Nokea
A patient is prescribed sildenafil (Viagra) for erectile dysfunction. What is a key contraindication that the nurse should review with the patient?
- A. History of hypertension
- B. Use of nitrates
- C. Use of antihypertensive medications
- D. History of peptic ulcer disease
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 and sildenafil both act as vasodilators, and their combined use can lead to a dangerous drop in blood pressure. Choices A, C, and D are incorrect because having a history of hypertension, using antihypertensive medications, or having a history of peptic ulcer disease are not key contraindications for sildenafil use.
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A 70-year-old client presents with weakness and sensory loss in the right hand and foot. The client also exhibits speech difficulties. Which condition is the client most likely experiencing?
- A. Transient ischemic attack (TIA)
- B. Brain tumor
- C. Cerebral infarction
- D. Multiple sclerosis
Correct Answer: C
Rationale: The correct answer is C: Cerebral infarction (stroke). In this case, the client's symptoms of weakness and sensory loss in the right hand and foot, along with speech difficulties, are indicative of a stroke. These symptoms are commonly seen in individuals experiencing a cerebral infarction, where a blockage in blood flow to the brain leads to neurological deficits. Choices A, B, and D are less likely as transient ischemic attacks (TIAs) typically have temporary symptoms with no permanent damage, brain tumors may present with a different set of symptoms depending on their location, and multiple sclerosis usually presents with a relapsing-remitting pattern of neurological symptoms rather than sudden onset unilateral deficits.
A client with chronic bronchitis is receiving education from a healthcare provider about the condition. Which statement made by the client indicates a need for further teaching?
- A. I should avoid being around people who smoke.
- B. I should try to avoid any exposure to pollutants and irritants.
- C. I should limit my fluid intake to avoid worsening my cough.
- D. I should use my inhaler regularly, even when I don't have symptoms.
Correct Answer: C
Rationale: The correct answer is C because limiting fluid intake is not recommended for chronic bronchitis. Hydration is essential as it helps thin mucus, making it easier to clear from the airways. Choices A, B, and D are all correct statements for managing chronic bronchitis. Avoiding exposure to smoke, pollutants, and irritants can help reduce respiratory symptoms and exacerbations. Using the inhaler regularly, even in the absence of symptoms, is crucial for controlling inflammation and maintaining airway function.
A staff member asks what leukocytosis means. How should the nurse respond? Leukocytosis can be defined as:
- A. A normal leukocyte count
- B. A high leukocyte count
- C. A low leukocyte count
- D. Another term for leukopenia
Correct Answer: B
Rationale: Leukocytosis refers to an abnormally high leukocyte count. This condition is characterized by an elevated number of white blood cells in the bloodstream. Choice A is incorrect because leukocytosis does not refer to a normal leukocyte count. Choice C is incorrect as leukocytosis is not related to a low leukocyte count. Choice D is incorrect as leukopenia is the opposite of leukocytosis, indicating a low white blood cell count.
A patient who is undergoing treatment for cytomegalovirus received his first dose of IV ganciclovir 3 days ago. When reviewing this patient's most recent blood work, what abnormality should the nurse most likely attribute to the use of this drug?
- A. Hemoglobin 17 g/dL (high normal)
- B. INR 3.8 (high)
- C. Platelet count 118,000/mm3 (low)
- D. Leukocytes 11,900/mm3 (high)
Correct Answer: C
Rationale: The correct answer is C: Platelet count 118,000/mm3 (low). Ganciclovir, used to treat cytomegalovirus, is known to cause bone marrow suppression, leading to decreased platelet count (thrombocytopenia). This condition can increase the risk of bleeding. Choices A, B, and D are not typically associated with ganciclovir therapy. High hemoglobin levels (choice A) are not commonly seen with ganciclovir treatment. INR elevation (choice B) is associated with coagulation abnormalities, which are not a typical side effect of ganciclovir. Elevated leukocyte count (choice D) is not a common consequence of ganciclovir use.
A patient is starting on medroxyprogesterone acetate (Provera) for endometriosis. What should the nurse include in the patient teaching?
- A. Take the medication with food to prevent nausea.
- B. Take the medication at the same time each day to maintain consistent hormone levels.
- C. Avoid prolonged sun exposure while taking this medication.
- D. Discontinue the medication if side effects occur.
Correct Answer: B
Rationale: The correct answer is B. Patients starting on medroxyprogesterone acetate (Provera) for endometriosis should be instructed to take the medication at the same time each day to maintain consistent hormone levels and effectiveness. Choice A is incorrect because medroxyprogesterone acetate can be taken with or without food. Choice C is unrelated to the medication and not a specific concern with its use. Choice D is incorrect as patients should not discontinue the medication without consulting their healthcare provider, even if side effects occur.