Nursing Elites

1. A patient is starting on alendronate (Fosamax) for osteoporosis. What instructions should the nurse provide to ensure the effectiveness of the medication?

• A. Take the medication with a full glass of water and remain upright for at least 30 minutes.
• B. Take the medication at bedtime to ensure absorption during sleep.
• C. Take the medication with milk to enhance calcium absorption.
• D. Take the medication with food to prevent gastrointestinal upset.

Correct answer: A

Rationale: The correct answer is to take alendronate with a full glass of water and remain upright for at least 30 minutes. This is essential to prevent esophageal irritation and ensure proper absorption. Choice B is incorrect because taking alendronate at bedtime can increase the risk of esophageal irritation due to lying down. Choice C is incorrect as taking alendronate with milk can reduce its absorption. Choice D is incorrect because alendronate should be taken on an empty stomach to enhance its effectiveness.

2. A woman with severe visual and auditory deficits is able to identify individuals by running her fingers lightly over her face. Which source is most likely to provide the input that allows for the woman's unique ability?

• A. Special somatic afferent fibers
• B. General somatic afferents
• C. Special visceral afferent cells
• D. General visceral afferent neurons

Correct answer: C

Rationale: The correct answer is C, special visceral afferent cells. These cells are responsible for functions like taste and smell. In individuals with severe visual and auditory deficits, their other sensory abilities, such as touch, can be heightened. Special somatic afferent fibers (choice A) are involved in sensations like touch and vibration from the skin and muscles, but they are not specific to the face. General somatic afferents (choice B) transmit sensory information from the skin, muscles, and joints, but they are not specialized for the unique ability described. General visceral afferent neurons (choice D) are responsible for transmitting sensory information from internal organs, not relevant to the woman's ability to identify individuals through touch on her face.

3. A patient is prescribed tadalafil (Cialis) for erectile dysfunction. What specific contraindication should the nurse discuss with the patient?

• 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 taking nitrates due to the risk of severe hypotension. Nitrates and Cialis both cause vasodilation, which can lead to a dangerous drop in blood pressure when used together. Choices A, C, and D are incorrect because a history of hypertension, use of antihypertensive medications, and a history of peptic ulcer disease are not specific contraindications for tadalafil use.

4. A patient has been diagnosed with chronic renal failure. Which of the following agents will assist in raising the patient's hemoglobin levels?

• A. Epoetin alfa (Epogen, Procrit)
• B. Pentoxifylline (Pentoxil)
• C. Estazolam (ProSom)
• D. Dextromethorphan hydrobromide

Correct answer: A

Rationale: The correct answer is A: Epoetin alfa (Epogen, Procrit). Epoetin alfa is a synthetic form of erythropoietin that stimulates red blood cell production and is commonly used to treat anemia in patients with chronic renal failure. By increasing red blood cell production, epoetin alfa helps raise hemoglobin levels in these patients. Pentoxifylline (Choice B) is not indicated for raising hemoglobin levels in chronic renal failure patients; it is a peripheral vasodilator used to improve blood flow. Estazolam (Choice C) is a benzodiazepine used for treating insomnia and has no role in raising hemoglobin levels. Dextromethorphan hydrobromide (Choice D) is a cough suppressant and is not used to raise hemoglobin levels in patients with chronic renal failure.

5. Which ability should Nurse Rebecca expect from a client in the mild stage of dementia of the Alzheimer’s type?

• A. Remembering the daily schedule
• B. Recalling past events
• C. Coping with anxiety
• D. Solving problems of daily living

Correct answer: B

Rationale: In the mild stage of dementia of the Alzheimer’s type, clients can often recall past events but may have difficulty with new information. Therefore, Nurse Rebecca should expect the client to have the ability to recall past events. Choice A is incorrect because remembering the daily schedule may become challenging as the disease progresses. Choice C is incorrect as clients in the mild stage may experience anxiety, but coping with anxiety is not a specific ability associated with this stage of dementia. Choice D is incorrect as solving problems of daily living becomes more challenging as the disease advances, not in the mild stage.

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