Nursing Elites

1. The nurse is closely following a patient who began treatment with testosterone several months earlier. When assessing the patient for potential adverse effects of treatment, the nurse should prioritize which of the following assessments?

• A. Skin inspection for developing lesions
• B. Lung function testing
• C. Assessment of serum calcium levels
• D. Assessment of arterial blood gases

Correct answer: C

Rationale: In patients receiving testosterone therapy, the nurse should prioritize assessing serum calcium levels. Testosterone therapy can lead to hypercalcemia, making the evaluation of serum calcium levels crucial. Skin inspection for developing lesions, lung function testing, and arterial blood gas assessment are not the priority assessments for potential adverse effects of testosterone therapy. Skin inspection may be relevant for dermatological side effects, lung function testing and arterial blood gas assessment are not directly related to the common side effects of testosterone therapy.

2. A 21-year-old male is being started on zidovudine (AZT) for the treatment of HIV/AIDS. Which of the following statements made by the patient indicates that he has understood the patient teaching?

• A. “AZT inactivates the virus and prevents recurrence of the disease.”
• B. “AZT therapy may result in the development of AZT-resistant strains.”
• C. “AZT slows the progression of the disease but does not cure it.”
• D. “AZT prevents the occurrence of opportunistic infections.”

Correct answer: C

Rationale: The correct answer is C. When the patient states, “AZT slows the progression of the disease but does not cure it,” it shows an understanding that zidovudine (AZT) does not provide a cure for HIV/AIDS but helps in slowing down the progression of the disease. Choice A is incorrect because AZT does not inactivate the virus or prevent recurrence. Choice B is incorrect as AZT resistance can develop with therapy. Choice D is incorrect because while AZT can help prevent opportunistic infections by boosting the immune system, its primary action is not the prevention of opportunistic infections.

3. A nurse is teaching a patient about the use of testosterone gel for the treatment of hypogonadism. What important instruction should the nurse provide?

• A. Apply the gel after showering, and allow it to dry completely before dressing.
• B. Apply the gel to the genitals for maximum absorption.
• C. Apply the gel before bedtime to enhance absorption during sleep.
• D. Apply the gel to the face and neck for improved results.

Correct answer: A

Rationale: The correct instruction is to apply testosterone gel after showering and allow it to dry completely before dressing. This helps prevent the transfer of the gel to others and ensures proper absorption. Choice B is incorrect because the gel should not be applied to the genitals. Choice C is incorrect as there is no specific benefit to applying the gel before bedtime. Choice D is incorrect as the gel should not be applied to the face and neck for the treatment of hypogonadism.

4. A patient is administered isoniazid (INH) for tuberculosis. Which of the following adverse effects will result in discontinuation of the medication?

• A. Weight gain
• B. Jaundice
• C. Fever
• D. Arthralgia

Correct answer: B

Rationale: The correct answer is B: Jaundice. Isoniazid (INH) is known to cause hepatotoxicity, which can manifest as jaundice. Jaundice is a serious adverse effect that warrants immediate discontinuation of the medication to prevent further liver damage. Weight gain, fever, and arthralgia are not typically associated with isoniazid use and would not necessitate discontinuation of the medication.

5. When a patient asks the nurse what hypersensitivity is, how should the nurse respond? Hypersensitivity is best defined as:

• A. A reduced immune response found in most pathologic states
• B. A normal immune response to an infectious agent
• C. An excessive or inappropriate response of the immune system to a sensitizing antigen
• D. Antigenic desensitization

Correct answer: C

Rationale: Hypersensitivity is correctly defined as an excessive or inappropriate response of the immune system to a sensitizing antigen. This response leads to tissue damage or other clinical manifestations. Choice A is incorrect as hypersensitivity involves an exaggerated, not a reduced, immune response. Choice B is incorrect because hypersensitivity is not a normal immune response to an infectious agent but rather an exaggerated one. Choice D is incorrect as it refers to desensitization, which is the opposite of hypersensitivity.

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