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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.
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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.
What type of immunity will the hepatitis B series provide a nursing student scheduled to receive it?
- A. Active immunity
- B. Passive immunity
- C. Innate immunity
- D. Natural immunity
Correct Answer: A
Rationale: The correct answer is active immunity. The hepatitis B series immunization will provide active immunity, where the individual's immune system is stimulated to produce antibodies against the hepatitis B virus. This type of immunity is long-lasting and provides protection against future exposures. Passive immunity (choice B) involves the transfer of pre-formed antibodies and is temporary. Innate immunity (choice C) is the body's natural defense mechanisms, present at birth. Natural immunity (choice D) refers to immunity acquired through normal life processes, such as recovering from an infection.
In Guillain-Barre syndrome, what pathophysiologic process underlies the deficits that accompany the degeneration of myelin in the peripheral nervous system (PNS)?
- A. The destruction of myelin results in a reduction in Schwann cell production in the client's PNS.
- B. The lack of myelin surrounding nerve cells compromises the axonal transport system.
- C. Without remyelination, the axon will eventually die.
- D. A deficit of myelin makes the client more susceptible to infection by potential pathogens.
Correct Answer: C
Rationale: In Guillain-Barre syndrome, the destruction of myelin leads to axonal damage. If remyelination does not occur, the axon will eventually degenerate and die, impacting nerve function. Choice A is incorrect because the destruction of myelin does not affect Schwann cell production. Choice B is incorrect as the lack of myelin directly affects the conduction of nerve impulses, not the axonal transport system. Choice D is incorrect as a deficit of myelin does not predispose the client to infections by potential pathogens.
A patient who is undergoing treatment for cytomegalovirus received his first dose of IV ganciclovir 3 days ago. When reviewing this patient's most recent blood work, what abnormality should the nurse most likely attribute to the use of this drug?
- A. Hemoglobin 17 g/dL (high normal)
- B. INR 3.8 (high)
- C. Platelet count 118,000/mm3 (low)
- D. Leukocytes 11,900/mm3 (high)
Correct Answer: C
Rationale: The correct answer is C: Platelet count 118,000/mm3 (low). Ganciclovir, used to treat cytomegalovirus, is known to cause bone marrow suppression, leading to decreased platelet count (thrombocytopenia). This condition can increase the risk of bleeding. Choices A, B, and D are not typically associated with ganciclovir therapy. High hemoglobin levels (choice A) are not commonly seen with ganciclovir treatment. INR elevation (choice B) is associated with coagulation abnormalities, which are not a typical side effect of ganciclovir. Elevated leukocyte count (choice D) is not a common consequence of ganciclovir use.
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.