Nursing Elites

1. A patient has been using Viagra on an intermittent basis for several years. However, he has cited delays in the onset and peak of action as the occasional source of frustration. What PDE5 inhibitor may be of particular benefit to this patient's needs?

• A. Avanafil (Stendra)
• B. Tadalafil (Cialis)
• C. Vardenafil (Levitra)
• D. Alprostadil (Caverject)

Correct answer: A

Rationale: The correct answer is Avanafil (Stendra). Avanafil has a rapid onset of action compared to other PDE5 inhibitors, making it suitable for patients experiencing delays in onset and peak of action with other medications like Viagra. Tadalafil (Cialis), Vardenafil (Levitra), and Alprostadil (Caverject) do not offer the same rapid onset of action as Avanafil, making them less suitable for addressing the specific needs of this patient.

2. A patient is being administered chemotherapeutic agents for the treatment of cancer. Which of the following blood cells will be stimulated by the colony-stimulating factors in response to the effects of the chemotherapy?

• A. White blood cells
• B. Red blood cells
• C. Phagocytes
• D. Myocardial cells

Correct answer: A

Rationale: The correct answer is White blood cells. Colony-stimulating factors stimulate the production of white blood cells in response to the effects of chemotherapy, as it can lead to myelosuppression. Red blood cells are not directly stimulated by colony-stimulating factors. Phagocytes are a type of white blood cell involved in immune responses, but they are not specifically stimulated by colony-stimulating factors. Myocardial cells are cardiac muscle cells and are not directly involved in the response to chemotherapy-induced myelosuppression.

3. A patient is taking alendronate (Fosamax) for osteoporosis. What instructions should the nurse provide to ensure the effectiveness of the medication?

• A. Take the medication with a full glass of water and remain upright for at least 30 minutes.
• B. Take the medication at bedtime to ensure absorption during sleep.
• C. Take the medication with milk to enhance calcium absorption.
• D. Take the medication with food to prevent nausea.

Correct answer: A

Rationale: The correct answer is A. Alendronate should be taken with a full glass of water, and patients should remain upright for at least 30 minutes to prevent esophageal irritation and ensure proper absorption. Taking the medication at bedtime (choice B) is not recommended as it can lead to esophageal irritation when lying down. Taking the medication with milk (choice C) is incorrect as it may interfere with the absorption of alendronate. Taking the medication with food (choice D) is not recommended as it may reduce the effectiveness of the medication.

4. A patient with breast cancer is prescribed tamoxifen (Nolvadex). What key point should the nurse include in the patient education?

• A. Tamoxifen may increase the risk of venous thromboembolism.
• B. Tamoxifen may cause hot flashes and other menopausal symptoms.
• C. Tamoxifen may cause weight gain and fluid retention.
• D. Tamoxifen may decrease the risk of osteoporosis.

Correct answer: A

Rationale: The correct answer is A: "Tamoxifen may increase the risk of venous thromboembolism." It is crucial for patients to be aware of the signs and symptoms of blood clots while taking tamoxifen. Choice B is incorrect because hot flashes and menopausal symptoms are common side effects of tamoxifen, but they are not the key point to emphasize. Choice C is incorrect as weight gain and fluid retention are potential side effects of tamoxifen but not the key point for patient education. Choice D is incorrect as tamoxifen does not decrease the risk of osteoporosis; in fact, it may increase the risk of bone loss.

5. In a patient with a subconjunctival hemorrhage due to allergic rhinitis, which statement is accurate?

• A. The hemorrhage will resolve without treatment within 2 weeks.
• B. The patient should be referred for immediate ophthalmologic examination.
• C. Oral antihistamines should be started to prevent further complications.
• D. Topical corticosteroids may be considered to reduce inflammation.

Correct answer: A

Rationale: In a patient with a subconjunctival hemorrhage secondary to allergic rhinitis, the hemorrhage is typically self-limiting and will resolve on its own within 2 weeks without the need for specific treatment. Referring the patient for immediate ophthalmologic examination is not necessary unless there are other concerning symptoms. Starting oral antihistamines may help manage the underlying allergic rhinitis but is not specifically indicated for the hemorrhage. Topical corticosteroids are not routinely prescribed for subconjunctival hemorrhage as they may have limited benefit and could potentially cause complications.

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