Question

1.An older adult is reporting increasing fatigue and dark stools. On assessment, you note pale mucous membranes, low hemoglobin and red cell counts, and upper gastrointestional bleed in the stomach via endoscopy. Questioning reveals excess nonsteroidal anti-inflammatory drug (NSAID) usage to control rheumatoid arthritis pain. Which phenomenon is responsible for the present health problems?

	A.	NSAIDs increase the gastric production of gastrin, increasing gastric secretions and lowering stomach pH.
	B.	Drugs such as NSAIDs increase the H+ levels and thus decrease gastric pH, resulting in insult to the stomach lining.
	C.	NSAIDs, aspirin, and other drugs increase prostaglandin synthesis, resulting in disruption of cellular structures lining the stomach.
	D.	NSAIDs can disrupt the permeability of the gastric mucosa, causing hydrogen ions to accumulate in the mucosal cells of the lining.

2.Since steroid hormones are bound to protein carriers for transport, this means:

	A.	they are water-soluble and circulate freely in the blood.
	B.	they are degraded by enzymes in the blood.
	C.	they are inactive in the bound state.
	D.	they will be converted into a useable form by enzymes in the blood.

3.During a thyroid crisis, which medication may increase dissociation of free hormone from the binding proteins, resulting in a worsening effect on the client?

	A.	Lisinipril, an ACE-inhibitor
	B.	Atorvastatin, a statin drug
	C.	Acetylsalicylic acid, a nonsteroidal anti-inflammatory drug (NSAID)
	D.	Glucophage, a biguanide

4.During the follicular stage of menstruation, increased estradiol production causes an increase in FSH production. This increase in FSH production by the anterior pituitary gland will have what effect on the follicle?

	A.	Continued growth of the follicle until it can no longer stay in its membrane.
	B.	The follicle will die, which results in a fall of FSH.
	C.	The follicle will continue to grow and produce estradiol.
	D.	The follicle will secrete additional hormones to attract swimming sperm.

Answer 1

2.option A. Is incorrect because steroids are fat soluble. They are not water soluble and they cannot travel in blood which is water based wothout binding to a transport protein.

Option B. Is incorrect because they are not degraded by enzymes in the blood.

Option C: is correct because the steroids are inactive in bound state. They exerts their effect only after dissociation.

Option D:is incorrect because they are not converted to usable form in blood.

So, option C is correct.