50) ANSWER

C) Angiotensin-converting enzyme (ACE) inhibitors

Explanation

Because ACE inhibitors can cause fetal harm or death, they should be discontinued as soon as pregnancy is detected. The effect on breastfeeding infants is unknown. The effect of other medications is unknown during pregnancy. There is only one correct answer to this question. In order to select the correct answer, review the complications of each medication.

49) ANSWER

B. Blood is drawn at baseline, 30 minutes and 60 minutes after ACTH administration

RATIONALE

•First, cortisol and ACTH levels are drawn at baseline. Next, the nurse administers synthetic ACTH, I.V. Finally, cortisol and ACTH levels should be drawn at 30 minutes and 60 minutes after ACTH administration.

•ACTH stimulation test is used to assess the adrenal glands response to stress. This is used to help diagnose or exclude Addison’s disease and adrenal insufficiency.

48) ANSWER

D) Have potentially dangerous side effects.

Explanation

Ethical and legal considerations dictate that clients are knowledgeable of the benefits and risks of the contraceptive method. This empowers the client in making an informed decision. Not all contraceptive methods are invasive or require a surgical procedure. Informed consent is not related to the effectiveness of a method. Key words are "informed consent" and "ensure." Use knowledge of informed consent to determine that the client should be told the potential risks and benefits of contraceptives. The correct answer would be the option that includes information needed by the client to make a decision.

47) ANSWER

C. Hyperlipidemia

RATIONALE

•Gemfibrozil is a fibric acid derivative that is used to lower cholesterol and triglycerides. Fibrates increase lipoprotein breakdown and clearance.

•Gemfibrozil is not used in the treatment of hypertension, atrial fibrillation, or type 2 diabetes.

46) ANSWER

C) Nasal speculum

Explanation

Inspection of the mucosa of the nares for color, moisture, presence of polyps, exudate, and inflammation is performed with the aid of the nasal speculum. The otoscope can be used as a light source (as can a penlight). Recall the meaning of the anatomical term of ‘turbinate’ to know which piece of equipment is necessary.

45) ANSWER

A) "My sperm count should rise after the procedure."

Explanation

Varicoceles raise the scrotal temperature, thus decreasing the number of sperm and the number with normal morphology. Repairing the varicocele does not affect the ability to have or maintain an erection. Critical words are "needs additional teaching" and "varicoceles." Knowledge of varicoceles and the affect on fertility is needed to answer this question. The need for further teaching requires an incorrect response from the client.

44) ANSWER

C) A tall, thin young man who smokes

Explanation

The etiology is not fully understood, but tall, young, thin-chested men who smoke are more prone to developing a spontaneous pneumothorax. Option 1 is more likely to be positive for tuberculosis (TB); option 2 might experience sleep apnea; and option 4 is more likely to experience pulmonary hypertension. Recall that spontaneous pneumothorax occurs in young, tall, thin males.