Nursing Elites

1. A patient is prescribed tadalafil (Cialis) for erectile dysfunction. What condition would contraindicate the use of this medication?

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

Correct answer: B

Rationale: The correct answer is B: 'Use of nitrates.' Tadalafil (Cialis) is contraindicated in patients using nitrates due to the risk of severe hypotension. Nitrates and tadalafil both cause vasodilation, leading to a synergistic effect that can result in a dangerous drop in blood pressure. Choices A, C, and D are incorrect because a history of hypertension, the use of antihypertensive medications, and a history of peptic ulcer disease are not direct contraindications for tadalafil use.

2. What serious adverse effect should the nurse monitor for during testosterone therapy?

• A. Testosterone therapy increases the risk of cardiovascular events, so regular monitoring is essential.
• B. Testosterone therapy can cause liver dysfunction, so liver function tests should be monitored regularly.
• C. Testosterone therapy can lead to prostate cancer, so regular screenings are recommended.
• D. Testosterone therapy can lead to bone fractures, so bone density should be monitored.

Correct answer: A

Rationale: The correct answer is A. Testosterone therapy is associated with an increased risk of cardiovascular events. Therefore, the nurse should monitor the patient for cardiovascular complications. While monitoring liver function tests (choice B) and bone density (choice D) may be important in some cases, the primary concern during testosterone therapy is the risk of cardiovascular events. Prostate cancer screenings (choice C) are not directly related to testosterone therapy's adverse effects.

3. Which type of lymphocyte recognizes and eliminates virus-infected cells and cancerous cells?

• A. Neutrophils
• B. Macrophages
• C. Natural killer cells
• D. Langerhans cells

Correct answer: C

Rationale: Natural killer cells are a type of lymphocyte that plays a crucial role in recognizing and eliminating virus-infected cells and cancerous cells. Neutrophils (Choice A) are a type of white blood cell involved in fighting infections, mainly through phagocytosis. Macrophages (Choice B) are another type of white blood cell that engulfs and digests cellular debris and pathogens. Langerhans cells (Choice D) are a type of dendritic cell found in the skin and mucosa, primarily involved in antigen presentation.

4. What nursing diagnosis is suggested by the patient's statement regarding taking extra griseofulvin when she thinks her infection is getting worse?

• A. Deficient knowledge related to correct use of griseofulvin
• B. Effective therapeutic regimen management related to symptom identification
• C. Disturbed thought processes related to appropriate use of griseofulvin
• D. Ineffective coping related to self-medication

Correct answer: C

Rationale: The correct answer is C: 'Disturbed thought processes related to appropriate use of griseofulvin.' The patient's statement shows a misunderstanding of the correct use of griseofulvin by taking extra medication when she believes her infection is worsening. This behavior indicates a disturbance in her thought process regarding the appropriate use of the medication. Choice A is incorrect because the issue is not lack of knowledge but rather a misunderstanding leading to inappropriate actions. Choice B is incorrect as the patient's actions do not demonstrate effective management of her therapeutic regimen. Choice D is incorrect as the patient is not engaged in self-medication but rather misinterpreting signals and self-adjusting the prescribed medication.

5. A 37-year-old woman has a 10 pack-year smoking history and has been using oral contraceptives for the past 2 years. The nurse should plan health education interventions knowing that this patient faces an increased risk of

• A. osteoporosis.
• B. dementia.
• C. myocardial infarction.
• D. deep vein thrombosis.

Correct answer: C

Rationale: The correct answer is C: myocardial infarction. Women aged 35 and older who smoke, especially with a history of 10 pack-years like in this case, face an increased risk of cardiovascular disorders, including myocardial infarction, when using oral contraceptives. Choice A, osteoporosis, is incorrect because smoking and oral contraceptives do not significantly increase the risk of osteoporosis. Choice B, dementia, is not directly associated with smoking, oral contraceptives, or their combination. Choice D, deep vein thrombosis, is a risk associated with oral contraceptives, especially in combination with smoking, but the highest increased risk in this case is for myocardial infarction.

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