Nokea
A patient with a history of breast cancer is being prescribed tamoxifen (Nolvadex). The nurse should educate the patient about what potential side effect of this medication?
- A. Increased risk of venous thromboembolism
- B. Increased risk of hot flashes
- C. Increased risk of cataracts
- D. Increased risk of bone fractures
Correct Answer: A
Rationale: The correct answer is A: Increased risk of venous thromboembolism. Tamoxifen is known to increase the risk of venous thromboembolism, a serious side effect. Patients should be educated about the signs and symptoms of blood clots such as swelling, redness, warmth, or pain in the affected limb. Choices B, C, and D are incorrect because tamoxifen is not associated with an increased risk of hot flashes, cataracts, or bone fractures.
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A patient with a complex medical history is considering the use of oral contraceptives. The nurse should be aware that many antibiotics and antiseizure medications cause what effect when combined with oral contraceptives?
- A. Increased risk of pregnancy
- B. Increased blood pressure
- C. Increased risk of thromboembolism
- D. Increased gastric acid
Correct Answer: A
Rationale: The correct answer is A: Increased risk of pregnancy. Certain antibiotics and anticonvulsants can decrease the effectiveness of oral contraceptives by inducing liver enzymes that metabolize the hormones more quickly. This interaction can lead to a decreased contraceptive effect, thereby increasing the risk of pregnancy. Choices B, C, and D are incorrect as they do not directly relate to the effect of antibiotics and antiseizure medications on oral contraceptives.
A nurse is providing discharge teaching to a patient who will be taking sildenafil (Viagra). Which of the following should the nurse include in the instructions?
- A. Take this medication 1 hour before sexual activity.
- B. Do not take more than one dose in a 24-hour period.
- C. Seek immediate medical attention if you experience vision or hearing loss.
- D. Take this medication on an empty stomach.
Correct Answer: B
Rationale: The correct answer is B: 'Do not take more than one dose in a 24-hour period.' It is essential for the nurse to emphasize this instruction to prevent potential adverse effects from taking multiple doses of sildenafil. Choice A is incorrect because sildenafil should be taken approximately 30 minutes to 4 hours before sexual activity, not specifically 1 hour before. Choice C is important but not the priority; while vision or hearing loss are potential serious side effects of sildenafil, the immediate concern should be focused on dose frequency. Choice D is incorrect as sildenafil can be taken with or without food.
An older adult patient comes to the clinic complaining of not being able to do what he used to be able to. You know that normal changes associated with aging include:
- A. Improved blood flow
- B. Slowed metabolic rate
- C. Increased brain weight
- D. Improved nerve fiber conduction
Correct Answer: B
Rationale: Normal changes associated with aging include a slowed metabolic rate and decreased brain weight. Option A, 'Improved blood flow,' is incorrect as aging is generally associated with reduced vascular health rather than improved blood flow. Option D, 'Improved nerve fiber conduction,' is incorrect as aging typically leads to a decline in nerve function rather than improvement.
The unique clinical presentation of a 3-month-old infant in the emergency department leads the care team to suspect botulism. Which assessment question posed to the parents is likely to be most useful in the differential diagnosis?
- A. Has your child received all recommended vaccinations?
- B. Has your child been feeding poorly or showing signs of constipation?
- C. Has your child been exposed to any sick individuals?
- D. Has your child been displaying signs of respiratory distress?
Correct Answer: B
Rationale: The correct answer is B. Poor feeding and constipation are common early symptoms of infant botulism, which is caused by a neurotoxin that impairs muscle function. Option A is unrelated to the presentation of botulism. Option C does not directly relate to the symptoms of botulism. Option D is more indicative of respiratory issues rather than the constellation of symptoms seen in botulism.
Which type of lymphocyte recognizes and eliminates virus-infected cells and cancerous cells?
- A. Neutrophils
- B. Macrophages
- C. Natural killer cells
- D. Langerhans cells
Correct Answer: C
Rationale: Natural killer cells are a type of lymphocyte that plays a crucial role in recognizing and eliminating virus-infected cells and cancerous cells. Neutrophils (Choice A) are a type of white blood cell involved in fighting infections, mainly through phagocytosis. Macrophages (Choice B) are another type of white blood cell that engulfs and digests cellular debris and pathogens. Langerhans cells (Choice D) are a type of dendritic cell found in the skin and mucosa, primarily involved in antigen presentation.