Nursing Elites

1. In a patient with HIV infected with Mycobacterium avium complex from an indoor pool, which of the following medications is the recommended treatment for MAC?

• A. Clarithromycin
• B. Isoniazid (INH)
• C. Rifabutin
• D. Azithromycin

Correct answer: A

Rationale: The correct answer is Clarithromycin. Clarithromycin is one of the recommended medications for treating Mycobacterium avium complex (MAC) infections in patients with HIV. It is a macrolide antibiotic that is effective against MAC. Isoniazid (INH) is used to treat tuberculosis, not MAC. Rifabutin is another medication used in the treatment of MAC infections, but clarithromycin is preferred as a first-line agent. Azithromycin is also used in the treatment of MAC infections; however, clarithromycin is more commonly recommended due to its efficacy and safety profile.

2. Rhabdomyolysis can result in serious complications. In addition to muscle pain and weakness, a patient will complain of:

• A. paresthesias.
• B. bone pain.
• C. dark urine.
• D. diarrhea.

Correct answer: C

Rationale: Dark urine is a classic symptom of rhabdomyolysis. When muscle breakdown occurs, myoglobin is released into the bloodstream and filtered by the kidneys, leading to dark urine. Paresthesias (choice A) refer to abnormal sensations like tingling or numbness and are not typically associated with rhabdomyolysis. Bone pain (choice B) is not a prominent symptom of rhabdomyolysis. Diarrhea (choice D) is not a common complaint in rhabdomyolysis cases and is not directly related to muscle breakdown.

3. The parents of a 3-year-old boy have brought him to a pediatrician for assessment of the boy's late ambulation and frequent falls. Subsequent muscle biopsy has confirmed a diagnosis of Duchenne muscular dystrophy. Which teaching point should the physician include when explaining the child's diagnosis to his parents?

• A. Your child may develop breathing difficulties as the disease progresses.
• B. Your child is likely to benefit from physical therapy and exercise.
• C. This condition can be cured with early intervention and treatment.
• D. The disease is caused by inflammation in the muscles, which leads to weakness.

Correct answer: A

Rationale: The correct teaching point that the physician should include when explaining Duchenne muscular dystrophy to the parents is that 'Your child may develop breathing difficulties as the disease progresses.' Duchenne muscular dystrophy is a progressive condition that affects muscle strength, including respiratory muscles, leading to breathing difficulties as the disease advances. Choice B is incorrect because while physical therapy and exercise can help maintain muscle function and mobility, they do not cure the condition. Choice C is incorrect because Duchenne muscular dystrophy is a genetic disorder with no known cure. Choice D is incorrect as Duchenne muscular dystrophy is primarily characterized by a lack of dystrophin protein due to genetic mutations, not inflammation in the muscles.

4. A male patient with benign prostatic hyperplasia (BPH) is being treated with tamsulosin (Flomax). What should the nurse include in the teaching plan for this patient?

• A. Avoid lying down after taking the medication.
• B. Take the medication with meals.
• C. Report any side effects such as dizziness or fainting.
• D. Take the medication at bedtime.

Correct answer: C

Rationale: The correct answer is C: 'Report any side effects such as dizziness or fainting.' Patients taking tamsulosin should be advised to report any side effects, such as dizziness or fainting, which can occur due to orthostatic hypotension. Choices A, B, and D are incorrect because avoiding lying down after taking the medication, taking it with meals, or at bedtime are not specific teaching points related to the potential side effects of tamsulosin.

5. A patient is taking alendronate (Fosamax) for osteoporosis. What 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.
• B. Take the medication at bedtime to ensure absorption during sleep.
• C. Take the medication with milk to enhance calcium absorption.
• 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. Taking the medication at bedtime (choice B) is not recommended as it can lead to esophageal irritation when lying down. Taking the medication with milk (choice C) is incorrect as it may interfere with the absorption of alendronate. Taking the medication with food (choice D) is not recommended as it may reduce the effectiveness of the medication.

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