The renin-angiotensin-aldosterone system plays an important role in maintaining blood pressure. Which compound in this system is most powerful at raising blood pressure?

Correct Answer: B

Rationale: Angiotensin II is the most potent compound in the renin-angiotensin-aldosterone system for raising blood pressure. It acts as a powerful vasoconstrictor, leading to increased systemic vascular resistance. Angiotensin II is formed from angiotensin I through the action of the angiotensin-converting enzyme. While renin initiates the cascade by converting angiotensinogen to angiotensin I, it is angiotensin II that exerts the strongest pressor effect.

Correct Answer: C

Rationale: In the treatment of Parkinson's disease, the goal of pharmacologic therapy is to balance cholinergic and dopaminergic activity in the brain, which is why option C is correct. Dopamine is a neurotransmitter that is deficient in Parkinson's disease, leading to motor symptoms. By aiming to balance cholinergic (acetylcholine) and dopaminergic activity, medications can help alleviate symptoms and improve motor function in patients with Parkinson's disease. Option A, to increase the amount of acetylcholine at the pre-synaptic neurons, is incorrect because Parkinson's disease is primarily characterized by a lack of dopamine, not acetylcholine. Option B, to reduce the amount of dopamine available in the substantia nigra, is also incorrect as the goal is to increase dopamine levels to compensate for the deficiency. Option D, to block dopamine receptors in pre-synaptic and post-synaptic neurons, is not aligned with the treatment approach for Parkinson's disease, which focuses on enhancing dopamine activity rather than blocking it. Educationally, understanding the goals of pharmacologic therapy in Parkinson's disease is crucial for pediatric nurses caring for patients with this condition. By grasping the rationale behind the medications used, nurses can ensure safe administration, monitor for effectiveness, and educate patients and families on the purpose and expected outcomes of treatment. This knowledge enhances the quality of care provided to pediatric patients with Parkinson's disease and contributes to better patient outcomes.

Correct Answer: C

Rationale: Following the administration of Gardasil, the HPV vaccine, routine screening with a PAP test is necessary. While Gardasil protects against certain types of HPV, it does not cover all strains that could lead to cervical cancer. Therefore, individuals who have received the vaccine should still undergo regular PAP tests to screen for cervical abnormalities caused by other HPV strains.

Correct Answer: C

Rationale: In this scenario, option C is the most appropriate statement to include in the teaching plan as it provides crucial information about the fentanyl patch's onset of action. Understanding that it may take about 24 hours for the patient to feel the full effects of the patch is essential for managing pain effectively without becoming discouraged by immediate results. Option A is incorrect as fentanyl patches are typically worn for 72 hours before being changed, not daily. Changing the patch more frequently could lead to overdose. Option B is incorrect because fentanyl, being a potent opioid, does have the potential to cause respiratory depression, especially if used improperly or in high doses. It is crucial for patients to be aware of this risk. Option D is incorrect as using a heating pad with a fentanyl patch can increase the absorption rate of the medication, leading to potential overdose and adverse effects. It is important to educate patients to avoid heat sources with fentanyl patches. Educationally, this question emphasizes the importance of accurate patient education regarding pain management medications, including dosing, onset of action, potential side effects, and proper use to ensure safe and effective pain control in pediatric oncology patients.

Correct Answer: A

Rationale: Glucocorticoids are contraindicated in the treatment of a patient with systemic fungal infection or in patients receiving live vaccines due to their immunosuppressive effects. Glucocorticoids can exacerbate fungal infections by suppressing the immune response. While caution is advised in patients with diabetes mellitus, myasthenia gravis, and glaucoma, the presence of a systemic fungal infection warrants questioning the use of glucocorticoids to prevent worsening of the fungal infection.