Nursing Elites

1. When treating a patient for a fungal infection with IV amphotericin B, what should the nurse consistently monitor the patient's levels of to prevent drug discomfort?

• A. sodium
• B. hemoglobin
• C. calcium
• D. leukocytes

Correct answer: C

Rationale: When a patient is being treated with IV amphotericin B for a fungal infection, it is crucial to monitor the patient's calcium levels consistently. IV amphotericin B can cause hypokalemia, hypomagnesemia, and most notably, hypocalcemia. Monitoring calcium levels helps prevent drug-related discomfort and adverse effects. Sodium (Choice A), hemoglobin (Choice B), and leukocytes (Choice D) are not the primary parameters to monitor specifically for drug discomfort related to amphotericin B. Therefore, they are incorrect choices.

2. What part of the heart is responsible for starting the electrical impulse to conduct a heart rhythm and contraction of the atria and ventricles?

• A. The Purkinje fibers in the ventricles
• B. The right & left bundle branches
• C. The atrioventricular node
• D. The sinoatrial node in the atrium

Correct answer: D

Rationale: The sinoatrial node (SA node) in the atrium is indeed responsible for initiating the electrical impulse that starts the heart's rhythm. The SA node is known as the heart's natural pacemaker. Choices A, B, and C are incorrect because while the Purkinje fibers, bundle branches, and atrioventricular node play crucial roles in the conduction of the electrical impulse throughout the heart, the SA node is specifically responsible for initiating this impulse.

3. A homeless man was screened for tuberculosis (TB) during a health consultation at a shelter, and the results indicate latent TB. The community health nurse who is liaising with the providers of the shelter would anticipate what component of this man's plan of care?

• A. The man will undergo conservative treatment for TB using adjuvant medications.
• B. The man will be treated for TB using first-line antitubercular drugs.
• C. The man will be monitored closely to determine if treatment is necessary.
• D. The man will be screened again in 10 to 12 weeks to determine if he has developed active TB.

Correct answer: B

Rationale: The correct answer is B. When a patient is diagnosed with latent TB infection, the standard approach involves treating them with first-line antitubercular drugs to prevent the progression to active TB. Adjuvant medications are not typically used for latent TB. Close monitoring without initiating treatment can lead to the development of active TB, so immediate treatment is crucial. Screening the individual again in 10 to 12 weeks does not address the immediate need for treatment of latent TB, which is essential to prevent the progression of the disease.

4. What important instruction should the nurse provide about taking medroxyprogesterone acetate (Provera) for a patient with endometriosis?

• A. Take the medication at the same time each day to maintain consistent hormone levels.
• B. Medroxyprogesterone should be taken with food to reduce gastrointestinal upset.
• C. Discontinue medroxyprogesterone if side effects occur.
• D. Medroxyprogesterone should be taken once a week to maintain effectiveness.

Correct answer: A

Rationale: The correct answer is to take the medication at the same time each day to maintain consistent hormone levels and effectiveness. This consistency is crucial for achieving therapeutic outcomes. Choice B is incorrect because medroxyprogesterone should be taken at the same time each day, regardless of food intake. Choice C is incorrect because side effects should be reported to the healthcare provider for further evaluation rather than discontinuing the medication abruptly. Choice D is incorrect as medroxyprogesterone is usually taken daily for the prescribed duration.

5. What long-term risks should the nurse discuss with a patient being treated with hormone replacement therapy (HRT) for menopausal symptoms?

• A. HRT may increase the risk of cardiovascular events and breast cancer.
• B. HRT may decrease the risk of osteoporosis.
• C. HRT may improve mood and energy levels.
• D. HRT may increase the risk of venous thromboembolism.

Correct answer: A

Rationale: The correct answer is A. Long-term hormone replacement therapy (HRT) is associated with increased risks of cardiovascular events and breast cancer. These risks should be discussed with the patient to ensure they are aware of the potential adverse effects. Choice B is incorrect because HRT does not decrease the risk of osteoporosis; in fact, it has been linked to an increased risk of this condition. Choice C is incorrect as while HRT may have positive effects on mood and energy levels for some individuals, the focus here is on the long-term risks that need to be addressed. Choice D is incorrect as HRT is indeed associated with an increased risk of venous thromboembolism, but the primary focus of the question is on cardiovascular events and breast cancer.

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