Which of the following cytotoxic drugs is least likely to cause emesis during chemotherapy?

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.

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: 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: Styptics and astringents are hemostatic agents that work by precipitating tissue proteins in the immediate area of a small vessel to stop bleeding. Styptics such as alum, silver nitrate, and ferric subsulfate directly induce coagulation at the site of bleeding, forming a protective scab to stop the flow of blood. Astringents like tannic acid work by tightening the tissue proteins around the blood vessel to create a seal and halt bleeding. These agents are commonly used in the management of minor cuts and wounds to promote hemostasis.

Correct Answer: A

Rationale: ACE (Angiotensin-Converting Enzyme) inhibitors are known to act on the Renin-Angiotensin-Aldosterone System (RAAS) by blocking the conversion of angiotensin I to the active angiotensin II. Angiotensin II is a potent vasoconstrictor and also stimulates the release of aldosterone, leading to increased blood pressure. By inhibiting ACE, ACE inhibitors help to lower blood pressure and reduce the secretion of aldosterone, thereby decreasing the overall vasoconstriction and volume expansion effects of the RAAS. Examples of ACE inhibitors include medications such as lisinopril, enalapril, and captopril.