Nursing Elites

1. A patient is prescribed tadalafil (Cialis) for erectile dysfunction. What critical contraindication should the nurse discuss 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. Tadalafil (Cialis) is contraindicated in patients taking nitrates due to the risk of severe hypotension. Nitrates potentiate the hypotensive effects of tadalafil, leading to a potentially life-threatening drop in blood pressure. Choices B, C, and D are incorrect because antihypertensive medications, history of hypertension, and history of peptic ulcer disease are not critical contraindications for tadalafil use. While caution may be needed in patients with certain conditions, the highest priority is addressing the interaction with nitrates.

2. A patient's antiretroviral therapy has not been as efficacious as her care team had predicted, and maraviroc (Selzentry) has consequently been added to her drug regimen. The nurse should recognize this drug as belonging to what category of antiretroviral?

• A. Fusion protein inhibitors
• B. Protease inhibitors
• C. CCR5 antagonists
• D. Integrase strand transfer inhibitors

Correct answer: C

Rationale: Women with a history of breast cancer should avoid hormone replacement therapy due to the increased risk of cancer recurrence.

3. Ivermectin (Stromectol) appears on a list of a patient's recent medications. The nurse who is reviewing the medications is justified in suspecting that the patient may have been receiving treatment for a parasitic infection with

• A. Entamoeba histolytica.
• B. Giardia lamblia.
• C. Strongyloides stercoralis.
• D. Plasmodium falciparum.

Correct answer: C

Rationale: Ivermectin (Stromectol) is commonly used to treat parasitic infections, particularly Strongyloides stercoralis. This parasitic infection is known to respond well to Ivermectin therapy. Entamoeba histolytica causes amoebiasis and is typically treated with antiprotozoal drugs like metronidazole, not Ivermectin. Giardia lamblia is a protozoan parasite causing giardiasis, which is usually treated with medications like metronidazole or tinidazole, not Ivermectin. Plasmodium falciparum is a malaria-causing parasite and is not treated with Ivermectin but with antimalarial medications like chloroquine or artemisinin-based combination therapies.

4. A person is given an attenuated antigen as a vaccine. When the person asks what was given in the vaccine, how should the nurse respond? The antigen is:

• A. Alive, but less infectious
• B. Mutated, but highly infectious
• C. Normal, but not infectious
• D. Inactive, but infectious

Correct answer: A

Rationale: An attenuated antigen used in a vaccine is alive but less infectious, aiming to stimulate an immune response. Choice B is incorrect because an attenuated antigen is not highly infectious. Choice C is incorrect as the antigen is intentionally altered to be less infectious. Choice D is incorrect as an attenuated antigen is not infectious.

5. What is a common trigger for acute bronchospasm in asthma?

• A. Infection
• B. Allergic reaction
• C. Excessive exercise
• D. High altitude

Correct answer: B

Rationale: An allergic reaction is a common trigger for acute bronchospasm in asthma patients. When individuals with asthma come in contact with allergens like pollen, dust mites, or pet dander, it can lead to an allergic reaction that triggers bronchospasm. Infections, excessive exercise, and high altitudes can exacerbate asthma symptoms, but they are not the most common trigger for acute bronchospasm in asthma patients.

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