Nursing Elites

1. A child with a serious fungal infection is receiving amphotericin B parenterally. Which of the following minerals will the patient most likely be required to receive?

• A. Chloride
• B. Magnesium
• C. Glucose
• D. Sodium

Correct answer: B

Rationale: When a patient is receiving amphotericin B, which is known to cause renal toxicity, they are most likely to require magnesium supplementation. Amphotericin B can lead to renal loss of magnesium, potassium, and calcium. Magnesium is an essential mineral that plays a vital role in various physiological functions, and its levels need to be monitored and supplemented when necessary. Chloride, glucose, and sodium are not typically supplemented in the context of amphotericin B therapy for a serious fungal infection.

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. A patient with a history of osteoporosis is prescribed raloxifene (Evista). What is the primary therapeutic effect of this medication?

• A. It stimulates the formation of new bone.
• B. It decreases bone resorption and increases bone density.
• C. It increases calcium absorption in the intestines.
• D. It increases the excretion of calcium through the kidneys.

Correct answer: B

Rationale: The correct answer is B. Raloxifene, such as Evista, works by decreasing bone resorption and increasing bone density. This medication is beneficial in the prevention and treatment of osteoporosis by slowing down the breakdown of bone tissue, thereby reducing the risk of fractures. Choices A, C, and D are incorrect because raloxifene does not directly stimulate the formation of new bone, increase calcium absorption in the intestines, or increase the excretion of calcium through the kidneys.

4. A nurse recalls an example of an immune-complex-mediated disease is:

• A. Bronchial asthma
• B. Contact dermatitis
• C. Serum sickness
• D. Rheumatoid arthritis

Correct answer: C

Rationale: The correct answer is C: Serum sickness. Serum sickness is characterized by the formation of immune complexes in response to certain medications or proteins. These immune complexes can deposit in tissues, leading to inflammation and tissue damage. Bronchial asthma (Choice A) is a chronic inflammatory condition of the airways not primarily mediated by immune complexes. Contact dermatitis (Choice B) is a type IV hypersensitivity reaction mediated by T cells, not immune complexes. Rheumatoid arthritis (Choice D) is an autoimmune disease where antibodies target self-antigens, but it is not primarily mediated by immune complexes.

5. A patient with erectile dysfunction is prescribed sildenafil (Viagra). What condition would contraindicate the use of this medication?

• A. History of hypertension
• B. Use of nitrates
• C. Recent 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 cause vasodilation, and their combined use can lead to a dangerous drop in blood pressure. Choices A, C, and D are incorrect because a history of hypertension, recent use of antihypertensive medications, or a history of peptic ulcer disease are not direct contraindications for using sildenafil.

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