Nursing Elites

1. A patient suffers from an autoimmune disorder. Which of the following represents a potential result of a viral infection in a patient with an autoimmune disorder?

• A. Lymphocytes recognize the host's tissue as foreign.
• B. Erythrocytes destroy the T cells of the host.
• C. The involution of the thymus gland increases the risk of infection.
• D. The differential decreases the sedimentation rate.

Correct answer: A

Rationale: In a patient with an autoimmune disorder, a viral infection can trigger an immune response where lymphocytes mistakenly recognize the host's tissue as foreign. This can lead to an exacerbation of the autoimmune condition. Choice B is incorrect because erythrocytes are not responsible for destroying T cells. Choice C is incorrect as thymus involution weakens the immune response, making the patient more susceptible to infections rather than increasing the infection risk. Choice D is unrelated to the potential effects of a viral infection in a patient with an autoimmune disorder.

2. A patient with a history of cardiovascular disease is being prescribed hormone replacement therapy (HRT). What should the nurse include in the patient education regarding the risks associated with HRT?

• A. HRT may increase the risk of cardiovascular events, including heart attack and stroke.
• B. HRT may decrease the risk of osteoporosis.
• C. HRT may increase the risk of venous thromboembolism.
• D. HRT may decrease the risk of breast cancer.

Correct answer: A

Rationale: The correct answer is A. Hormone replacement therapy (HRT) is associated with an increased risk of cardiovascular events, including heart attack and stroke, especially in patients with a history of cardiovascular disease. Choice B is incorrect because HRT does not decrease the risk of osteoporosis; in fact, it may increase the risk of certain conditions like venous thromboembolism, as mentioned in choice C. Choice D is also incorrect as HRT has been associated with a slight increase in the risk of breast cancer.

3. A patient is administered isoniazid (INH) for tuberculosis. Which of the following adverse effects will result in discontinuation of the medication?

• A. Weight gain
• B. Jaundice
• C. Fever
• D. Arthralgia

Correct answer: B

Rationale: The correct answer is B: Jaundice. Isoniazid (INH) is known to cause hepatotoxicity, which can manifest as jaundice. Jaundice is a serious adverse effect that warrants immediate discontinuation of the medication to prevent further liver damage. Weight gain, fever, and arthralgia are not typically associated with isoniazid use and would not necessitate discontinuation of the medication.

4. A patient with a history of venous thromboembolism is prescribed hormone replacement therapy (HRT). What should the nurse discuss with the patient regarding the risks of HRT?

• A. HRT is associated with an increased risk of venous thromboembolism, so the patient should be aware of the signs and symptoms of blood clots.
• B. HRT can decrease the risk of osteoporosis, but the patient should also be aware of the increased risk of venous thromboembolism.
• C. HRT may increase the risk of breast cancer, so the patient should undergo regular breast exams.
• D. HRT can improve mood and energy levels, but it also carries a risk of cardiovascular events.

Correct answer: A

Rationale: The correct answer is A. Hormone replacement therapy (HRT) is indeed associated with an increased risk of venous thromboembolism. Therefore, patients should be educated about the signs and symptoms of blood clots and advised to seek immediate medical attention if they occur. Choice B is incorrect because although HRT may decrease the risk of osteoporosis, the focus of concern in this case is the increased risk of venous thromboembolism. Choice C is incorrect as it mentions the risk of breast cancer, which is not the primary concern when discussing HRT with a patient with a history of venous thromboembolism. Choice D is also incorrect as it mentions cardiovascular events, which are not the main focus of risk associated with HRT in this scenario.

5. A patient has been prescribed sildenafil (Viagra) for erectile dysfunction. What important information should the healthcare provider provide?

• A. This medication can cause sudden hearing loss.
• B. This medication should not be taken more than once a day.
• C. You should avoid taking this medication with high-fat meals.
• D. Avoid taking nitrates while on this medication.

Correct answer: D

Rationale: The correct answer is D. Sildenafil (Viagra) should not be taken with nitrates due to the risk of severe hypotension. Nitrates can potentiate the hypotensive effects of sildenafil, leading to a dangerous drop in blood pressure. Choice A is incorrect because sudden hearing loss is a rare but serious side effect associated with sildenafil, not a common side effect. Choice B is not the most important information related to sildenafil use. While it is generally recommended not to exceed one dose per day, the interaction with nitrates is more critical. Choice C is also important to consider as high-fat meals can delay the onset of action of sildenafil, but it is not as crucial as avoiding nitrates.

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