Nursing Elites

1. A patient with a history of osteoporosis is prescribed alendronate (Fosamax). What specific 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 to prevent esophageal irritation and ensure proper absorption.
• B. Take the medication with milk to enhance calcium absorption.
• C. Take the medication at bedtime to ensure absorption during sleep.
• D. Take the medication with food to prevent nausea.

Correct answer: A

Rationale: The correct answer is A. Alendronate should be taken with a full glass of water, and patients should remain upright for at least 30 minutes to prevent esophageal irritation and ensure proper absorption. This positioning helps reduce the risk of esophageal irritation and ensures adequate drug absorption. Choice B is incorrect because alendronate should be taken with water, not milk. Choice C is incorrect as there is no specific advantage to taking alendronate at bedtime. Choice D is incorrect because taking alendronate with food may interfere with its absorption.

2. A male patient receiving androgen therapy is concerned about prostate cancer. What should the nurse explain about the risks associated with this therapy?

• A. Finasteride has been shown to reduce the risk of developing prostate cancer.
• B. Finasteride has no impact on the risk of developing prostate cancer.
• C. Finasteride may increase the risk of developing prostate cancer.
• D. Finasteride has no effect on the risk of prostate cancer.

Correct answer: A

Rationale: The correct answer is A. Finasteride, a type of androgen therapy, has been shown to reduce the risk of developing prostate cancer. It works by shrinking the prostate gland, which can help lower the risk of developing prostate cancer. However, while it may reduce the risk, regular screening is still recommended to monitor for any potential issues. Choice B is incorrect because finasteride does have an impact on reducing the risk of prostate cancer. Choice C is incorrect as finasteride is not known to increase the risk of developing prostate cancer. Choice D is incorrect as finasteride does have an effect on reducing the risk of prostate cancer.

3. A patient who was frequently homeless over the past several years has begun a drug regimen consisting solely of isoniazid (INH). What is this patient's most likely diagnosis?

• A. Active tuberculosis
• B. Latent tuberculosis
• C. Mycobacterium avium complex
• D. Human immunodeficiency virus

Correct answer: A

Rationale: The correct answer is A: Active tuberculosis. Given the patient's history of homelessness and initiation of isoniazid (INH) treatment, the most likely diagnosis is active tuberculosis. Isoniazid is a first-line medication used in the treatment of active tuberculosis. Latent tuberculosis (choice B) would not typically necessitate treatment with isoniazid alone. Mycobacterium avium complex (choice C) is not typically treated with isoniazid alone. Human immunodeficiency virus (choice D) is a risk factor for developing tuberculosis but is not the primary diagnosis in this patient scenario.

4. 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.

5. When the maternal immune system becomes sensitized against antigens expressed by the fetus, what type of immune reaction occurs?

• A. Autoimmune
• B. Anaphylaxis
• C. Alloimmune
• D. Allergic

Correct answer: C

Rationale: When the maternal immune system becomes sensitized against antigens expressed by the fetus, an alloimmune reaction occurs. In this situation, the mother's immune system recognizes the fetus as foreign due to differences in antigens, leading to an immune response against the fetus. Choice A, 'Autoimmune,' is incorrect because it refers to the immune system mistakenly attacking the body's own cells and tissues. Choice B, 'Anaphylaxis,' is not the correct answer as it is a severe allergic reaction that can be life-threatening. Choice D, 'Allergic,' is also incorrect as it refers to an immune response triggered by allergens, not antigens expressed by the fetus.

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