Nursing Elites

1. A patient is prescribed sildenafil (Viagra) for erectile dysfunction. What important contraindication should the nurse emphasize during patient education?

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

Correct answer: A

Rationale: The correct answer is A: 'Use of nitrates.' Sildenafil (Viagra) is contraindicated in patients using nitrates due to the risk of severe hypotension. Nitrates and sildenafil both cause vasodilation, leading to a synergistic effect that can result in a dangerous drop in blood pressure. Choices B, C, and D are incorrect because they are not direct contraindications for sildenafil use. While a history of hypertension or peptic ulcer disease may require caution, they are not absolute contraindications like the concomitant use of nitrates.

2. Which of the following describes the damage to the brain that results in cerebral palsy?

• A. Reversible with cognitive therapy in infancy
• B. Transient and resolves in adulthood through physical therapy
• C. Manifests in adulthood after regular childhood activities
• D. Irreversible and occurs before, during, or after birth or infancy

Correct answer: D

Rationale: The correct answer is D. Cerebral palsy involves irreversible damage to the brain that occurs before, during, or shortly after birth, impacting movement and coordination. Choices A, B, and C are incorrect because cerebral palsy is not reversible with cognitive therapy or physical therapy, does not resolve in adulthood, and does not manifest in adulthood after regular childhood activities.

3. Which of the following nursing diagnoses would provide the most plausible indication for the use of epoetin alfa (Epogen) in a patient with renal failure?

• A. Risk for infection related to decreased erythropoiesis
• B. Activity intolerance related to decreased oxygen-carrying capacity
• C. Powerlessness related to sequelae of renal failure
• D. Ineffective breathing pattern related to inadequate erythropoietin synthesis

Correct answer: B

Rationale: The correct answer is B. In a patient with renal failure, the use of epoetin alfa (Epogen) is primarily aimed at addressing the decreased oxygen-carrying capacity due to impaired erythropoiesis. Epoetin alfa is a medication that stimulates red blood cell production, thereby improving the oxygen-carrying capacity of the blood. This would directly address the activity intolerance commonly seen in patients with renal failure. Choices A, C, and D are incorrect because they do not directly relate to the primary purpose of using epoetin alfa in this context. Risk for infection, powerlessness, and ineffective breathing pattern are important considerations in the care of a patient with renal failure, but they are not the primary indications for using epoetin alfa.

4. A 20-year-old college student has presented to the campus medical clinic seeking to begin oral contraceptive therapy. The nurse has recognized the need for adequate health education related to the patient's request. The nurse should emphasize the fact that successful prevention of pregnancy depends primarily on the patient's

• A. current health status.
• B. vigilant adherence to the drug regimen.
• C. knowledge of sexual health.
• D. risk factors for adverse effects.

Correct answer: B

Rationale: The correct answer is B: 'vigilant adherence to the drug regimen.' When initiating oral contraceptive therapy, the success of preventing pregnancy relies heavily on the patient's commitment to following the prescribed regimen consistently. Compliance with taking the oral contraceptives as directed is crucial for their effectiveness. Choice A, 'current health status,' is not the primary factor for successful prevention of pregnancy with oral contraceptives. Choice C, 'knowledge of sexual health,' while important, is not the primary determinant of contraceptive efficacy. Choice D, 'risk factors for adverse effects,' though relevant for monitoring and managing side effects, is not the primary focus for ensuring contraceptive success.

5. A patient is diagnosed with ischemic heart disease. She is prescribed filgrastim (Neupogen). What effect will this medication provide in the treatment of ischemic heart disease?

• A. Increase platelets
• B. Decrease platelets
• C. Promote angiogenesis
• D. Prevent thrombus formation

Correct answer: C

Rationale: Filgrastim (Neupogen) is a medication that promotes the growth of white blood cells. In the context of ischemic heart disease, promoting angiogenesis, the formation of new blood vessels, can improve blood flow to the heart muscle, reducing ischemia and potentially improving cardiac function. Therefore, the correct answer is C. Choices A and B are incorrect because filgrastim does not directly affect platelet levels. Choice D is also incorrect as filgrastim does not prevent thrombus formation.

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