A patient with a known history of angina was walking his dog and developed chest pain. The patient immediately stops walking and sits down. He continues to experience chest pain when sitting down. When should he call 911?

Correct Answer: A

Rationale: A patient with a known history of angina who experiences chest pain while walking, which persists even when sitting down, should call 911 immediately. This is indicative of unstable angina, which can progress to a heart attack (myocardial infarction). Given the potential seriousness of the situation, prompt medical attention is warranted to evaluate and manage the condition effectively. It is crucial not to delay in seeking emergency help when experiencing such symptoms, even if the pain might seem to improve temporarily or persist at a certain level.

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: A

Rationale: Insulin glargine is a type of long-acting insulin that is given via subcutaneous injection. Subcutaneous administration involves injecting the medication into the fatty tissue layer just beneath the skin. This route allows for slow and consistent absorption of the insulin into the bloodstream, providing a prolonged effect on lowering blood sugar levels. Insulin cannot be taken orally because it would be broken down by the digestive system before it could be effective. Intravenous (IV) administration is also not appropriate for insulin glargine because it is meant to have a slow, sustained release in the body, which cannot be achieved with IV administration. Sublingual administration, where a medication is placed under the tongue for absorption, is not suitable for insulin as it requires specific pathways for absorption that are not present under the tongue.

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: B

Rationale: Omeprazole, a proton pump inhibitor (PPI), is most effective when taken 30 minutes before meals. This allows the medication to inhibit proton pumps during meal-stimulated acid production. Taking it after (A) or with meals (C) reduces its effectiveness. While it can be taken without regard to meals (D), taking it before meals is optimal.