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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A patient is prescribed clomiphene citrate (Clomid) for the treatment of infertility. Which of the following statements should be included in the nurse's teaching?
- A. This drug induces ovulation by stimulating gonadotropins.
- B. This drug induces ovulation by inhibiting gonadotropins.
- C. This drug suppresses ovulation by inhibiting gonadotropins.
- D. This drug increases progesterone levels, which maintains pregnancy.
Correct Answer: A
Rationale: The correct statement to include in the nurse's teaching is that clomiphene induces ovulation by stimulating the release of gonadotropins, which in turn stimulate the ovaries. Choice B is incorrect because clomiphene does not induce ovulation by inhibiting gonadotropins. Choice C is also incorrect as clomiphene does not suppress ovulation by inhibiting gonadotropins. Choice D is inaccurate as clomiphene does not directly increase progesterone levels to maintain pregnancy.
A patient is prescribed sildenafil (Viagra) for erectile dysfunction. What is a key contraindication that the nurse should review with the patient?
- A. History of hypertension
- B. Use of nitrates
- C. Use of antihypertensive medications
- D. History of peptic ulcer disease
Correct Answer: B
Rationale: The correct answer is B: 'Use of nitrates.' Sildenafil (Viagra) is contraindicated in patients taking nitrates due to the risk of severe hypotension. Nitrates and sildenafil both act as vasodilators, and their combined use can lead to a dangerous drop in blood pressure. Choices A, C, and D are incorrect because having a history of hypertension, using antihypertensive medications, or having a history of peptic ulcer disease are not key contraindications for sildenafil use.
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 patient with a diagnosis of renal failure is being treated with epoetin alfa (Epogen). Frequent assessment of which of the following laboratory values should be prioritized before and during treatment?
- A. AST
- B. C-reactive protein
- C. CBC
- D. ALT
Correct Answer: A
Rationale: The correct answer is AST. Epoetin alfa is a medication used to treat anemia associated with chronic renal failure. During treatment with epoetin alfa, it is crucial to monitor AST levels as this medication can potentially lead to liver toxicity. Assessing AST levels before and throughout treatment helps in early detection of any liver abnormalities. C-reactive protein is not specifically related to the use of epoetin alfa in renal failure. While CBC (Complete Blood Count) monitoring is essential during treatment with epoetin alfa to evaluate the response to therapy, prioritizing AST assessment is more critical due to the potential for liver toxicity. ALT monitoring is also important but AST is prioritized in this scenario.
In a 41-year-old male patient with a complex medical history diagnosed with secondary hypogonadism, which of the following health problems is the most likely etiology of his diagnosis?
- A. Type 1 diabetes
- B. Mumps
- C. An inflammatory process in the testicles
- D. Testicular trauma
Correct Answer: C
Rationale: The correct answer is C: An inflammatory process in the testicles. Secondary hypogonadism in males can be caused by various factors, including an inflammatory process in the testicles. Mumps (choice B) can lead to orchitis but is less common in adults. Type 1 diabetes (choice A) is not a common cause of secondary hypogonadism. Testicular trauma (choice D) can cause primary hypogonadism but is less likely to cause secondary hypogonadism.