Nursing Elites

1. What important information should the nurse provide about the risks associated with tamoxifen (Nolvadex) for a patient with a history of breast cancer?

• A. Tamoxifen may increase the risk of venous thromboembolism.
• B. Tamoxifen may decrease the risk of osteoporosis.
• C. Tamoxifen may cause hot flashes and other menopausal symptoms.
• D. Tamoxifen may cause weight gain and fluid retention.

Correct answer: A

Rationale: The correct answer is A: Tamoxifen may increase the risk of venous thromboembolism. Patients on tamoxifen should be educated about the signs and symptoms of blood clots. Choices B, C, and D are incorrect. Tamoxifen does not decrease the risk of osteoporosis; it may cause hot flashes and other menopausal symptoms, and it may cause weight gain and fluid retention.

2. A patient is prescribed dutasteride (Avodart) for benign prostatic hyperplasia (BPH). What outcome should the nurse expect to observe if the drug is having the desired effect?

• A. Decreased size of the prostate gland
• B. Increased urinary output
• C. Increased urine flow
• D. Decreased blood pressure

Correct answer: A

Rationale: The correct answer is A: Decreased size of the prostate gland. Dutasteride is a medication used for BPH to reduce the size of the prostate gland, thereby improving urinary flow and decreasing symptoms. Choice B, increased urinary output, is incorrect as dutasteride primarily targets the size of the prostate gland rather than directly affecting urinary output. Choice C, increased urine flow, is related to the expected outcome of dutasteride therapy but is not as direct as the reduction in the size of the prostate gland. Choice D, decreased blood pressure, is not an expected outcome of dutasteride therapy for BPH.

3. A patient is receiving chloroquine (Aralen) for extraintestinal amebiasis. Which of the following medications should be administered with chloroquine?

• A. Iodoquinol (Yodoxin)
• B. Metronidazole (Flagyl)
• C. Metyrosine (Demser)
• D. Carbamazepine (Tegretol)

Correct answer: B

Rationale: The correct answer is B: Metronidazole (Flagyl). When treating extraintestinal amebiasis, chloroquine is often used in combination with metronidazole to ensure the eradication of the parasite. Metronidazole helps to target the infection more effectively. Choices A, C, and D are incorrect. Iodoquinol (Yodoxin) is another antiprotozoal agent but is not typically used in combination with chloroquine for amebiasis. Metyrosine (Demser) is used in the management of pheochromocytoma, and carbamazepine (Tegretol) is an anticonvulsant and mood-stabilizing drug, neither of which are indicated for extraintestinal amebiasis.

4. A patient with breast cancer is prescribed tamoxifen (Nolvadex). What key point should the nurse include in the patient education?

• A. Tamoxifen may increase the risk of venous thromboembolism.
• B. Tamoxifen may cause hot flashes and other menopausal symptoms.
• C. Tamoxifen may cause weight gain and fluid retention.
• D. Tamoxifen may decrease the risk of osteoporosis.

Correct answer: A

Rationale: The correct answer is A: "Tamoxifen may increase the risk of venous thromboembolism." It is crucial for patients to be aware of the signs and symptoms of blood clots while taking tamoxifen. Choice B is incorrect because hot flashes and menopausal symptoms are common side effects of tamoxifen, but they are not the key point to emphasize. Choice C is incorrect as weight gain and fluid retention are potential side effects of tamoxifen but not the key point for patient education. Choice D is incorrect as tamoxifen does not decrease the risk of osteoporosis; in fact, it may increase the risk of bone loss.

5. What important instruction should the nurse provide regarding the application of testosterone gel in a patient with hypogonadism?

• A. Apply the gel to the chest or upper arms and allow it to dry completely before dressing.
• B. Apply the gel to the face and neck for maximum absorption.
• C. Apply the gel to the genitals for improved results.
• D. Apply the gel to the scalp and back for better results.

Correct answer: A

Rationale: The correct instruction for applying testosterone gel in a patient with hypogonadism is to apply it to the chest or upper arms and allow it to dry completely before dressing. This method helps avoid transfer to others. Applying the gel to the face, neck, or genitals is not recommended as it can lead to unintended exposure to others. Additionally, applying the gel to the scalp and back is not a standard or effective route of administration for testosterone gel. Therefore, choice A is the correct answer as it ensures proper application and safety.

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