Nokea
A 70-year-old patient is seen in the family practice clinic. Which of the following vaccines should be administered to prevent shingles?
- A. Zoster vaccine
- B. Haemophilus influenzae Type b (Hib) vaccine
- C. Human papillomavirus (HPV) vaccine
- D. Pneumococcal polyvalent vaccine
Correct Answer: A
Rationale: The correct answer is A: Zoster vaccine. The Zoster vaccine is recommended for the prevention of shingles in individuals aged 50 years and older. Shingles is caused by the reactivation of the varicella-zoster virus, the same virus that causes chickenpox. The vaccine helps reduce the risk of developing shingles and decreases the severity and duration of the illness if it occurs. Choices B, C, and D are incorrect: Haemophilus influenzae Type b (Hib) vaccine is used to prevent infections caused by Haemophilus influenzae type b, Human papillomavirus (HPV) vaccine is used to prevent HPV infections that can lead to cervical cancer and other cancers, and Pneumococcal polyvalent vaccine is used to protect against infections caused by the bacterium Streptococcus pneumoniae.
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A patient is found to have liver disease, resulting in the removal of a lobe of his liver. Adaptation to the reduced size of the liver leads to ___________ of the remaining liver cells.
- A. Metaplasia
- B. Organ atrophy
- C. Compensatory hyperplasia
- D. Physiologic hyperplasia
Correct Answer: C
Rationale: Compensatory hyperplasia is the process by which the remaining cells increase in number to adapt to the reduced size of the liver. In this case, after the removal of a lobe of the liver, the remaining cells undergo compensatory hyperplasia to compensate for the lost tissue. Metaplasia refers to the reversible change of one cell type to another, not an increase in cell number. Organ atrophy is the decrease in organ size due to cell shrinkage or loss, which is opposite to an increase in cell number seen in compensatory hyperplasia. Physiologic hyperplasia is the increase in cell number in response to a normal physiological demand, not specifically due to the removal of a portion of the organ.
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.
A patient is starting on alendronate (Fosamax) for osteoporosis. What 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.
- B. Take the medication at bedtime to ensure absorption during sleep.
- C. Take the medication with milk to enhance calcium absorption.
- D. Take the medication with food to prevent gastrointestinal upset.
Correct Answer: A
Rationale: The correct answer is to take alendronate with a full glass of water and remain upright for at least 30 minutes. This is essential to prevent esophageal irritation and ensure proper absorption. Choice B is incorrect because taking alendronate at bedtime can increase the risk of esophageal irritation due to lying down. Choice C is incorrect as taking alendronate with milk can reduce its absorption. Choice D is incorrect because alendronate should be taken on an empty stomach to enhance its effectiveness.
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.
A nursing student is learning about the effects of bactericidal agents. How does rifampin (Rifadin) achieve a therapeutic action against both intracellular and extracellular tuberculosis organisms?
- A. It is metabolized in the liver.
- B. It binds to acetylcholine.
- C. It inhibits synthesis of RNA.
- D. It causes phagocytosis.
Correct Answer: C
Rationale: Rifampin (Rifadin) achieves a therapeutic action against both intracellular and extracellular tuberculosis organisms by inhibiting the synthesis of RNA. This action interferes with bacterial RNA synthesis, leading to the suppression of protein synthesis in the bacteria, ultimately causing their death. Option A is incorrect because rifampin is primarily metabolized in the liver, but this is not how it exerts its bactericidal effects. Option B is incorrect as rifampin does not bind to acetylcholine. Option D is also incorrect as rifampin does not cause phagocytosis.