Nursing Elites

1. A patient is administered isoniazid (INH) for tuberculosis. Which of the following adverse effects will result in discontinuation of the medication?

• A. Weight gain
• B. Jaundice
• C. Fever
• D. Arthralgia

Correct answer: B

Rationale: The correct answer is B: Jaundice. Isoniazid (INH) is known to cause hepatotoxicity, which can manifest as jaundice. Jaundice is a serious adverse effect that warrants immediate discontinuation of the medication to prevent further liver damage. Weight gain, fever, and arthralgia are not typically associated with isoniazid use and would not necessitate discontinuation of the medication.

2. A patient is prescribed acyclovir (Zovirax) for the treatment of genital herpes. What is the expected outcome of this medication?

• A. Decreased testosterone production
• B. Decreased libido
• C. Decreased viral shedding
• D. Decreased bacterial replication

Correct answer: C

Rationale: The expected outcome of acyclovir (Zovirax) for the treatment of genital herpes is decreased viral shedding. Acyclovir is an antiviral medication that works by inhibiting the replication of the herpes virus, thereby reducing viral shedding and helping to control outbreaks. Choice A, decreased testosterone production, and Choice B, decreased libido, are unrelated outcomes of acyclovir treatment for genital herpes. Choice D, decreased bacterial replication, is also incorrect as acyclovir specifically targets viruses and does not affect bacterial replication.

3. A hospital client is at a high risk of developing bacterial endocarditis. Which of the following prophylactic measures is likely to be most effective?

• A. Avoiding exposure to individuals known to carry the streptococcus bacterium
• B. Daily administration of low-dose corticosteroids
• C. Prophylactic antimicrobial therapy before any invasive procedure
• D. Routine vaccinations against meningococcal and pneumococcal infections

Correct answer: C

Rationale: Prophylactic antimicrobial therapy before any invasive procedure is the most effective measure in preventing bacterial endocarditis in at-risk individuals. This measure helps to reduce the risk of bacterial infection during invasive procedures, which can lead to endocarditis. Choice A is incorrect as avoiding exposure to individuals with streptococcus does not address the primary preventive measure needed. Choice B is incorrect as corticosteroids do not prevent bacterial endocarditis, and daily administration is not the recommended prophylactic measure. Choice D is incorrect as routine vaccinations against meningococcal and pneumococcal infections are important for other conditions but not specifically for preventing bacterial endocarditis.

4. When starting on oral contraceptives, what should the nurse include in the education regarding the timing of the medication?

• A. Oral contraceptives should be taken at the same time each day to maintain stable hormone levels and prevent pregnancy.
• B. Oral contraceptives can be taken at any time of day, as long as the schedule is consistent.
• C. Oral contraceptives should be taken in the morning to avoid nighttime side effects.
• D. Oral contraceptives are effective immediately upon starting, regardless of timing.

Correct answer: A

Rationale: When educating a patient starting on oral contraceptives, it is essential to stress the importance of taking the medication at the same time each day. This ensures stable hormone levels, improving the effectiveness of the contraceptives in preventing pregnancy. Choice B is incorrect because consistency in timing is crucial for maintaining hormone levels. Choice C is incorrect as there is no specific requirement to take oral contraceptives in the morning to avoid side effects. Choice D is incorrect as oral contraceptives may take some time to become fully effective, and consistent timing is important for their efficacy.

5. When discussing the risks associated with hormone replacement therapy (HRT) with a patient who has a history of coronary artery disease, what should the nurse emphasize?

• A. HRT may increase the risk of cardiovascular events such as heart attack and stroke.
• B. HRT may increase the risk of osteoporosis.
• C. HRT may decrease the risk of venous thromboembolism.
• D. HRT may increase the risk of breast cancer.

Correct answer: A

Rationale: The correct answer is A. Hormone replacement therapy (HRT) is associated with an increased risk of cardiovascular events, such as heart attack and stroke, especially in patients with a history of coronary artery disease. Choice B is incorrect because HRT is actually known to decrease the risk of osteoporosis. Choice C is incorrect as HRT is associated with an increased risk of venous thromboembolism. Choice D is also incorrect as HRT may slightly increase the risk of breast cancer.

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