Nursing Elites

1. What instruction should the nurse include in this patient's health education regarding chloroquine phosphate (Aralen) for malaria prophylaxis?

• A. “Take your pill on the same day each week.”
• B. “Watch out for any unusual rash on your trunk and arms, but this isn't cause for concern.”
• C. “Remember to take your chloroquine on an empty stomach.”
• D. “We'll provide you with enough syringes and teach you how to inject the drug.”

Correct answer: A

Rationale: The correct instruction for the nurse to include in this patient's health education regarding chloroquine phosphate (Aralen) for malaria prophylaxis is to “Take your pill on the same day each week.” This is essential because chloroquine is typically taken once a week on the same day to ensure consistent protection against malaria. Choice B is incorrect because while rashes are a possible side effect of chloroquine, they are not a usual occurrence and should be reported to the healthcare provider. Choice C is incorrect because chloroquine does not need to be taken on an empty stomach. Choice D is incorrect as chloroquine is typically administered orally, not by injection.

2. A client with a history of chronic alcoholism presents to the emergency department with a complaint of double vision. Which cranial nerve is most likely involved?

• A. Cranial nerve I (Olfactory)
• B. Cranial nerve III (Oculomotor)
• C. Cranial nerve VI (Abducens)
• D. Cranial nerve VII (Facial)

Correct answer: C

Rationale: The correct answer is Cranial nerve VI (Abducens). Chronic alcoholism can lead to damage to the abducens nerve, which controls the lateral movement of the eye. This damage can result in symptoms like double vision. Cranial nerve I (Olfactory) is responsible for the sense of smell and is not related to eye movement. Cranial nerve III (Oculomotor) controls most of the eye movements but is less likely to be affected in chronic alcoholism than the abducens nerve. Cranial nerve VII (Facial) is responsible for facial movements and is not associated with double vision.

3. What does a client's symptoms of headache, vomiting, blurred vision, and loss of consciousness following a concussion indicate?

• A. Increased intracranial pressure
• B. Lower extremity compartment syndrome
• C. Consuming too much food at once
• D. Improved kidney function

Correct answer: A

Rationale: The symptoms of headache, vomiting, blurred vision, and loss of consciousness following a concussion are indicative of increased intracranial pressure. These symptoms suggest a serious condition that can occur after head trauma, requiring immediate medical attention. Lower extremity compartment syndrome presents with symptoms related to pressure build-up in the muscles of the legs, not the head. Consuming too much food at once does not manifest with these neurological symptoms. Improved kidney function would not present with symptoms such as headache, vomiting, blurred vision, and loss of consciousness.

4. Which of the following nursing diagnoses would provide the most plausible indication for the use of epoetin alfa (Epogen) in a patient with renal failure?

• A. Risk for infection related to decreased erythropoiesis
• B. Activity intolerance related to decreased oxygen-carrying capacity
• C. Powerlessness related to sequelae of renal failure
• D. Ineffective breathing pattern related to inadequate erythropoietin synthesis

Correct answer: B

Rationale: The correct answer is B. In a patient with renal failure, the use of epoetin alfa (Epogen) is primarily aimed at addressing the decreased oxygen-carrying capacity due to impaired erythropoiesis. Epoetin alfa is a medication that stimulates red blood cell production, thereby improving the oxygen-carrying capacity of the blood. This would directly address the activity intolerance commonly seen in patients with renal failure. Choices A, C, and D are incorrect because they do not directly relate to the primary purpose of using epoetin alfa in this context. Risk for infection, powerlessness, and ineffective breathing pattern are important considerations in the care of a patient with renal failure, but they are not the primary indications for using epoetin alfa.

5. A patient is prescribed tadalafil (Cialis) for erectile dysfunction. What specific contraindication should the nurse discuss 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.' Tadalafil (Cialis) is contraindicated in patients taking nitrates due to the risk of severe hypotension. Nitrates and Cialis both cause vasodilation, which can lead to a dangerous drop in blood pressure when used together. Choices A, C, and D are incorrect because a history of hypertension, use of antihypertensive medications, and a history of peptic ulcer disease are not specific contraindications for tadalafil use.

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