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A patient has been prescribed raloxifene (Evista) for the prevention of osteoporosis. What effect should the nurse include in the teaching plan regarding the action of this medication?
- A. Decreases calcium excretion by the kidneys.
- B. Increases intestinal absorption of calcium.
- C. Stimulates bone formation by increasing osteoblast activity.
- D. Selectively binds to estrogen receptors, decreasing bone resorption.
Correct Answer: D
Rationale: The correct answer is D: Selectively binds to estrogen receptors, decreasing bone resorption. Raloxifene is a selective estrogen receptor modulator (SERM) that works by binding to estrogen receptors, thereby decreasing bone resorption. This action helps in the prevention and treatment of osteoporosis by preserving bone density. Choices A, B, and C are incorrect because raloxifene does not directly affect calcium excretion by the kidneys, intestinal absorption of calcium, or stimulate bone formation by increasing osteoblast activity.
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A 30-year-old male has been brought to the emergency department by his wife because of a severe headache, nausea, vomiting, and fever. A lumbar puncture is performed, and cerebrospinal fluid (CSF) analysis reveals a high protein count, low glucose, and numerous polymorphonuclear leukocytes (PMNs). Which organism is the most likely cause of these findings?
- A. Streptococcus pneumoniae
- B. Neisseria meningitidis
- C. Escherichia coli
- D. Listeria monocytogenes
Correct Answer: A
Rationale: The cerebrospinal fluid (CSF) analysis findings of high protein count, low glucose, and numerous polymorphonuclear leukocytes (PMNs) are classic for bacterial meningitis. Among the choices, Streptococcus pneumoniae is the most likely cause in this case. Streptococcus pneumoniae is a common cause of bacterial meningitis in adults, especially presenting with symptoms such as severe headache, nausea, vomiting, and fever. Neisseria meningitidis is another common cause of bacterial meningitis but is more frequently associated with a different CSF profile. Escherichia coli is a common cause of neonatal meningitis, not typically seen in a 30-year-old male. Listeria monocytogenes is more commonly associated with meningitis in immunocompromised individuals and neonates, and typically presents differently in CSF analysis.
A 57-year-old male presents to his primary care provider with a red face, hands, feet, ears, headache, and drowsiness. A blood smear reveals an increased number of erythrocytes, indicating:
- A. Leukemia
- B. Sideroblastic anemia
- C. Hemosiderosis
- D. Polycythemia vera
Correct Answer: D
Rationale: In this case, the symptoms of a red face, hands, feet, ears, headache, and drowsiness along with an increased number of erythrocytes in the blood smear are indicative of polycythemia vera. This condition is characterized by the overproduction of red blood cells, leading to symptoms related to increased blood volume and viscosity. Leukemia (Choice A) is a cancer of the blood and bone marrow, but the presentation described here is more suggestive of polycythemia vera. Sideroblastic anemia (Choice B) is characterized by abnormal iron deposits in erythroblasts, not an increased number of erythrocytes. Hemosiderosis (Choice C) refers to abnormal accumulation of iron in the body, not an increase in red blood cells as seen in polycythemia vera.
A nurse is educating a client with peripheral artery disease (PAD). Which statement made by the client indicates a need for further teaching?
- A. I should avoid walking for long periods to prevent leg pain.
- B. I should inspect my feet daily for any sores or wounds.
- C. I should wear compression stockings to improve circulation.
- D. I should avoid smoking to prevent further damage to my arteries.
Correct Answer: A
Rationale: The correct answer is A. Walking is crucial in improving circulation in peripheral artery disease; therefore, the client should not avoid walking for long periods. Choices B, C, and D are correct statements for a client with PAD. Inspecting feet daily helps in early detection of sores or wounds, wearing compression stockings improves circulation, and avoiding smoking helps prevent further damage to arteries in PAD.
A patient is starting on finasteride (Proscar) for the treatment of benign prostatic hyperplasia (BPH). What should the nurse include in the patient teaching?
- A. The medication will cure BPH after treatment is complete.
- B. The effects of the medication may take several weeks or months to become noticeable.
- C. The medication may cause increased hair growth.
- D. The medication may decrease libido.
Correct Answer: B
Rationale: The correct answer is B. The effects of finasteride in treating BPH may take several weeks or months to become noticeable. It is important for the nurse to educate the patient about this expected time frame to manage expectations. Choice A is incorrect because finasteride does not cure BPH but helps in managing symptoms. Choice C is incorrect as one of the side effects of finasteride is decreased hair growth. Choice D is incorrect as finasteride may cause a decrease in libido as a side effect.
A 60-year-old male patient is receiving androgen therapy for the treatment of hypogonadism. Which of the following adverse effects should the nurse monitor for?
- A. Hepatotoxicity
- B. Nephrotoxicity
- C. Cardiotoxicity
- D. Pulmonary toxicity
Correct Answer: A
Rationale: The correct answer is A: Hepatotoxicity. Androgen therapy, such as testosterone, can lead to hepatotoxicity, which is toxic to the liver. Therefore, the nurse should monitor the patient's liver function. Choices B, C, and D are incorrect because androgen therapy is not typically associated with nephrotoxicity, cardiotoxicity, or pulmonary toxicity.