Nursing Elites

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

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

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, which can lead to a dangerous drop in blood pressure. Choice B (Use of antihypertensive medications) is incorrect because antihypertensive medications are not a critical contraindication for sildenafil use. Choice C (History of hypertension) is incorrect as it is not a contraindication for sildenafil; in fact, sildenafil is sometimes used in patients with hypertension. Choice D (History of peptic ulcer disease) is also incorrect as it is not a critical contraindication for sildenafil use.

2. A male patient with benign prostatic hyperplasia (BPH) is prescribed finasteride (Proscar). What is the expected therapeutic effect of this medication?

• A. Decreased urinary frequency and urgency
• B. Decreased blood pressure
• C. Increased urinary output
• D. Increased hair growth

Correct answer: A

Rationale: The correct answer is A: Decreased urinary frequency and urgency. Finasteride is used to reduce the size of the prostate gland in patients with BPH, which helps alleviate symptoms such as urinary frequency and urgency. Choice B, decreased blood pressure, is incorrect because finasteride is not indicated for lowering blood pressure. Choice C, increased urinary output, is incorrect as finasteride does not typically increase urine production. Choice D, increased hair growth, is incorrect as the primary use of finasteride is not for promoting hair growth but rather for treating BPH.

3. A patient is to be administered an immunization. The serum contains aluminum phosphate. What route is most appropriate to administer this immunization?

• A. Intramuscularly
• B. Subcutaneously
• C. Intravenously
• D. Orally

Correct answer: A

Rationale: The most appropriate route to administer an immunization containing aluminum phosphate is intramuscularly. Aluminum phosphate is commonly used as an adjuvant in vaccines to enhance the immune response. Intramuscular administration allows for the vaccine to be delivered into the muscle tissue, where it can be effectively absorbed by the body's immune cells. Subcutaneous administration is not ideal for vaccines containing aluminum phosphate, as it may not elicit the desired immune response. Intravenous administration is typically reserved for specific medications or situations that require rapid absorption into the bloodstream. Oral administration is not suitable for vaccines containing aluminum phosphate as they would be degraded in the gastrointestinal tract.

4. Which of the following findings is commonly associated with congestive heart failure?

• A. Decreased jugular venous pressure
• B. Pulmonary edema
• C. Hyperactive bowel sounds
• D. Weight loss

Correct answer: B

Rationale: Pulmonary edema is a common finding in congestive heart failure. In congestive heart failure, the heart is unable to pump effectively, leading to fluid buildup in the lungs, causing pulmonary edema. This results in symptoms like shortness of breath, coughing, and wheezing. Choices A, C, and D are not typically associated with congestive heart failure. Jugular venous pressure is often elevated, not decreased in heart failure. Hyperactive bowel sounds and weight loss are not specific findings for congestive heart failure.

5. When does pain in the lower extremities due to peripheral artery disease usually worsen?

• A. with rest because blood flow decreases.
• B. with elevation of the extremity because blood is diverted away.
• C. when the leg is in a dependent position because blood pools.
• D. when the leg is touched or massaged because cytokines are released.

Correct answer: B

Rationale: Pain in the lower extremities due to peripheral artery disease usually worsens with elevation of the extremity because blood is diverted away from the affected area, leading to decreased perfusion and exacerbation of symptoms. Choices A, C, and D are incorrect because resting, dependent position, and touch/massage do not typically worsen the pain associated with peripheral artery disease.

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