Nursing Elites

1. A patient is being treated with amphotericin B. Which of the following statements indicates that the patient has understood the patient teaching?

• A. “The medication may cause diabetes.”
• B. “The medication will cause liver necrosis.”
• C. “The medication may cause kidney damage.”
• D. “The medication will cause pancreatitis.”

Correct answer: C

Rationale: The correct answer is C: 'The medication may cause kidney damage.' Amphotericin B is known for its potential to cause nephrotoxicity, which can manifest as kidney damage. It is crucial for the patient to be aware of this possible adverse effect. Choices A, B, and D are incorrect because amphotericin B is not typically associated with causing diabetes, liver necrosis, or pancreatitis. Therefore, these statements do not reflect an accurate understanding of the medication's side effects.

2. While assessing a critically ill client in the emergency department, the nurse notes on the cardiac monitor an R-on-T premature ventricular beat that develops into ventricular tachycardia (VT). Immediately, the client became unresponsive. The nurse knows that based on pathophysiologic principles, the most likely cause of the unresponsiveness is:

• A. metabolic acidosis that occurs spontaneously following any dysrhythmias.
• B. interruption of the blood/oxygen supply to the brain.
• C. massive cerebrovascular accident (CVA) resulting from increased perfusion.
• D. a blood clot coming from the heart and occluding the carotid arteries.

Correct answer: B

Rationale: The correct answer is B. Ventricular tachycardia (VT) can disrupt the normal heart function, leading to a decreased cardiac output. This decreased output can interrupt the blood supply to the brain, causing the client to become unresponsive. Metabolic acidosis (Choice A) is not the most likely cause of unresponsiveness in this scenario. A massive cerebrovascular accident (CVA) (Choice C) would not result from increased perfusion. A blood clot occluding the carotid arteries (Choice D) may lead to a stroke but is not the most likely cause of sudden unresponsiveness in this situation.

3. A patient arrives at her follow-up appointment 1 month post-hysterectomy and complains to the nurse that her scars do not seem to be healing properly. Upon inspection, the nurse notices that the scars are raised but still within the boundaries of the original incisions. The nurse tells the patient this kind of dysfunctional wound healing is called:

• A. Hypertrophic scarring
• B. Dehiscence
• C. Contracture
• D. A keloid

Correct answer: A

Rationale: Hypertrophic scarring occurs when a scar is raised but remains within the boundaries of the original wound, unlike keloids, which extend beyond the wound edges. Dehiscence refers to the separation of wound edges, while contracture involves the tightening or constriction of a scar, leading to limited mobility.

4. Interpret the following arterial blood gas results: PH = 7.30; PaCO2 = 55 mmHg; HCO3 = 24 mEq/L

• A. Respiratory acidosis
• B. Metabolic acidosis
• C. Respiratory alkalosis
• D. Metabolic alkalosis

Correct answer: A

Rationale: The correct answer is A: Respiratory acidosis. In respiratory acidosis, there is an accumulation of CO2 in the blood, leading to a decrease in pH. The elevated PaCO2 of 55 mmHg in the given results indicates hypoventilation, causing respiratory acidosis. Choices B, C, and D are incorrect because the provided data does not show metabolic acidosis, respiratory alkalosis, or metabolic alkalosis.

5. A patient is prescribed sildenafil (Viagra) for erectile dysfunction. What key contraindication should the nurse review with the patient?

• A. Use of nitrates
• B. History of hypertension
• C. Use of antihypertensive medications
• D. Use of antihypertensive medications

Correct answer: A

Rationale: The correct answer is A: Use of nitrates. Sildenafil (Viagra) is contraindicated in patients taking nitrates due to the risk of severe hypotension. Nitrates and sildenafil both cause vasodilation, so their combined use can lead to a dangerous drop in blood pressure. Choices B, C, and D are incorrect because while a history of hypertension or use of antihypertensive medications may influence treatment decisions, they are not the key contraindication specifically related to sildenafil use.

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