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. A patient who was frequently homeless over the past several years has begun a drug regimen consisting solely of isoniazid (INH). What is this patient's most likely diagnosis?

• A. Active tuberculosis
• B. Latent tuberculosis
• C. Mycobacterium avium complex
• D. Human immunodeficiency virus

Correct answer: A

Rationale: The correct answer is A: Active tuberculosis. Given the patient's history of homelessness and initiation of isoniazid (INH) treatment, the most likely diagnosis is active tuberculosis. Isoniazid is a first-line medication used in the treatment of active tuberculosis. Latent tuberculosis (choice B) would not typically necessitate treatment with isoniazid alone. Mycobacterium avium complex (choice C) is not typically treated with isoniazid alone. Human immunodeficiency virus (choice D) is a risk factor for developing tuberculosis but is not the primary diagnosis in this patient scenario.

3. Which manifestation of stress reflects the non-specific fight or flight response?

• A. Decreased pupillary light response
• B. Increased GI motility
• C. Decreased short-term memory
• D. Increased cardiopulmonary rates

Correct answer: D

Rationale: The correct answer is D, 'Increased cardiopulmonary rates.' The fight or flight response, activated by stress, is a non-specific physiological reaction that prepares the body to deal with perceived threats. In this response, the heart rate and breathing rate increase to supply more oxygen to muscles and vital organs, enabling a rapid response in dangerous situations. Choices A, B, and C are incorrect because decreased pupillary light response, increased GI motility, and decreased short-term memory are not typical manifestations of the fight or flight response.

4. Helicobacter pylori (H. pylori) often causes which of the following?

• A. Colon cancer
• B. Hiatal hernia
• C. Peptic ulcer disease
• D. Esophageal varices

Correct answer: C

Rationale: Helicobacter pylori is a bacterium known to cause peptic ulcer disease by weakening the protective lining of the stomach and duodenum, leading to inflammation and ulcers. While chronic H. pylori infection is a risk factor for stomach cancer, it is not directly linked to colon cancer (Choice A), hiatal hernia (Choice B), or esophageal varices (Choice D). Therefore, the correct answer is C.

5. A client with a history of smoking presents with a chronic cough and shortness of breath. The nurse should suspect which condition?

• A. Pulmonary fibrosis
• B. Chronic obstructive pulmonary disease (COPD)
• C. Lung cancer
• D. Pulmonary edema

Correct answer: B

Rationale: The correct answer is B: Chronic obstructive pulmonary disease (COPD). COPD is often associated with a chronic cough and shortness of breath, especially in individuals with a history of smoking. Pulmonary fibrosis (choice A) typically presents with progressive dyspnea and dry cough. Lung cancer (choice C) may present with a chronic cough, shortness of breath, and other symptoms like weight loss and hemoptysis. Pulmonary edema (choice D) presents with symptoms such as acute shortness of breath, orthopnea, and pink, frothy sputum.

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