Nursing Elites

1. A patient with erectile dysfunction is prescribed sildenafil (Viagra). What condition would contraindicate the use of this medication?

• A. History of hypertension
• B. Use of nitrates
• C. Recent use of antihypertensive medications
• D. History of peptic ulcer disease

Correct answer: B

Rationale: The correct answer is B: 'Use of nitrates.' Sildenafil (Viagra) is contraindicated in patients taking nitrates due to the risk of severe hypotension. Nitrates and sildenafil both cause vasodilation, and their combined use can lead to a dangerous drop in blood pressure. Choices A, C, and D are incorrect because a history of hypertension, recent use of antihypertensive medications, or a history of peptic ulcer disease are not direct contraindications for using sildenafil.

2. What is the action of amphotericin B?

• A. It binds to ergosterol and forms holes in the membrane.
• B. It binds to an enzyme required for the synthesis of ergosterol.
• C. It disrupts the fungal cell walls rather than the cell membrane.
• D. It inhibits glucan synthetase required for glucan synthesis.

Correct answer: A

Rationale: Amphotericin B is an antifungal medication that acts by binding to ergosterol, a component of fungal cell membranes, forming pores that disrupt the integrity of the membrane. This action leads to leakage of cellular contents and ultimately cell death. Choice B is incorrect as amphotericin B does not bind to an enzyme required for the synthesis of ergosterol. Choice C is incorrect as the drug primarily affects the cell membrane rather than the cell wall. Choice D is also incorrect as amphotericin B does not inhibit glucan synthetase.

3. A patient with a history of breast cancer is being prescribed tamoxifen (Nolvadex). The nurse should educate the patient about what potential side effect of this medication?

• A. Increased risk of venous thromboembolism
• B. Increased risk of hot flashes
• C. Increased risk of cataracts
• D. Increased risk of bone fractures

Correct answer: A

Rationale: The correct answer is A: Increased risk of venous thromboembolism. Tamoxifen is known to increase the risk of venous thromboembolism, a serious side effect. Patients should be educated about the signs and symptoms of blood clots such as swelling, redness, warmth, or pain in the affected limb. Choices B, C, and D are incorrect because tamoxifen is not associated with an increased risk of hot flashes, cataracts, or bone fractures.

4. During the home visit of a client with dementia, the nurse notes that an adult daughter persistently corrects her father’s misperceptions of reality, even when the father becomes upset and anxious. Which intervention should the nurse teach the caregiver?

• A. Anxiety-reducing measures
• B. Positive reinforcement
• C. Reality orientation techniques
• D. Validation techniques

Correct answer: D

Rationale: The correct answer is D: Validation techniques. In dementia care, using validation techniques involves acknowledging the person's feelings and reality, even if it differs from actual events or facts. It helps in reducing the client's anxiety and distress. In this scenario, the daughter persistently correcting her father's misperceptions can escalate his anxiety. Teaching the daughter validation techniques will encourage her to validate her father's feelings and perceptions, ultimately promoting a more supportive and less confrontational environment. Choices A, B, and C are incorrect in this context. While anxiety-reducing measures can be beneficial, the primary issue here is the father's misperceptions being consistently corrected. Positive reinforcement focuses on rewarding desired behaviors, which is not directly related to the situation described. Reality orientation techniques involve constantly reminding the person of the correct time, place, and other details, which may not be suitable for someone with dementia experiencing distress.

5. What nursing diagnosis is suggested by the patient's statement regarding taking extra griseofulvin when she thinks her infection is getting worse?

• A. Deficient knowledge related to correct use of griseofulvin
• B. Effective therapeutic regimen management related to symptom identification
• C. Disturbed thought processes related to appropriate use of griseofulvin
• D. Ineffective coping related to self-medication

Correct answer: C

Rationale: The correct answer is C: 'Disturbed thought processes related to appropriate use of griseofulvin.' The patient's statement shows a misunderstanding of the correct use of griseofulvin by taking extra medication when she believes her infection is worsening. This behavior indicates a disturbance in her thought process regarding the appropriate use of the medication. Choice A is incorrect because the issue is not lack of knowledge but rather a misunderstanding leading to inappropriate actions. Choice B is incorrect as the patient's actions do not demonstrate effective management of her therapeutic regimen. Choice D is incorrect as the patient is not engaged in self-medication but rather misinterpreting signals and self-adjusting the prescribed medication.

Similar Questions