Nursing Elites

1. An adult patient has begun treatment with fluconazole. The nurse should recognize the need to likely discontinue the drug if the patient develops which of the following signs or symptoms?

• A. Jaundice
• B. Weight gain
• C. Iron deficiency anemia
• D. Hematuria

Correct answer: A

Rationale: The correct answer is A: Jaundice. Fluconazole, an antifungal medication, can rarely cause hepatotoxicity, which may manifest as jaundice. Monitoring for signs of liver dysfunction, such as jaundice, is crucial during fluconazole therapy. Weight gain, iron deficiency anemia, and hematuria are not commonly associated with fluconazole use and are not indications for discontinuing the drug.

2. What laboratory tests should the nurse monitor regularly when a male patient is receiving androgen therapy?

• A. Monitor liver function tests regularly.
• B. Monitor renal function tests regularly.
• C. Monitor blood glucose levels regularly.
• D. Monitor complete blood count (CBC) regularly.

Correct answer: A

Rationale: The correct answer is to monitor liver function tests regularly when a male patient is receiving androgen therapy. Androgen therapy can impact liver function, making it crucial to monitor liver function tests to assess any potential adverse effects on the liver. Renal function tests (choice B) are not typically affected by androgen therapy and do not need specific monitoring for this treatment. Blood glucose levels (choice C) are more relevant in conditions like diabetes or with medications affecting blood sugar, not typically in androgen therapy. Complete blood count (CBC) (choice D) is not directly impacted by androgen therapy and is not a priority for monitoring in this context.

3. A patient is prescribed raloxifene (Evista) for osteoporosis. What is the primary mechanism of action for this medication?

• A. Raloxifene decreases bone resorption, which helps to maintain or increase bone density.
• B. Raloxifene increases calcium absorption in the intestines, which helps build stronger bones.
• C. Raloxifene stimulates new bone formation by increasing osteoblast activity.
• D. Raloxifene decreases calcium excretion by the kidneys, helping to maintain bone density.

Correct answer: A

Rationale: Raloxifene decreases bone resorption, which helps to maintain or increase bone density, making it effective in the prevention and treatment of osteoporosis.

4. When preparing to administer parenteral acyclovir (Zovirax) to an 80-year-old patient with chronic renal failure and herpes simplex, what would the nurse expect in regard to the dose?

• A. The dose is smaller due to the herpes simplex infection.
• B. The dose is smaller based on the patient's kidney function.
• C. The dose is higher in treating genital herpes.
• D. The dose is higher if the creatinine clearance is above 4.0 mg/dL.

Correct answer: B

Rationale: In patients with chronic renal failure, especially in older adults, dosages of medications excreted renally need to be adjusted based on kidney function. Acyclovir is primarily eliminated by the kidneys, so in a patient with chronic renal failure, the dose would need to be smaller to prevent drug accumulation and toxicity. Choice A is incorrect because the dose adjustment is more related to the patient's kidney function than the presence of herpes simplex. Choice C is incorrect because the type of herpes infection does not determine the dose adjustment for acyclovir. Choice D is incorrect as the creatinine clearance is a more accurate measure of kidney function compared to creatinine levels.

5. How will taking an oral contraceptive affect the physiologically of an insulin-dependent diabetic patient?

• A. Increase risk of hypoglycemia
• B. Increase heart rate
• C. Increase blood glucose
• D. Increase risk of metabolic alkalosis

Correct answer: C

Rationale: Taking an oral contraceptive can lead to an increase in blood glucose levels in insulin-dependent diabetic patients. This occurs due to the hormonal changes induced by the contraceptive, which can impact insulin sensitivity. Therefore, diabetic patients need to closely monitor their blood glucose levels when starting an oral contraceptive to prevent complications. The other choices are incorrect as oral contraceptives do not typically lead to an increase in heart rate, risk of hypoglycemia, or risk of metabolic alkalosis in this context.

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