If the client's dorsal columns are not functioning, the nurse will observe which response during neuro testing, where the nurse asks the client to close his eyes and then proceeds to touch corresponding parts of the body on each side simultaneously with two sharp points?
- A. The client will not be able to distinguish between the two points.
- B. The client will feel only one point of contact.
- C. The client will accurately identify both points.
- D. The client will report no sensation in the touched areas.
Correct Answer: A
Rationale: If the client's dorsal columns are not functioning, the ability to distinguish between two closely spaced points is impaired. This results in the client not being able to differentiate between the two points when touched simultaneously. Choice B is incorrect because the client feeling only one point suggests an intact dorsal column function. Choice C is incorrect as accurately identifying both points indicates normal discrimination ability. Choice D is incorrect as reporting no sensation does not correspond to the specific impairment related to dorsal column dysfunction.
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A 10-year-old male is stung by a bee while playing in the yard. He experiences a severe allergic reaction and has to go to the ER. The nurse providing care realizes this reaction is the result of:
- A. Toxoids
- B. IgA
- C. IgE
- D. IgM
Correct Answer: C
Rationale: The correct answer is C: IgE. A severe allergic reaction, such as the one experienced by the 10-year-old male after being stung by a bee, is mediated by IgE. IgE is involved in common allergic responses, triggering the release of histamine and other chemicals that lead to allergy symptoms. Choice A, Toxoids, are inactivated toxins used in vaccines. Choice B, IgA, is mainly found in mucosal areas and secretions, playing a role in mucosal immunity. Choice D, IgM, is the first antibody produced in response to an infection.
What key contraindication should the nurse emphasize to a patient prescribed sildenafil (Viagra) for erectile dysfunction?
- A. Sildenafil is contraindicated in patients taking nitrates due to the risk of severe hypotension.
- B. Sildenafil should not be taken with food as it can reduce its effectiveness.
- C. Sildenafil is contraindicated in patients with a history of hypertension.
- D. Sildenafil should not be taken with grapefruit juice as it can lead to dangerous side effects.
Correct Answer: A
Rationale: The correct answer is A. Sildenafil is contraindicated in patients taking 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 there is no specific contraindication for taking sildenafil with food, having a history of hypertension, or taking it with grapefruit juice. The main concern is the concurrent use of nitrates with sildenafil.
When educating a patient starting on oral contraceptives, what should the nurse include regarding the medication's effectiveness?
- A. Oral contraceptives are 100% effective when taken correctly.
- B. Oral contraceptives are effective immediately after starting.
- C. Oral contraceptives are less effective if taken with antibiotics.
- D. Oral contraceptives are less effective if taken with food.
Correct Answer: C
Rationale: The correct answer is C. Oral contraceptives can be less effective when taken with certain antibiotics as they may interfere with the contraceptive's efficacy, potentially leading to decreased effectiveness. Therefore, patients should be advised to use additional contraception methods if they are also taking antibiotics. Choice A is incorrect because while oral contraceptives are highly effective, they are not 100% foolproof. Choice B is incorrect as oral contraceptives may take some time to reach their full effectiveness after starting. Choice D is incorrect since taking oral contraceptives with food does not necessarily impact their effectiveness.
A patient with a history of osteoporosis is prescribed alendronate (Fosamax). What instructions should the nurse provide to ensure the effectiveness of the medication?
- A. Take the medication with a full glass of water and remain upright for at least 30 minutes to prevent esophageal irritation and ensure proper absorption.
- B. Take the medication with milk to enhance calcium absorption.
- C. Take the medication at bedtime to ensure absorption during sleep.
- D. Take the medication with food to prevent nausea.
Correct Answer: A
Rationale: The correct answer is A. Alendronate should be taken with a full glass of water and patients should remain upright for at least 30 minutes to prevent esophageal irritation and ensure proper absorption. Taking the medication with milk (choice B) is not recommended as it may interfere with the absorption of alendronate. Taking the medication at bedtime (choice C) is not necessary for optimal absorption. Taking the medication with food (choice D) is also not recommended as food can reduce the absorption of alendronate.
A patient is prescribed finasteride (Proscar) for benign prostatic hyperplasia (BPH). What should the nurse include in the patient teaching regarding the expected outcomes of this therapy?
- A. The medication will cure BPH after treatment is complete.
- B. The effects of the medication may take several weeks or months to become noticeable.
- C. The medication may cause increased hair growth.
- D. The medication may decrease libido.
Correct Answer: B
Rationale: The correct answer is B. The effects of finasteride in treating BPH may take several weeks or months to become noticeable, so patients should be informed about this expected time frame. Choice A is incorrect because finasteride does not cure BPH but helps manage symptoms. Choice C is incorrect as increased hair growth is a side effect of finasteride, not an expected outcome for BPH treatment. Choice D is also incorrect as decreased libido is a potential side effect of finasteride, not an expected outcome for BPH treatment.