Nokea
A male patient is receiving testosterone therapy for hypogonadism. What serious adverse effect should the nurse monitor for during this therapy?
- A. Increased risk of liver dysfunction
- B. Increased risk of prostate cancer
- C. Increased risk of bone fractures
- D. Increased risk of breast cancer
Correct Answer: A
Rationale: The correct answer is A: Increased risk of liver dysfunction. Testosterone therapy can lead to liver dysfunction, including cholestatic jaundice and hepatitis. This adverse effect necessitates monitoring of liver function tests during testosterone therapy. Choice B, increased risk of prostate cancer, is incorrect because testosterone therapy does not cause prostate cancer but is contraindicated in patients with known or suspected prostate cancer. Choice C, increased risk of bone fractures, is incorrect as testosterone therapy is actually associated with an increase in bone mineral density, reducing the risk of fractures. Choice D, increased risk of breast cancer, is incorrect because testosterone therapy in males does not increase the risk of breast cancer.
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A male patient with erectile dysfunction is prescribed sildenafil (Viagra). What specific instruction should the nurse provide to ensure the safe use of this medication?
- A. Take the medication with food to prevent nausea.
- B. Avoid taking nitrates while on this medication.
- C. Take the medication at bedtime to ensure absorption during sleep.
- D. Take the medication with milk to enhance absorption.
Correct Answer: B
Rationale: The correct instruction the nurse should provide is to avoid taking nitrates while on sildenafil (Viagra). Combining sildenafil with nitrates can result in severe hypotension due to additive vasodilatory effects. Choice A is incorrect because sildenafil can be taken with or without food. Choice C is incorrect as there is no specific requirement to take sildenafil at bedtime. Choice D is incorrect as taking sildenafil with milk has not been shown to enhance its absorption.
A patient with a history of osteoporosis is prescribed alendronate (Fosamax). What specific 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 to prevent esophageal irritation and ensure proper absorption.
- B. Take the medication with milk to enhance calcium absorption.
- C. Take the medication at bedtime to ensure absorption during sleep.
- 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. This positioning helps reduce the risk of esophageal irritation and ensures adequate drug absorption. Choice B is incorrect because alendronate should be taken with water, not milk. Choice C is incorrect as there is no specific advantage to taking alendronate at bedtime. Choice D is incorrect because taking alendronate with food may interfere with its absorption.
A patient with a history of osteoporosis is prescribed raloxifene (Evista). What is the primary therapeutic action of this medication?
- A. It stimulates the formation of new bone.
- B. It decreases bone resorption and increases bone density.
- C. It increases calcium absorption in the intestines.
- D. It increases the excretion of calcium through the kidneys.
Correct Answer: B
Rationale: The correct answer is B: 'It decreases bone resorption and increases bone density.' Raloxifene, as a selective estrogen receptor modulator (SERM), works by reducing bone resorption (breakdown) and maintaining or increasing bone density. This mechanism helps in preventing further bone loss and can even increase bone mass. Choices A, C, and D are incorrect. Raloxifene does not stimulate the formation of new bone (choice A), increase calcium absorption in the intestines (choice C), or increase the excretion of calcium through the kidneys (choice D).
A nurse recalls an example of an immune-complex-mediated disease is:
- A. Bronchial asthma
- B. Contact dermatitis
- C. Serum sickness
- D. Rheumatoid arthritis
Correct Answer: C
Rationale: The correct answer is C: Serum sickness. Serum sickness is characterized by the formation of immune complexes in response to certain medications or proteins. These immune complexes can deposit in tissues, leading to inflammation and tissue damage. Bronchial asthma (Choice A) is a chronic inflammatory condition of the airways not primarily mediated by immune complexes. Contact dermatitis (Choice B) is a type IV hypersensitivity reaction mediated by T cells, not immune complexes. Rheumatoid arthritis (Choice D) is an autoimmune disease where antibodies target self-antigens, but it is not primarily mediated by immune complexes.
What is the expected outcome of administering a granulocyte colony-stimulating factor (G-CSF)?
- A. Reduction in red blood cell count
- B. Decreased number of infections
- C. Decreased fatigue and increased energy
- D. Increase in white blood cell count
Correct Answer: B
Rationale: The correct answer is B: Decreased number of infections. Granulocyte colony-stimulating factor (G-CSF) is a medication used to stimulate the production of white blood cells, specifically granulocytes, in the body. By increasing the number of white blood cells, G-CSF helps in boosting the immune system, leading to a decreased number of infections. Choice A is incorrect as G-CSF does not cause a reduction in red blood cell count. Choice C is incorrect as G-CSF primarily affects white blood cells and is not directly related to fatigue or energy levels. Choice D is incorrect as G-CSF does increase the white blood cell count but does not usually elevate it to 20,000 mm3.