Nokea
A patient is prescribed sildenafil (Viagra) for erectile dysfunction. What condition would contraindicate the use of this medication?
- A. History of peptic ulcer disease
- B. Use of nitrates
- C. Use of antihypertensive medications
- D. History of hypertension
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 combined with sildenafil can lead to a dangerous drop in blood pressure. Choices A, C, and D are incorrect because a history of peptic ulcer disease, use of antihypertensive medications, or a history of hypertension are not direct contraindications for sildenafil use.
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An influenza outbreak has spread through a long-term care residence, affecting many of the residents with severe malaise, fever, and nausea and vomiting. In an effort to curb the outbreak, the nurse has liaised with a physician to see if residents may be candidates for treatment with what drug?
- A. Saquinavir mesylate
- B. Oseltamivir phosphate
- C. Lamivudine
- D. Ribavirin
Correct Answer: B
Rationale: The correct answer is B: Oseltamivir phosphate. Oseltamivir is an antiviral medication used to treat influenza infections. It works by inhibiting the neuraminidase enzyme of the influenza virus, reducing the spread of the virus in the body. Saquinavir mesylate (choice A) is used in the treatment of HIV, not influenza. Lamivudine (choice C) is also an antiviral medication primarily used in the treatment of HIV and hepatitis B, not influenza. Ribavirin (choice D) is used to treat certain viral infections like hepatitis C, respiratory syncytial virus (RSV), and some viral hemorrhagic fevers, but it is not a first-line treatment for influenza.
A patient is starting on a statin medication for hyperlipidemia. What critical instruction should the nurse provide?
- A. Take the medication at night to reduce the risk of muscle pain and other side effects.
- B. Take the medication in the morning with breakfast to improve absorption.
- C. Avoid alcohol consumption while taking this medication to reduce the risk of liver damage.
- D. Take the medication with a high-fat meal to increase its effectiveness.
Correct Answer: A
Rationale: The correct answer is A. Statins like atorvastatin should be taken at night to reduce the risk of muscle pain and other side effects. Taking the medication with a high-fat meal (choice D) is not recommended as it can decrease the effectiveness of the medication. Alcohol consumption (choice C) should be moderated but does not need to be completely avoided unless contraindicated. Taking the medication with breakfast (choice B) may not be as effective as taking it at night due to the circadian rhythm of cholesterol synthesis.
A patient is taking raloxifene (Evista) for osteoporosis. What is the primary therapeutic effect of this medication?
- A. It stimulates the formation of new bone.
- B. It decreases bone resorption and increases bone density.
- C. It increases the excretion of calcium through the kidneys.
- D. It increases calcium absorption in the intestines.
Correct Answer: B
Rationale: The correct answer is B. Raloxifene, a selective estrogen receptor modulator (SERM), primarily works by decreasing bone resorption and increasing bone density. This mechanism of action helps in the prevention and treatment of osteoporosis by maintaining or improving bone strength. Choice A is incorrect because raloxifene does not directly stimulate the formation of new bone but rather helps in preserving existing bone. Choice C is incorrect because raloxifene does not increase the excretion of calcium through the kidneys; instead, it acts on bone tissue. Choice D is incorrect as raloxifene does not directly increase calcium absorption in the intestines but rather focuses on bone health.
In the ED, a homeless client is brought in with severe hypothermia. The police officers also state that they found a 'bottle of booze' on the sidewalk next to him. This puts the nurse on high alert since alcohol contributes to hypothermia by:
- A. interfering with the appetite center in the brain, causing the person to not respond to hunger cues.
- B. causing the person to have less insulation from body fat.
- C. dulling mental awareness, impairing judgment to seek shelter.
- D. increasing the basal metabolic rate, leading to faster depletion of ATP.
Correct Answer: C
Rationale: Alcohol impairs judgment and dulls mental awareness, making a person less likely to seek shelter when experiencing hypothermia. This impaired judgment can lead to risky behaviors that exacerbate the effects of cold exposure. Choice A is incorrect because alcohol does not directly interfere with the appetite center in the brain to the extent described. Choice B is incorrect as alcohol consumption does not directly impact the amount of body fat present. Choice D is incorrect because alcohol does not increase the basal metabolic rate but rather slows it down.
A group of nursing students and their professor are engaged in a service learning project and will be caring for patients in Haiti. What medication should be administered to prevent the development of malaria?
- A. Metronidazole (Flagyl)
- B. Oprelvekin (Neumega)
- C. Chloroquine phosphate (Aralen)
- D. Chloroprocaine hydrochloride (Nesacaine)
Correct Answer: C
Rationale: The correct answer is Chloroquine phosphate (Aralen). Chloroquine is a medication used to prevent and treat malaria. It works by killing the malaria parasite in the red blood cells. Metronidazole (Flagyl) is an antibiotic used to treat various bacterial and parasitic infections, not malaria. Oprelvekin (Neumega) is a medication used to stimulate platelet production. Chloroprocaine hydrochloride (Nesacaine) is a local anesthetic used for epidural anesthesia. Therefore, Chloroquine phosphate is the appropriate medication for preventing malaria in this scenario.