A male patient is being treated with sildenafil (Viagra) for erectile dysfunction. What condition would contraindicate the use of this medication?
- A. Peptic ulcer disease
- B. History of myocardial infarction
- C. Recent use of antihypertensive medications
- D. Use of nitrates
Correct Answer: D
Rationale: The correct answer is D: 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 the combination can lead to a dangerous drop in blood pressure. Choice A, peptic ulcer disease, is not a contraindication for sildenafil use. Choice B, a history of myocardial infarction, is not a contraindication unless the patient is also taking nitrates. Choice C, recent use of antihypertensive medications, is not a contraindication but requires caution as the combination can lead to additive effects lowering blood pressure.
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A client with a history of hypertension presents with a severe headache and blurred vision. What is the nurse's priority action?
- A. Administer pain relief medication.
- B. Obtain a stat head CT scan.
- C. Administer antihypertensive medications as prescribed.
- D. Call the healthcare provider immediately.
Correct Answer: C
Rationale: The correct answer is to administer antihypertensive medications as prescribed. In a client with a history of hypertension presenting with severe headache and blurred vision, these symptoms could indicate a hypertensive crisis. The priority action is to lower the blood pressure promptly to prevent complications such as stroke, heart attack, or organ damage. Administering antihypertensive medications is crucial in this situation. Administering pain relief medication (Choice A) may temporarily alleviate symptoms but does not address the underlying issue of elevated blood pressure. Obtaining a stat head CT scan (Choice B) may be necessary to rule out other causes but should not delay the administration of antihypertensive medications. Calling the healthcare provider immediately (Choice D) is important but may not address the immediate need to lower blood pressure in a hypertensive crisis.
What is the best way to prevent transmission of infectious agents?
- A. Take antibiotics daily
- B. Call the practitioner for herbal supplements
- C. Wash hands
- D. Avoid public areas as much as possible
Correct Answer: C
Rationale: The correct answer is C: Wash hands. Washing hands is the most effective way to prevent the transmission of infectious agents. Antibiotics are not effective in preventing infections, and their overuse can lead to antibiotic resistance. Calling a practitioner for herbal supplements is not a primary method for preventing the transmission of infectious agents. Avoiding public areas entirely is impractical and not as effective as proper hand hygiene.
How should the nurse prepare a patient who is to receive a Schilling test for pernicious anemia?
- A. Administer radioactive cobalamin and measure its excretion time
- B. Measure antigen-antibody immune complexes
- C. Measure serum ferritin and total iron-binding capacity
- D. Administer folate and evaluate folate content in a blood serum sample
Correct Answer: A
Rationale: The correct answer is A. To prepare a patient for a Schilling test for pernicious anemia, the nurse should administer radioactive cobalamin and measure its excretion time. This test is specifically designed to assess the absorption of vitamin B12. Choices B, C, and D are incorrect because they do not align with the preparation and procedure of a Schilling test. Measuring antigen-antibody immune complexes, serum ferritin, or total iron-binding capacity, as well as administering folate and evaluating folate content, are not part of the Schilling test protocol.
A 30-year-old woman is taking an oral contraceptive and is concerned about the potential side effects. What should the nurse include in the patient education?
- A. Oral contraceptives can cause weight loss and increased energy levels.
- B. Oral contraceptives can cause increased appetite and weight gain.
- C. Oral contraceptives can cause headaches and breast tenderness.
- D. Oral contraceptives have no side effects.
Correct Answer: C
Rationale: The correct answer is C: 'Oral contraceptives can cause headaches and breast tenderness.' It is essential for the nurse to educate the patient about common side effects of oral contraceptives, such as headaches and breast tenderness. Choices A, B, and D are incorrect. Weight loss and increased energy levels (Choice A) are not common side effects of oral contraceptives. Similarly, increased appetite and weight gain (Choice B) are not typical side effects. Finally, stating that oral contraceptives have no side effects (Choice D) is inaccurate as they can have various side effects, albeit usually mild and manageable.
What causes secondary brain injury after head trauma?
- A. Brain injury resulting from the body's response to tissue damage
- B. Brain injury resulting from initial trauma
- C. Injury as a result of medical therapy
- D. Focal areas of bleeding
Correct Answer: A
Rationale: The correct answer is A. Secondary brain injury occurs due to the body's response to the initial trauma, which can worsen the effects of the primary injury. This response includes processes like inflammation, increased intracranial pressure, and reduced oxygen delivery to tissues. Choice B is incorrect because it refers to the primary trauma itself, not the secondary injury. Choice C is incorrect as it relates to injury caused by medical interventions rather than the body's response. Choice D is incorrect as it specifically mentions focal areas of bleeding, which is a consequence of trauma rather than the cause of secondary brain injury.