic effects instead. Option C is incorrect because while some herbs like garlic and ginger may have anti-inflammatory properties, there is no established evidence to suggest that increasing their consumption will potentiate the effects of aspirin. Option D is incorrect because low doses of aspirin (81-325 mg) are typically used for its anti-inflammatory effects, but it may not significantly reduce inflammation at the 325 mg dose mentioned in the option. Educationally, it is crucial for healthcare professionals to understand the proper dosing, indications, and potential side effects of medications like aspirin to ensure safe and effective patient care. Understanding the rationale behind using enteric-coated capsules to reduce GI side effects can help in making informed decisions when managing patients with pain who require aspirin therapy.

Correct Answer: C

Rationale: Amitriptyline, a tricyclic antidepressant, has anticholinergic effects, including urinary retention , a medical emergency risking bladder damage or infection, needing immediate intervention. Dry mouth and constipation are common, manageable side effects. Drowsiness is expected with its sedative action. Urinary retention's severity'potential for acute retention'sets it apart, requiring rapid reporting or catheterization. This aligns with amitriptyline's blockade of muscarinic receptors, where bladder dysfunction can escalate fast, making C the finding demanding urgent attention over chronic annoyances.

Correct Answer: D

Rationale: In the context of ATI Pharmacology and the Respiratory System, understanding the differences between beta-1 selective blockers is crucial for safe and effective pharmacological management. The correct answer is D) Metoprolol because it is a selective beta-1 blocker, meaning it primarily targets beta-1 adrenergic receptors in the heart, leading to decreased heart rate and contractility without significantly affecting beta-2 receptors in the lungs. On the other hand, options A) Atenolol, B) Propranolol, and C) Carvedilol are not beta-1 selective blockers. Atenolol (A) is also a beta-1 selective blocker like Metoprolol, but it is not as selective as Metoprolol. Propranolol (B) is a non-selective beta blocker, affecting both beta-1 and beta-2 receptors, potentially causing bronchoconstriction in patients with respiratory conditions. Carvedilol (C) is a non-selective beta blocker with additional alpha-blocking properties, making it unsuitable for patients with respiratory conditions due to its potential to worsen bronchoconstriction. Educationally, this question highlights the importance of medication specificity in managing respiratory and cardiovascular conditions. By understanding the selectivity of beta blockers, healthcare professionals can make informed decisions to optimize patient outcomes and minimize adverse effects, especially in patients with respiratory comorbidities.