Nursing Elites

1. Which of the following disorders is more likely associated with blood in stool?

• A. Gastroesophageal reflux
• B. Crohn's disease
• C. Irritable bowel syndrome
• D. Colon cancer

Correct answer: D

Rationale: Colon cancer is more likely associated with blood in stool due to the presence of bleeding from the tumor in the colon. Gastroesophageal reflux (Choice A) typically presents with heartburn and regurgitation but not blood in stool. Crohn's disease (Choice B) can cause gastrointestinal symptoms, but bloody stools are more commonly associated with ulcerative colitis. Irritable bowel syndrome (Choice C) is characterized by abdominal pain, bloating, and changes in bowel habits, but it does not typically cause blood in stool. Therefore, the correct answer is D, Colon cancer.

2. What is the primary cause of primary hypercholesteremia?

• A. High-density lipoprotein (HDL) defects
• B. Monogenic mutations, sedentary lifestyle, and high cholesterol diet
• C. Polygenic mutations and environmental factors
• D. Low-density lipoprotein (LDL) receptor mutation with defects in breakdown

Correct answer: D

Rationale: The correct answer is 'Low-density lipoprotein (LDL) receptor mutation with defects in breakdown.' Primary hypercholesteremia is mainly caused by mutations in the LDL receptor, leading to impaired clearance of LDL cholesterol from the blood. This results in high levels of LDL cholesterol in the bloodstream. Choices A, B, and C are incorrect because they do not directly relate to the primary cause of primary hypercholesteremia.

3. A patient is prescribed sildenafil (Viagra) for erectile dysfunction. What is a key contraindication that the nurse should review with the patient?

• A. History of hypertension
• B. Use of nitrates
• C. Use of antihypertensive medications
• D. History of peptic ulcer disease

Correct answer: B

Rationale: The correct answer is B: 'Use of nitrates.' Sildenafil (Viagra) is contraindicated in patients taking nitrates due to the risk of severe hypotension. Nitrates and sildenafil both act as vasodilators, and their combined use can lead to a dangerous drop in blood pressure. Choices A, C, and D are incorrect because having a history of hypertension, using antihypertensive medications, or having a history of peptic ulcer disease are not key contraindications for sildenafil use.

4. When treating a patient for a fungal infection with IV amphotericin B, what should the nurse consistently monitor the patient's levels of to prevent drug discomfort?

• A. sodium
• B. hemoglobin
• C. calcium
• D. leukocytes

Correct answer: C

Rationale: When a patient is being treated with IV amphotericin B for a fungal infection, it is crucial to monitor the patient's calcium levels consistently. IV amphotericin B can cause hypokalemia, hypomagnesemia, and most notably, hypocalcemia. Monitoring calcium levels helps prevent drug-related discomfort and adverse effects. Sodium (Choice A), hemoglobin (Choice B), and leukocytes (Choice D) are not the primary parameters to monitor specifically for drug discomfort related to amphotericin B. Therefore, they are incorrect choices.

5. A patient with breast cancer is prescribed tamoxifen (Nolvadex). What critical information should the nurse provide during patient education?

• A. Tamoxifen may increase the risk of venous thromboembolism, so patients should be educated about the signs and symptoms of blood clots.
• B. Tamoxifen may decrease the risk of osteoporosis, so adequate calcium intake is important.
• C. Tamoxifen may cause weight gain, so patients should monitor their diet.
• D. Tamoxifen may increase the risk of breast cancer, so regular mammograms are essential.

Correct answer: A

Rationale: When a patient is prescribed tamoxifen, a critical piece of information that the nurse should provide during patient education is that tamoxifen may increase the risk of venous thromboembolism. Therefore, patients should be educated about the signs and symptoms of blood clots and advised to seek immediate medical attention if they occur. Choice B is incorrect because tamoxifen does not decrease the risk of osteoporosis. Choice C is incorrect as weight gain is a possible side effect of tamoxifen, but it is not a critical piece of information compared to the risk of venous thromboembolism. Choice D is incorrect because tamoxifen is actually used to treat breast cancer, not increase its risk.

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