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A patient is prescribed sildenafil (Viagra) for erectile dysfunction. What important contraindication should the nurse emphasize during patient education?
- A. Use of nitrates
- B. History of hypertension
- C. History of peptic ulcer disease
- D. Use of antihypertensive medications
Correct Answer: A
Rationale: The correct answer is A: 'Use of nitrates.' Sildenafil (Viagra) is contraindicated in patients using nitrates due to the risk of severe hypotension. Nitrates and sildenafil both cause vasodilation, leading to a synergistic effect that can result in a dangerous drop in blood pressure. Choices B, C, and D are incorrect because they are not direct contraindications for sildenafil use. While a history of hypertension or peptic ulcer disease may require caution, they are not absolute contraindications like the concomitant use of nitrates.
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A patient is prescribed raloxifene (Evista) for osteoporosis. What is the primary mechanism of action for this medication?
- A. Raloxifene decreases bone resorption, which helps to maintain or increase bone density.
- B. Raloxifene increases calcium absorption in the intestines, which helps build stronger bones.
- C. Raloxifene stimulates new bone formation by increasing osteoblast activity.
- D. Raloxifene decreases calcium excretion by the kidneys, helping to maintain bone density.
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A patient with a history of venous thromboembolism is prescribed hormone replacement therapy (HRT). What should the nurse emphasize about the risks associated with this therapy?
- A. HRT is associated with an increased risk of venous thromboembolism, so patients should be educated about the signs and symptoms of blood clots.
- B. HRT may improve mood and energy levels, but it also increases the risk of osteoporosis.
- C. HRT can decrease the risk of fractures, but it also increases the risk of developing diabetes.
- D. HRT may increase the risk of breast cancer, so regular mammograms are essential.
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
During surgery, the anesthesia personnel notice the client is having a steady rise in end-tidal carbon dioxide level. At this time, the nurse anesthetist begins to assess the client for malignant hyperthermia. The initial (priority) assessment for this disorder may include:
- A. measuring serum potassium levels.
- B. monitoring for muscle rigidity.
- C. evaluating renal function.
- D. checking arterial blood gases.
Correct Answer: B
Rationale: The correct answer is B: monitoring for muscle rigidity. Muscle rigidity is a hallmark sign of malignant hyperthermia, a life-threatening condition triggered by certain anesthetics. Monitoring for this sign is critical in the early identification of the condition. Choices A, C, and D are not the initial priority assessments for malignant hyperthermia. Measuring serum potassium levels, evaluating renal function, and checking arterial blood gases are not specific initial assessments for malignant hyperthermia and would not aid in its early identification.
A homeless man was screened for tuberculosis (TB) during a health consultation at a shelter, and the results indicate latent TB. The community health nurse who is liaising with the providers of the shelter would anticipate what component of this man's plan of care?
- A. The man will undergo conservative treatment for TB using adjuvant medications.
- B. The man will be treated for TB using first-line antitubercular drugs.
- C. The man will be monitored closely to determine if treatment is necessary.
- D. The man will be screened again in 10 to 12 weeks to determine if he has developed active TB.
Correct Answer: B
Rationale: The correct answer is B. When a patient is diagnosed with latent TB infection, the standard approach involves treating them with first-line antitubercular drugs to prevent the progression to active TB. Adjuvant medications are not typically used for latent TB. Close monitoring without initiating treatment can lead to the development of active TB, so immediate treatment is crucial. Screening the individual again in 10 to 12 weeks does not address the immediate need for treatment of latent TB, which is essential to prevent the progression of the disease.
A patient suffers from dysmenorrhea. Which oral medication will be prescribed that has the ability to provide physiological actions on the neuroendocrine control of ovarian function?
- A. Estrogen
- B. Progestins
- C. Naproxen
- D. Ibuprofen
Correct Answer: B
Rationale: Progestins are prescribed for dysmenorrhea as they help reduce menstrual pain by inhibiting ovulation and decreasing the production of prostaglandins. Estrogen (Choice A) is not typically used alone in dysmenorrhea treatment as it can worsen symptoms. Naproxen (Choice C) and Ibuprofen (Choice D) are nonsteroidal anti-inflammatory drugs (NSAIDs) commonly used to relieve pain associated with dysmenorrhea, but they do not directly affect the neuroendocrine control of ovarian function like progestins do.