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A male patient with benign prostatic hyperplasia (BPH) is prescribed finasteride (Proscar). What therapeutic effect is expected from this medication?
- A. Reduction in prostate size and improvement in urinary symptoms
- B. Increase in urine flow and relief of urinary obstruction
- C. Improvement in erectile function
- D. Relief of pain associated with BPH
Correct Answer: A
Rationale: The correct answer is A: Reduction in prostate size and improvement in urinary symptoms. Finasteride works by reducing the size of the prostate gland, which in turn helps alleviate urinary symptoms such as frequency, urgency, weak stream, and incomplete emptying of the bladder. Choice B is incorrect as while finasteride can improve urine flow indirectly by reducing prostate size, it does not directly increase urine flow. Choice C is incorrect because finasteride is not intended to improve erectile function. Choice D is incorrect as finasteride does not primarily provide relief from pain associated with BPH.
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A 35-year-old male has enlarged lymph nodes in the neck and a mediastinal mass. He was diagnosed with Hodgkin lymphoma. Which of the following abnormal cells would the nurse expect to find with this disease?
- A. Merkel cell
- B. Schwann cell
- C. Reed-Sternberg cell
- D. Kupffer cell
Correct Answer: C
Rationale: Reed-Sternberg cells are characteristic of Hodgkin lymphoma. These large abnormal cells have a bi-lobed or multi-lobed nucleus and are essential for diagnosing Hodgkin lymphoma through histological examination. Merkel cells are associated with Merkel cell carcinoma, Schwann cells are related to nerve sheaths, and Kupffer cells are liver macrophages. Therefore, choices A, B, and D are incorrect for Hodgkin lymphoma.
A patient is starting on atorvastatin (Lipitor) for hyperlipidemia. What important instruction should the nurse provide?
- A. Take the medication at night to reduce the risk of muscle pain.
- B. Avoid consuming grapefruit juice while taking this medication.
- C. Take the medication in the morning with breakfast.
- D. Avoid taking the medication with alcohol to reduce the risk of liver damage.
Correct Answer: A
Rationale: The correct answer is A. Atorvastatin should be taken at night to reduce the risk of muscle pain and other side effects. Taking it at night aligns with the body's natural rhythm of cholesterol production, optimizing its effectiveness. Choice B is incorrect because grapefruit juice can increase the risk of side effects by affecting the metabolism of atorvastatin. Choice C is incorrect as taking atorvastatin in the morning does not maximize its effectiveness. Choice D is incorrect because alcohol consumption can increase the risk of liver damage when combined with atorvastatin.
A client with diabetes mellitus has just undergone a right, below-the-knee amputation following gangrene infection. A few days after the amputation, the client confides in the nurse that he still feels his right foot. Knowing the pathophysiologic principles behind this, the nurse can:
- A. administer a psychotropic medication to help the client cope with the sensation of his amputated leg.
- B. explain that many amputees have this sensation and that one theory surmises the end of a regenerating nerve becomes trapped in the scar tissue of the amputation site.
- C. call the physician and request an order for a psychological consult.
- D. educate the client that this area has an unusually abnormal increase in sensitivity to sensation but that it will go away with time.
Correct Answer: B
Rationale: The correct answer is B. The sensation of feeling the amputated limb is known as phantom limb pain, which is common after amputation. One theory suggests that it occurs because the end of a regenerating nerve becomes trapped in the scar tissue at the amputation site. Administering psychotropic medication (choice A) is not the first-line treatment for phantom limb pain. Requesting a psychological consult (choice C) is premature without first addressing the known pathophysiological basis of phantom limb pain. Educating the client that the sensitivity will go away with time (choice D) is not entirely accurate as phantom limb pain can persist long-term.
A client with amyotrophic lateral sclerosis (ALS) is admitted to the hospital. Which intervention should the nurse include in the plan of care?
- A. Administer muscle relaxants as prescribed.
- B. Assist the client with activities of daily living (ADLs).
- C. Provide nutritional support to prevent aspiration.
- D. Encourage the client to participate in physical therapy.
Correct Answer: C
Rationale: The correct intervention for a client with ALS is to provide nutritional support to prevent aspiration. ALS causes muscle weakness, including the muscles used for swallowing, increasing the risk of aspiration. Providing proper nutrition and support can help prevent this complication. Administering muscle relaxants (Choice A) may not be suitable for ALS as it can further weaken muscles. While assisting with ADLs (Choice B) and encouraging physical therapy (Choice D) are important aspects of care, the priority for a client with ALS is to prevent complications related to swallowing and nutrition.
How should rifampin most likely be administered to a patient diagnosed with tuberculosis?
- A. Orally, with food
- B. Orally, on an empty stomach
- C. Intramuscularly
- D. Intravenously, as a bolus
Correct Answer: A
Rationale: Rifampin is typically administered orally, and it is recommended to be taken with food to enhance its absorption and reduce gastrointestinal side effects. Administering rifampin intramuscularly or intravenously is not the standard route of administration for this medication used in tuberculosis treatment.