Nokea
A home care nurse visits a patient who is bed-bound and lives in a 12-story high-rise apartment complex. Her daughter states that she has small red skin lesions over her body and she has been itching. What parasite is most likely responsible for this patient's skin lesions?
- A. Sarcoptes scabiei
- B. Pediculus humanus corporis
- C. Pediculus humanus pubis
- D. Toxoplasma gondii
Correct Answer: A
Rationale: The correct answer is Sarcoptes scabiei. Sarcoptes scabiei is a parasitic mite that causes scabies, characterized by small red skin lesions and intense itching. Pediculosis corporis (choice B) refers to body lice, which do not cause the specific symptoms described. Pediculosis pubis (choice C) is caused by pubic lice and presents differently from the symptoms described. Toxoplasma gondii (choice D) is a parasite that causes toxoplasmosis, but it does not typically manifest with small red skin lesions and itching.
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What should the nurse emphasize regarding the risks associated with hormone replacement therapy (HRT) in a patient with a history of cardiovascular disease?
- A. HRT is associated with an increased risk of cardiovascular events, including heart attack and stroke.
- B. HRT may decrease the risk of osteoporosis.
- C. HRT may improve mood and energy levels.
- D. HRT may increase the risk of venous thromboembolism.
Correct Answer: A
Rationale: The correct answer is A because hormone replacement therapy (HRT) is associated with an increased risk of cardiovascular events, including heart attack and stroke, particularly in patients with a history of cardiovascular disease. Choice B is incorrect because HRT does not decrease the risk of osteoporosis; instead, it may have adverse effects on bone health. Choice C is incorrect as the improvement in mood and energy levels is not a significant risk associated with HRT. Choice D is incorrect because while HRT may increase the risk of venous thromboembolism, the question specifically focuses on patients with a history of cardiovascular disease, where the emphasis should be on cardiovascular risks.
A female patient is taking combined hormonal contraceptives to prevent pregnancy. She visits the gynecology clinic and is noted to have a blood pressure of 176/102 mm Hg. The patient is started on enalapril mesylate 10 mg. In collaboration with the primary care provider, what other patient teaching should be provided based on her current medication regimen?
- A. Instruct on a low-salt diet.
- B. Instruct to discontinue the contraceptives.
- C. Instruct on the use of relaxation techniques to decrease stress.
- D. Instruct on the rationale for increasing the contraceptive dose.
Correct Answer: A
Rationale: Women on hormonal contraceptives and antihypertensives like enalapril should be counseled to adopt a low-salt diet if severe hypertension occurs. This dietary modification can help in managing blood pressure levels. Instructing to discontinue the contraceptives is crucial in cases of severe hypertension as it poses an increased risk of cardiovascular events. Instructing on relaxation techniques may have some benefits in reducing stress levels but addressing the root cause, such as discontinuing contraceptives in this scenario, is more critical. There is no rationale for increasing the contraceptive dose when hypertension is present; in fact, it should be stopped to prevent complications.
A young man has received a diagnosis of androgen deficiency and has been prescribed testosterone. At clinic follow-up appointments, the nurse should prioritize which of the following assessments?
- A. Bladder ultrasound and urine testing for glucose and ketones
- B. Weight and measurement of blood pressure
- C. Hearing assessment and abdominal girth measurement
- D. Deep tendon reflexes and random blood glucose testing
Correct Answer: B
Rationale: In a patient receiving testosterone therapy for androgen deficiency, monitoring weight and blood pressure is crucial. Testosterone therapy can lead to weight gain and hypertension, making regular assessments of these parameters important to detect and manage any adverse effects. Choices A, C, and D are not the priority assessments for a patient on testosterone therapy. Bladder ultrasound and urine testing for glucose and ketones, hearing assessment and abdominal girth measurement, and deep tendon reflexes and random blood glucose testing are not directly related to the common side effects or monitoring requirements of testosterone therapy.
A male patient is receiving testosterone therapy for hypogonadism. What adverse effect should the nurse be most concerned about?
- A. Increased risk of breast cancer
- B. Increased risk of liver dysfunction
- C. Increased risk of cardiovascular events
- D. Increased risk of prostate cancer
Correct Answer: C
Rationale: The correct answer is C: Increased risk of cardiovascular events. Cardiovascular events such as stroke and myocardial infarction are the most concerning adverse effects of testosterone therapy, especially in older patients. Choice A, increased risk of breast cancer, is not a common adverse effect of testosterone therapy in males. Choice B, increased risk of liver dysfunction, is a potential adverse effect but is not the most concerning. Choice D, increased risk of prostate cancer, is a consideration in patients with a history of prostate cancer or those with prostate carcinoma, not typically in patients receiving testosterone therapy for hypogonadism.
A client is admitted with a suspected aortic dissection. What is the priority nursing intervention?
- A. Administer antihypertensive medications as prescribed.
- B. Prepare the client for emergency surgery.
- C. Administer intravenous fluids to maintain blood pressure.
- D. Monitor the client's urine output closely.
Correct Answer: B
Rationale: The correct answer is B: Prepare the client for emergency surgery. Aortic dissection is a life-threatening emergency that often necessitates immediate surgical intervention to prevent rupture and further complications. Administering antihypertensive medications (choice A) may be necessary but is not the priority over surgical intervention. While maintaining blood pressure with intravenous fluids (choice C) is important, the urgent need for surgery takes precedence. Monitoring urine output (choice D) is essential for assessing renal function but is not the priority in this critical situation.