Nursing Elites

1. A patient who is being administered isoniazid (INH) for tuberculosis has a yellow color in the sclera of her eye. What other finding would lead you to believe that hepatotoxicity has developed?

• A. Diarrhea
• B. Numbness
• C. Diminished vision
• D. Light-colored stools

Correct answer: A

Rationale: The correct answer is A: Diarrhea. Hepatotoxicity caused by isoniazid can present with various symptoms, including yellow discoloration of the sclera of the eyes, which indicates jaundice. Another common sign of hepatotoxicity is gastrointestinal symptoms such as nausea, vomiting, and diarrhea, which can occur due to liver dysfunction affecting bile production and digestion. Numbness (choice B) is more commonly associated with peripheral neuropathy caused by isoniazid, while diminished vision (choice C) and light-colored stools (choice D) are not typical manifestations of hepatotoxicity.

2. In chronic obstructive pulmonary disease, the inflammatory response predominantly involves:

• A. eosinophils
• B. neutrophils
• C. monocytes
• D. cells

Correct answer: B

Rationale: In chronic obstructive pulmonary disease, the inflammatory response predominantly involves neutrophils. Neutrophils play a key role in COPD due to their involvement in initiating and sustaining the inflammatory process. Eosinophils are more commonly associated with asthma rather than COPD. Monocytes are less involved in the inflammatory response in COPD compared to neutrophils. The choice 'cells' is too broad and vague to be a specific answer in this context.

3. Which of the following disorders is more likely to be associated with blood in the stool?

• A. Gastroesophageal reflux
• B. Crohn's disease
• C. Irritable bowel syndrome
• D. Colon cancer

Correct answer: D

Rationale: The correct answer is D, Colon cancer. Colon cancer commonly presents with blood in the stool due to bleeding from the tumor. Gastroesophageal reflux (Choice A) is associated with heartburn and regurgitation of stomach contents into the esophagus. Crohn's disease (Choice B) is a type of inflammatory bowel disease that can cause symptoms like abdominal pain, diarrhea, and weight loss, but it does not typically present with blood in the stool as a primary symptom. Irritable bowel syndrome (Choice C) is a functional gastrointestinal disorder characterized by symptoms such as abdominal pain, bloating, and changes in bowel habits, but it does not usually involve blood in the stool as a prominent feature.

4. A patient has been using Viagra on an intermittent basis for several years. However, he has cited delays in the onset and peak of action as the occasional source of frustration. What PDE5 inhibitor may be of particular benefit to this patient's needs?

• A. Avanafil (Stendra)
• B. Tadalafil (Cialis)
• C. Vardenafil (Levitra)
• D. Alprostadil (Caverject)

Correct answer: A

Rationale: The correct answer is Avanafil (Stendra). Avanafil has a rapid onset of action compared to other PDE5 inhibitors, making it suitable for patients experiencing delays in onset and peak of action with other medications like Viagra. Tadalafil (Cialis), Vardenafil (Levitra), and Alprostadil (Caverject) do not offer the same rapid onset of action as Avanafil, making them less suitable for addressing the specific needs of this patient.

5. What causes osteoporosis?

• A. Poor nutrition in infancy
• B. Regularly weight-bearing exercise
• C. Bone loss, frequently during aging
• D. Cerebral palsy and associated disorders

Correct answer: C

Rationale: The correct answer is C. Osteoporosis is commonly caused by bone loss that occurs with aging, leading to brittle bones. Choice A, poor nutrition in infancy, is not a direct cause of osteoporosis. Choice B, regularly weight-bearing exercise, actually helps in maintaining bone density and strength, reducing the risk of osteoporosis. Choice D, cerebral palsy and associated disorders, is not a common cause of osteoporosis.

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