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: Etanercept, a TNF-α inhibitor, works by inhibiting TNF-α signaling , reducing RA inflammation. Substance P depletion , COX inhibition , and chemotaxis inhibition are unrelated. Arachidonic acid prevention (E) isn't its role. This targets a key RA cytokine.

Correct Answer: D

Rationale: Preschoolers (3-5) respond to simple explanations and swift action-e.g., 'This helps you feel better,' then give-matching their short attention and trust needs. Parents often calm, not hinder, cooperation. Play aids understanding, not just verbal. Restraint may be needed if uncooperative-age doesn't rule it out. Brief rationale and quick delivery suit developmental stage, minimizing distress.

Correct Answer: D

Rationale: Of the nonselective alpha-adrenergic blocking agents, only phentolamine is still used today. Metoprolol is a beta1-selective adrenergic blocking agent. Timolol and propranolol are nonselective beta-adrenergic blocking agents. The nurse should understand the indications for phentolamine to ensure safe and effective administration.

Correct Answer: A

Rationale: Rash 3 months after stopping allopurinol suggests contact dermatitis . Allopurinol's hypersensitivity resolves faster. Dermatitis herpetiformis , carcinoma , and telangiectasia (E) don't fit. An external allergen likely caused this delayed presentation.

Correct Answer: B

Rationale: Enteric-coated aspirin reduces GI irritation, an accurate statement for pain management. High doses are for anticoagulation, not pain. Herbs increase bleeding risk, not inflammation relief. Low doses prevent clotting, not inflammation. B enhances safety, making it correct.

Correct Answer: A

Rationale: A side effect of a medication is an unintended or undesired effect that occurs in addition to the desired therapeutic effect. Bloody stools can be a serious side effect of certain medications, indicating potential gastrointestinal bleeding. It is important to monitor for this side effect and report it to a healthcare provider promptly if observed, as it may require immediate medical attention. Changes in stomach pH, thirst, and constipation are also potential side effects of medications, but bloody stools indicate a more severe issue that should be addressed promptly.

Correct Answer: D

Rationale: The best explanation for the prescription of the ACE inhibitor lisinopril for a patient with diabetes who does not have hypertension is that this medication has a protective effect on the kidneys for patients with diabetes. ACE inhibitors like lisinopril have been shown to have renal protective benefits by reducing the progression of diabetic nephropathy, a common complication of diabetes that affects the kidneys. Therefore, even in the absence of hypertension, using an ACE inhibitor like lisinopril can help preserve kidney function in patients with diabetes.

Correct Answer: B

Rationale: Methylphenidate curbs appetite-giving it post-meals and adding snacks offsets weight loss, per practical management. Depression isn't indicated-appetite loss is a known effect. Appetite stimulants aren't standard. Nutritionists help long-term, not acutely. Post-meal dosing balances efficacy and nutrition, per care.

Correct Answer: D

Rationale: Emesis risk depends on chemotherapeutic emetogenicity. Cisplatin, dacarbazine, doxorubicin, and mustine are highly emetogenic, triggering vomiting via chemoreceptor zones. Vincristine, a vinca alkaloid, is least emetogenic, causing neuropathy instead, making it the exception. This lower risk reduces antiemetic needs, easing patient burden during treatment.