Nursing Elites

1. A male patient with benign prostatic hyperplasia (BPH) is prescribed finasteride (Proscar). What is the expected therapeutic effect of this medication?

• A. Decreased urinary frequency and urgency
• B. Decreased blood pressure
• C. Increased urinary output
• D. Increased hair growth

Correct answer: A

Rationale: The correct answer is A: Decreased urinary frequency and urgency. Finasteride is used to reduce the size of the prostate gland in patients with BPH, which helps alleviate symptoms such as urinary frequency and urgency. Choice B, decreased blood pressure, is incorrect because finasteride is not indicated for lowering blood pressure. Choice C, increased urinary output, is incorrect as finasteride does not typically increase urine production. Choice D, increased hair growth, is incorrect as the primary use of finasteride is not for promoting hair growth but rather for treating BPH.

2. What is reperfusion injury?

• A. Healing bone tissue after fracture
• B. Skin wound tunneling and shear
• C. Secondary injury after reestablishing blood flow
• D. Injury after blood transfusion

Correct answer: C

Rationale: Reperfusion injury refers to the secondary injury that occurs after blood flow is reestablished following ischemia. This process leads to tissue damage due to the sudden reintroduction of oxygen and nutrients, causing oxidative stress, inflammation, and cell death. Choice A is incorrect as it describes the normal healing process of bone tissue after a fracture. Choice B is incorrect as it describes specific mechanisms related to skin wounds, not reperfusion injury. Choice D is incorrect as it refers to a different concept, which is adverse reactions or complications that can occur after a blood transfusion, not reperfusion injury.

3. A 5-year-old female takes a hike through the woods during a school field trip. Upon returning home, she hugs her father, and he later develops poison ivy. Which of the following immune reactions is he experiencing?

• A. IgE-mediated
• B. Tissue-specific
• C. Immune complex
• D. Cell-mediated

Correct answer: D

Rationale: The father's immune reaction to poison ivy is an example of cell-mediated immunity, specifically a type IV hypersensitivity reaction. In this type of reaction, sensitized T cells react to antigens, leading to inflammation and tissue damage. IgE-mediated reactions involve antibodies of the IgE class, commonly seen in allergic responses like anaphylaxis. Tissue-specific reactions target specific organs or tissues. Immune complex reactions involve immune complexes formed by antigens and antibodies that can deposit in tissues, leading to inflammation.

4. A 30-year-old male has been brought to the emergency department by his wife because of a severe headache, nausea, vomiting, and fever. A lumbar puncture is performed, and cerebrospinal fluid (CSF) analysis reveals a high protein count, low glucose, and numerous polymorphonuclear leukocytes (PMNs). Which organism is the most likely cause of these findings?

• A. Streptococcus pneumoniae
• B. Neisseria meningitidis
• C. Escherichia coli
• D. Listeria monocytogenes

Correct answer: A

Rationale: The cerebrospinal fluid (CSF) analysis findings of high protein count, low glucose, and numerous polymorphonuclear leukocytes (PMNs) are classic for bacterial meningitis. Among the choices, Streptococcus pneumoniae is the most likely cause in this case. Streptococcus pneumoniae is a common cause of bacterial meningitis in adults, especially presenting with symptoms such as severe headache, nausea, vomiting, and fever. Neisseria meningitidis is another common cause of bacterial meningitis but is more frequently associated with a different CSF profile. Escherichia coli is a common cause of neonatal meningitis, not typically seen in a 30-year-old male. Listeria monocytogenes is more commonly associated with meningitis in immunocompromised individuals and neonates, and typically presents differently in CSF analysis.

5. A patient who is taking metronidazole for the past 4 days for the treatment of a parasitic infection reports to the nurse that his most recent dose made him 'flushed, sweaty, and sick in the stomach.' What assessment is most likely to address the cause of this phenomenon?

• A. “Have you experienced any allergic reactions to metronidazole before?”
• B. “Did you drink any alcoholic beverages around the time of taking the drug?”
• C. “Did you take this dose on an empty stomach?”
• D. “Are you currently using any over-the-counter antihistamines?”

Correct answer: B

Rationale: The correct answer is B. Metronidazole can cause a disulfiram-like reaction when taken with alcohol, leading to symptoms such as flushing, sweating, and gastrointestinal upset. Asking the patient about alcohol consumption can help identify if this reaction is due to alcohol interaction. Choice A is incorrect as it focuses on penicillin allergy, which is not relevant to metronidazole. Choice C is less likely to cause the reported symptoms and is not a common concern with metronidazole. Choice D is not directly related to the symptoms described by the patient.

Similar Questions