Nursing Elites

1. A 21-year-old male is being started on zidovudine (AZT) for the treatment of HIV/AIDS. Which of the following statements made by the patient indicates that he has understood the patient teaching?

• A. “AZT inactivates the virus and prevents recurrence of the disease.”
• B. “AZT therapy may result in the development of AZT-resistant strains.”
• C. “AZT slows the progression of the disease but does not cure it.”
• D. “AZT prevents the occurrence of opportunistic infections.”

Correct answer: C

Rationale: The correct answer is C. When the patient states, “AZT slows the progression of the disease but does not cure it,” it shows an understanding that zidovudine (AZT) does not provide a cure for HIV/AIDS but helps in slowing down the progression of the disease. Choice A is incorrect because AZT does not inactivate the virus or prevent recurrence. Choice B is incorrect as AZT resistance can develop with therapy. Choice D is incorrect because while AZT can help prevent opportunistic infections by boosting the immune system, its primary action is not the prevention of opportunistic infections.

2. A school nurse is meeting with a high school student who mentions that she is frustrated with her repeated outbreaks of cold sores. The student states that she tried an over-the-counter topical cream but that it failed to produce an appreciable improvement. The nurse should recognize that this student used what medication?

• A. Ganciclovir
• B. Valacyclovir (Valtrex)
• C. Famciclovir (Famvir)
• D. Docosanol (Abreva)

Correct answer: D

Rationale: The correct answer is D: Docosanol (Abreva). Docosanol is an over-the-counter topical cream commonly used to treat cold sores caused by the herpes simplex virus. It works by inhibiting viral fusion to host cell membranes, reducing the spread of the virus. Ganciclovir (Choice A) is an antiviral medication used for the treatment of cytomegalovirus infections. Valacyclovir (Choice B) and Famciclovir (Choice C) are prescription antiviral medications used to treat herpes simplex virus infections but are not typically available over-the-counter like Docosanol.

3. Multiple sclerosis manifests as asymmetrical and in different parts of the body because:

• A. Autoreactive lymphocytes are causing diffuse patchy damage to the myelin sheath in the central nervous system.
• B. Acetylcholine receptors are destroyed by immunoglobulin G.
• C. Autoreactive T lymphocytes cause progressive loss of neurons in the substantia nigra.
• D. Cortical motor cells degenerate.

Correct answer: A

Rationale: The correct answer is A. Multiple sclerosis is characterized by the immune system attacking the myelin sheath in the central nervous system. This attack leads to patchy damage on the myelin sheath, resulting in asymmetrical neurological symptoms. Choices B, C, and D are incorrect because they do not accurately describe the pathophysiology of multiple sclerosis. In multiple sclerosis, it is the autoreactive lymphocytes that target and damage the myelin sheath, not acetylcholine receptors, T lymphocytes, or cortical motor cells.

4. A nurse is caring for a client with a newly inserted pacemaker. What is the most important nursing action post-procedure?

• A. Monitor the insertion site for signs of infection.
• B. Educate the client about activity restrictions.
• C. Monitor the client's heart rate and rhythm.
• D. Assess the client's lung sounds for signs of fluid overload.

Correct answer: A

Rationale: Post-procedure, monitoring the insertion site for signs of infection is crucial because it helps in early detection of any potential complications such as infection. While educating the client about activity restrictions, monitoring the client's heart rate and rhythm, and assessing lung sounds for signs of fluid overload are important aspects of care, the immediate priority post-procedure is to prevent infection at the insertion site, which could lead to serious complications.

5. Why is testosterone therapy prescribed for a 70-year-old man being treated for osteoporosis?

• A. To increase bone density
• B. To reduce the risk of fractures
• C. To enhance sexual performance
• D. To restore testosterone levels

Correct answer: D

Rationale: The primary reason for prescribing testosterone therapy for osteoporosis in men is to restore testosterone levels, not specifically to increase bone density. Testosterone plays a crucial role in maintaining bone density, so by restoring testosterone levels, it indirectly helps in maintaining bone density. Choices A and B are partially correct but do not address the primary reason for testosterone therapy in this context. Choice C is incorrect as the main focus of testosterone therapy in osteoporosis treatment is not related to enhancing sexual performance.

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