Nursing Elites

1. A group of prison inmates developed tuberculosis following exposure to an infected inmate. On examination, tissues were soft and granular (like clumped cheese). Which of the following is the most likely cause?

• A. Coagulative necrosis
• B. Liquefactive necrosis
• C. Caseous necrosis
• D. Autonecrosis

Correct answer: C

Rationale: The correct answer is C. Caseous necrosis is characteristic of tuberculosis, where the tissue has a soft, cheese-like appearance. Coagulative necrosis involves protein denaturation, liquefactive necrosis is seen in brain infarcts and abscesses, and autonecrosis is not a recognized term in pathology, making them incorrect choices in this scenario.

2. 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.

3. A male patient is receiving androgen therapy for hypogonadism. What adverse effect should the nurse monitor for during this therapy?

• A. Increased risk of bone fractures
• B. Increased risk of cardiovascular events
• C. Increased risk of liver dysfunction
• D. Increased risk of prostate cancer

Correct answer: B

Rationale: The correct answer is B: Increased risk of cardiovascular events. Androgen therapy can lead to an increased risk of cardiovascular events like heart attacks and strokes, especially in older patients. Monitoring for signs and symptoms of cardiovascular issues is essential during this therapy. Choices A, C, and D are incorrect because androgen therapy is not typically associated with an increased risk of bone fractures, liver dysfunction, or prostate cancer.

4. What should a nurse include in patient teaching for a patient prescribed medroxyprogesterone acetate (Provera) for endometriosis?

• A. Medroxyprogesterone should be taken at the same time each day to maintain consistent hormone levels and effectiveness in treating endometriosis.
• B. Medroxyprogesterone can be taken with food to reduce gastrointestinal upset.
• C. Medroxyprogesterone should be discontinued if side effects occur.
• D. Medroxyprogesterone should be taken once a week to maintain effectiveness.

Correct answer: A

Rationale: When teaching a patient prescribed medroxyprogesterone acetate (Provera) for endometriosis, the nurse should emphasize the importance of taking the medication at the same time each day. This helps maintain consistent hormone levels and ensures the effectiveness of the treatment. Option A is correct because it addresses this key point. Option B is incorrect because medroxyprogesterone should be taken consistently but not necessarily with food. Option C is incorrect because discontinuing the medication without consulting a healthcare provider is not advisable. Option D is incorrect as medroxyprogesterone is usually taken daily, not weekly, for the treatment of endometriosis.

5. A client has been admitted to the hospital with symptoms of Guillain-Barré syndrome. Which aspect of the client's condition would require priority monitoring?

• A. Monitoring oxygen saturation levels
• B. Monitoring for signs of respiratory compromise
• C. Monitoring for changes in consciousness
• D. Monitoring blood pressure closely

Correct answer: B

Rationale: In Guillain-Barré syndrome, respiratory muscle weakness can lead to respiratory compromise, making it crucial to prioritize monitoring for signs of respiratory distress. Monitoring oxygen saturation levels is important but is secondary to assessing for respiratory compromise in this condition. Changes in consciousness and monitoring blood pressure closely are not typically the priority in Guillain-Barré syndrome.

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