Nursing Elites

1. A patient is prescribed estradiol (Estrace) for hormone replacement therapy. What should the nurse monitor during this therapy?

• A. Blood pressure
• B. Blood glucose levels
• C. Liver function tests
• D. Kidney function tests

Correct answer: C

Rationale: During estradiol therapy, the nurse should monitor liver function tests. Estradiol can potentially impact liver function, making it essential to assess for any signs of liver dysfunction. Monitoring blood pressure (Choice A) is not directly related to estradiol therapy. While blood glucose levels (Choice B) should be monitored in patients taking certain medications like corticosteroids or antipsychotics, it is not typically necessary for patients on estradiol therapy. Kidney function tests (Choice D) are not the priority for monitoring during estradiol therapy, as the liver is more commonly affected.

2. Which of the following types of vitamin or mineral deficiency can cause megaloblastic anemia and is associated with lower extremity paresthesias?

• A. Vitamin B12
• B. Folate
• C. Iron
• D. Vitamin K

Correct answer: A

Rationale: The correct answer is Vitamin B12. Vitamin B12 deficiency can lead to megaloblastic anemia and neurological symptoms, including lower extremity paresthesias. Folate deficiency can also cause megaloblastic anemia but typically does not present with neurological symptoms. Iron deficiency leads to microcytic anemia, not megaloblastic anemia. Vitamin K deficiency is associated with coagulation abnormalities, not megaloblastic anemia.

3. A patient is receiving epoetin alfa (Epogen) for anemia. Which of the following adjunctive therapies is imperative with epoetin alfa?

• A. Potassium supplements
• B. Sodium restriction
• C. Iron supplement
• D. Renal dialysis

Correct answer: C

Rationale: The correct answer is C: Iron supplement. When a patient is receiving epoetin alfa for anemia, it is imperative to provide iron supplementation as epoetin alfa works by stimulating the production of red blood cells, which require iron for hemoglobin synthesis. Therefore, iron supplementation is crucial to support the increased erythropoiesis. Choices A, B, and D are incorrect because potassium supplements, sodium restriction, and renal dialysis are not typically indicated as adjunctive therapies with epoetin alfa for anemia.

4. What is the action of amphotericin B?

• A. It binds to ergosterol and forms holes in the membrane.
• B. It binds to an enzyme required for the synthesis of ergosterol.
• C. It disrupts the fungal cell walls rather than the cell membrane.
• D. It inhibits glucan synthetase required for glucan synthesis.

Correct answer: A

Rationale: Amphotericin B is an antifungal medication that acts by binding to ergosterol, a component of fungal cell membranes, forming pores that disrupt the integrity of the membrane. This action leads to leakage of cellular contents and ultimately cell death. Choice B is incorrect as amphotericin B does not bind to an enzyme required for the synthesis of ergosterol. Choice C is incorrect as the drug primarily affects the cell membrane rather than the cell wall. Choice D is also incorrect as amphotericin B does not inhibit glucan synthetase.

5. A male patient receiving androgen therapy is concerned about side effects. What is the most serious adverse effect the nurse should monitor for during this therapy?

• A. Increased risk of cardiovascular events
• B. Increased risk of bone fractures
• C. Increased risk of venous thromboembolism
• D. Increased risk of mood changes

Correct answer: A

Rationale: The correct answer is A: Increased risk of cardiovascular events. Androgen therapy can significantly increase the risk of cardiovascular events, such as heart attack and stroke, especially in older patients. Monitoring for signs and symptoms of cardiovascular issues is crucial during this therapy. Choice B, increased risk of bone fractures, is not typically associated with androgen therapy. Choice C, increased risk of venous thromboembolism, is more commonly linked to estrogen therapy rather than androgen therapy. Choice D, increased risk of mood changes, can occur with androgen therapy but is not as serious or life-threatening as cardiovascular events.

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