Nursing Elites

1. When evaluating the success of adding raltegravir to the drug regimen of a 42-year-old female patient with HIV, which laboratory value should the nurse prioritize?

• A. The patient's C-reactive protein levels
• B. The patient's erythrocyte sedimentation rate (ESR)
• C. The patient's viral load
• D. The patient's CD4 count

Correct answer: C

Rationale: The correct answer is C: The patient's viral load. In HIV management, monitoring the viral load is crucial to assess the effectiveness of antiretroviral therapy. A decrease in viral load indicates the treatment's success in controlling the HIV infection. Choices A, B, and D are less relevant in this context. C-reactive protein levels and erythrocyte sedimentation rate are markers of inflammation and non-specific indicators of infection, not specifically for HIV. CD4 count is important but not as immediate for evaluating the response to the newly added medication compared to monitoring the viral load.

2. Helicobacter pylori (H. pylori) often causes which of the following?

• A. Colon cancer
• B. Hiatal hernia
• C. Peptic ulcer disease
• D. Esophageal varices

Correct answer: C

Rationale: Helicobacter pylori is a bacterium known to cause peptic ulcer disease by weakening the protective lining of the stomach and duodenum, leading to inflammation and ulcers. While chronic H. pylori infection is a risk factor for stomach cancer, it is not directly linked to colon cancer (Choice A), hiatal hernia (Choice B), or esophageal varices (Choice D). Therefore, the correct answer is C.

3. On the advice of his brother, a 53-year-old man has made an appointment to request a prescription for Viagra. The nurse who works at the clinic is reviewing the man's medical history and would recognize what health problem as being prohibitive to this treatment?

• A. Type 2 diabetes, treated with metformin
• B. Hypercholesterolemia, treated with simvastatin
• C. Angina, treated with nitroglycerin
• D. Hypertension, treated with metoprolol

Correct answer: C

Rationale: Nitroglycerin is contraindicated with Viagra due to their combined effects on lowering blood pressure, which can result in a severe drop and potentially life-threatening complications. Using both medications together can lead to hypotension, putting the patient at risk. Therefore, the presence of angina treated with nitroglycerin would make prescribing Viagra unsafe. Choices A, B, and D are not directly contraindicated with Viagra and can be managed concurrently with this treatment.

4. A patient is receiving finasteride (Proscar) for the treatment of benign prostatic hyperplasia. Which of the following is an expected outcome of the medication?

• A. Decrease in the size of the prostate gland.
• B. Improved urinary flow and decreased symptoms of urinary retention.
• C. Increased production of prostate-specific antigen (PSA).
• D. Reduction in the number of nocturnal awakenings.

Correct answer: B

Rationale: The correct answer is B. Finasteride (Proscar) is used in the treatment of benign prostatic hyperplasia to improve urinary flow and decrease symptoms of urinary retention by reducing the size of the prostate gland. Choice A is incorrect because although finasteride may reduce the size of the prostate gland, the expected outcome relevant to the patient's symptoms is improved urinary flow rather than a specific change in gland size. Choice C is incorrect because finasteride actually decreases the production of prostate-specific antigen (PSA) due to its mechanism of action. Choice D is incorrect because although improved urinary flow may lead to a reduction in nocturnal awakenings, the main expected outcome of finasteride treatment is related to urinary symptoms.

5. A client is admitted with a suspected aortic dissection. What is the priority nursing intervention?

• A. Administer antihypertensive medications as prescribed.
• B. Prepare the client for emergency surgery.
• C. Administer intravenous fluids to maintain blood pressure.
• D. Monitor the client's urine output closely.

Correct answer: B

Rationale: The correct answer is B: Prepare the client for emergency surgery. Aortic dissection is a life-threatening emergency that often necessitates immediate surgical intervention to prevent rupture and further complications. Administering antihypertensive medications (choice A) may be necessary but is not the priority over surgical intervention. While maintaining blood pressure with intravenous fluids (choice C) is important, the urgent need for surgery takes precedence. Monitoring urine output (choice D) is essential for assessing renal function but is not the priority in this critical situation.

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