Nokea
A male patient is receiving testosterone therapy for hypogonadism. What adverse effect should the nurse monitor during this therapy?
- A. Increased risk of cardiovascular events
- B. Increased risk of liver dysfunction
- C. Increased risk of prostate cancer
- D. Increased risk of bone fractures
Correct Answer: A
Rationale: The correct answer is A: Increased risk of cardiovascular events. Testosterone therapy can lead to an increased risk of cardiovascular events like heart attacks and strokes, especially in older patients. Choice B, increased risk of liver dysfunction, is not a common adverse effect of testosterone therapy. Choice C, increased risk of prostate cancer, is a concern when using testosterone therapy in patients with existing prostate cancer, but not a general adverse effect. Choice D, increased risk of bone fractures, is not typically associated with testosterone therapy.
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Which type of lymphocyte recognizes and eliminates virus-infected cells and cancerous cells?
- A. Neutrophils
- B. Macrophages
- C. Natural killer cells
- D. Langerhans cells
Correct Answer: C
Rationale: Natural killer cells are a type of lymphocyte that plays a crucial role in recognizing and eliminating virus-infected cells and cancerous cells. Neutrophils (Choice A) are a type of white blood cell involved in fighting infections, mainly through phagocytosis. Macrophages (Choice B) are another type of white blood cell that engulfs and digests cellular debris and pathogens. Langerhans cells (Choice D) are a type of dendritic cell found in the skin and mucosa, primarily involved in antigen presentation.
A patient with osteoporosis is prescribed raloxifene (Evista). What is the primary therapeutic action of this medication?
- A. It decreases bone resorption and increases bone density.
- B. It stimulates the formation of new bone.
- C. It increases calcium absorption in the intestines.
- D. It increases the excretion of calcium through the kidneys.
Correct Answer: A
Rationale: The correct answer is A. Raloxifene works by decreasing bone resorption and increasing bone density. This helps in preventing further bone loss and reducing the risk of fractures in patients with osteoporosis. Choice B is incorrect because raloxifene does not stimulate the formation of new bone, but rather helps to maintain existing bone mass. Choice C is incorrect as raloxifene does not directly increase calcium absorption in the intestines. Choice D is also incorrect as raloxifene does not increase the excretion of calcium through the kidneys.
A patient's current medical condition is suggestive of impaired erythropoiesis. Which of the following laboratory studies would be most clinically relevant in diagnosing this health problem?
- A. White blood cell count with differential
- B. RBC, hemoglobin, and hematocrit
- C. INR and aPTT
- D. d-dimer and C-reactive protein
Correct Answer: B
Rationale: In this scenario, where impaired erythropoiesis is suspected, the most clinically relevant laboratory studies would focus on red blood cell parameters. Therefore, assessing RBC count, hemoglobin levels, and hematocrit values would provide direct insights into erythropoiesis. Choices A, C, and D are not directly related to erythropoiesis assessment. White blood cell count with a differential is more indicative of immune response and infection. INR and aPTT are coagulation studies, while d-dimer and C-reactive protein levels are more associated with inflammation and thrombotic events.
The unique clinical presentation of a 3-month-old infant in the emergency department leads the care team to suspect botulism. Which assessment question posed to the parents is likely to be most useful in the differential diagnosis?
- A. Has your child received all recommended vaccinations?
- B. Has your child been feeding poorly or showing signs of constipation?
- C. Has your child been exposed to any sick individuals?
- D. Has your child been displaying signs of respiratory distress?
Correct Answer: B
Rationale: The correct answer is B. Poor feeding and constipation are common early symptoms of infant botulism, which is caused by a neurotoxin that impairs muscle function. Option A is unrelated to the presentation of botulism. Option C does not directly relate to the symptoms of botulism. Option D is more indicative of respiratory issues rather than the constellation of symptoms seen in botulism.
A patient began antiretroviral therapy several weeks ago for the treatment of HIV, and he has now presented to the clinic for a scheduled follow-up appointment. He states to the nurse, "I've been pretty good about taking all my pills on time, though it was a bit hit and miss over the holiday weekend." How should the nurse best respond to this patient's statement?
- A. "Remember that if you miss a dose, you need to take a double dose at the next scheduled time."
- B. "It's acceptable to miss an occasional dose as long as your symptoms don't worsen, but it's important to strive for consistent adherence."
- C. "Remember that your antiretroviral drugs will only be effective if you take them consistently and as prescribed."
- D. "If you're not consistent with taking your medications, you're likely to develop more side effects."
Correct Answer: C
Rationale: The correct response is to remind the patient that antiretroviral drugs are most effective when taken consistently and as prescribed. Choice A is incorrect because taking a double dose after missing a dose is not recommended, as it can lead to medication toxicity. Choice B is incorrect as it may give the impression that missing doses is acceptable, which can reduce the effectiveness of the treatment. Choice D is incorrect because while consistency is important, the focus should be on treatment effectiveness rather than side effects.