Nokea
A patient is receiving epoetin alfa (Epogen) for anemia. Which of the following adjunctive therapies is imperative with epoetin alfa?
- A. Potassium supplements
- B. Sodium restriction
- C. Iron supplement
- D. Renal dialysis
Correct Answer: C
Rationale: The correct answer is C: Iron supplement. When a patient is receiving epoetin alfa for anemia, it is imperative to provide iron supplementation as epoetin alfa works by stimulating the production of red blood cells, which require iron for hemoglobin synthesis. Therefore, iron supplementation is crucial to support the increased erythropoiesis. Choices A, B, and D are incorrect because potassium supplements, sodium restriction, and renal dialysis are not typically indicated as adjunctive therapies with epoetin alfa for anemia.
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A 23-year-old pregnant female visits her primary care provider for her final prenatal checkup. The primary care provider determines that the fetus has developed an infection in utero. Which of the following would be increased in the fetus at birth?
- A. IgG
- B. IgA
- C. IgM
- D. IgD
Correct Answer: C
Rationale: The correct answer is IgM. IgM is the first antibody produced in response to an infection and is elevated in a fetus with an in utero infection. IgG is the primary antibody responsible for providing immunity to the fetus and is transferred across the placenta during the third trimester. IgA is mainly found in mucosal areas and colostrum but not significantly elevated in fetal infections. IgD is involved in the development and maturation of B cells but not typically increased in fetal infections.
Why is the administration of benzene hexachloride (Lindane) for the treatment of scabies applied in small quantities?
- A. Excessive applications will lead to central nervous system toxicity.
- B. Excessive applications will cause irritation, rash, and inflammation.
- C. Excessive applications will cause headaches, dizziness, and diarrhea.
- D. Excessive applications will lead to anorexia and cachexia.
Correct Answer: A
Rationale: The rationale for instructing the patient to apply benzene hexachloride (Lindane) in small quantities for scabies treatment is that excessive applications can lead to central nervous system toxicity. Lindane is a neurotoxin, and overuse or incorrect application can result in adverse effects on the central nervous system, such as seizures, dizziness, and even death. Choices B, C, and D are incorrect because they do not reflect the specific toxic effects associated with Lindane, which primarily affects the central nervous system rather than causing skin irritation, gastrointestinal symptoms, or metabolic issues.
When evaluating the success of adding raltegravir to the drug regimen of a 42-year-old female patient with HIV, which laboratory value should the nurse prioritize?
- A. The patient's C-reactive protein levels
- B. The patient's erythrocyte sedimentation rate (ESR)
- C. The patient's viral load
- D. The patient's CD4 count
Correct Answer: C
Rationale: The correct answer is C: The patient's viral load. In HIV management, monitoring the viral load is crucial to assess the effectiveness of antiretroviral therapy. A decrease in viral load indicates the treatment's success in controlling the HIV infection. Choices A, B, and D are less relevant in this context. C-reactive protein levels and erythrocyte sedimentation rate are markers of inflammation and non-specific indicators of infection, not specifically for HIV. CD4 count is important but not as immediate for evaluating the response to the newly added medication compared to monitoring the viral load.
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 male patient receiving androgen therapy is concerned about side effects. What adverse effect should the nurse monitor for during this therapy?
- A. Increased risk of liver dysfunction
- B. Increased risk of cardiovascular events
- C. Increased risk of prostate cancer
- D. Increased risk of bone fractures
Correct Answer: B
Rationale: The correct answer is B: Increased risk of cardiovascular events. Androgen therapy can lead to an increased risk of cardiovascular events such as heart attack and stroke, especially in older patients. Choice A is incorrect because androgen therapy usually does not significantly increase the risk of liver dysfunction. Choice C is incorrect as androgen therapy does not increase the risk of prostate cancer; in fact, it is sometimes used in the treatment of prostate cancer. Choice D is also incorrect as androgen therapy is more likely to improve bone density and reduce the risk of fractures.