Nursing Elites

1. A patient is administered a nucleotide reverse transcriptase inhibitor in combination with a nonnucleotide reverse transcriptase inhibitor. What is the main rationale for administering these medications together?

• A. They improve treatment adherence.
• B. They reduce the duration of illness.
• C. They exhibit synergistic antiviral effects.
• D. They prevent opportunistic infections.

Correct answer: C

Rationale: The main rationale for administering a nucleotide reverse transcriptase inhibitor in combination with a nonnucleotide reverse transcriptase inhibitor is that they exhibit synergistic antiviral effects when used together. This combination enhances their antiviral activity against HIV by targeting different steps in the viral replication cycle. Choice A is incorrect because the rationale for combining these medications is based on their antiviral effects, not treatment adherence. Choice B is incorrect because the primary purpose of combination therapy is not to reduce the duration of illness but to improve treatment efficacy. Choice D is incorrect as the main focus of this combination is not on preventing opportunistic infections but on directly targeting the HIV virus.

2. A nurse caring for a patient with a diagnosis of lung cancer is aware that the primary risk factor for developing lung cancer is:

• A. Alcohol consumption
• B. Smoking
• C. Poor diet
• D. Environmental exposure

Correct answer: B

Rationale: The correct answer is B: Smoking. Smoking is the primary risk factor for developing lung cancer. Tobacco smoke contains numerous carcinogens that can damage the cells in the lungs, leading to the development of cancer. Alcohol consumption (Choice A), poor diet (Choice C), and environmental exposure (Choice D) can contribute to overall health risks, but they are not the primary risk factors specifically associated with the development of lung cancer.

3. During an acute asthma exacerbation, what is the priority nursing intervention for a client with asthma?

• A. Administer corticosteroids to reduce airway inflammation.
• B. Position the client in high-Fowler's position.
• C. Administer short-acting beta-agonists (SABAs) as prescribed.
• D. Obtain a peak flow reading to assess the severity of the exacerbation.

Correct answer: C

Rationale: The priority nursing intervention during an acute asthma exacerbation is to administer short-acting beta-agonists (SABAs) as prescribed. SABAs help in quickly relieving bronchospasm and are considered the first-line treatment for acute exacerbations. Administering corticosteroids, positioning the client, and obtaining a peak flow reading are important interventions but come after administering SABAs in the management of acute asthma exacerbation.

4. 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.

5. A patient is prescribed dutasteride (Avodart) for benign prostatic hyperplasia (BPH). What outcome should the nurse expect to observe if the drug is having the desired effect?

• A. Decreased size of the prostate gland
• B. Increased urinary output
• C. Increased urine flow
• D. Decreased blood pressure

Correct answer: A

Rationale: The correct answer is A: Decreased size of the prostate gland. Dutasteride is a medication used for BPH to reduce the size of the prostate gland, thereby improving urinary flow and decreasing symptoms. Choice B, increased urinary output, is incorrect as dutasteride primarily targets the size of the prostate gland rather than directly affecting urinary output. Choice C, increased urine flow, is related to the expected outcome of dutasteride therapy but is not as direct as the reduction in the size of the prostate gland. Choice D, decreased blood pressure, is not an expected outcome of dutasteride therapy for BPH.

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