In a patient with renal failure secondary to an overdose of a nephrotoxic drug, which assessment findings would the nurse recognize as being most suggestive of impaired erythropoiesis?
- A. Frequent infections and low neutrophil levels
- B. Fatigue and increased heart rate
- C. Agitation and changes in cognition
- D. Increased blood pressure and peripheral edema
Correct Answer: A
Rationale: Impaired erythropoiesis refers to a decreased production of red blood cells. This can lead to anemia, resulting in symptoms like fatigue and increased heart rate (Choice B). However, the question specifically asks about assessment findings suggestive of impaired erythropoiesis. In this context, frequent infections and low neutrophil levels (Choice A) are more directly related to impaired erythropoiesis due to the impact of anemia on the immune system. Frequent infections are common in anemia due to a compromised immune response, and low neutrophil levels can be seen in conditions of impaired erythropoiesis. Agitation and changes in cognition (Choice C) are more indicative of neurological issues, while increased blood pressure and peripheral edema (Choice D) are commonly associated with renal failure but not specifically related to impaired erythropoiesis.
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A 44-year-old man presents with muscle weakness and fatigue. He states that he has experienced difficulty climbing stairs and even holding his arms up to comb his hair. Which test is most likely to help confirm the diagnosis?
- A. Electromyography (EMG)
- B. Nerve conduction studies
- C. Muscle biopsy
- D. Blood test for autoantibodies
Correct Answer: A
Rationale: The correct answer is Electromyography (EMG). EMG is commonly used to diagnose conditions involving muscle weakness and fatigue, such as myasthenia gravis. Nerve conduction studies primarily assess nerve function rather than muscle involvement. While a muscle biopsy can provide valuable information, EMG is more specific for evaluating muscle function in this context. A blood test for autoantibodies may be helpful in certain autoimmune conditions but is not the primary test for confirming the diagnosis based on the patient's symptoms of muscle weakness and fatigue.
What should the nurse include in patient education regarding the effectiveness of oral contraceptives?
- A. Oral contraceptives are highly effective when taken correctly but not 100% foolproof.
- B. Oral contraceptives may take some time to reach full effectiveness after starting.
- C. Oral contraceptives can be less effective if taken with certain antibiotics.
- D. Taking oral contraceptives with food does not significantly affect their efficacy.
Correct Answer: C
Rationale: The correct answer is C. Oral contraceptives can be less effective when taken with certain antibiotics due to potential drug interactions that may reduce contraceptive efficacy. It is crucial for patients to be aware of this to consider additional contraceptive measures when prescribed antibiotics. Choice A is incorrect because while oral contraceptives are highly effective when taken correctly, 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 also incorrect as taking oral contraceptives with food does not significantly affect their efficacy.
The nurse is closely following a patient who began treatment with testosterone several months earlier. When assessing the patient for potential adverse effects of treatment, the nurse should prioritize which of the following assessments?
- A. Skin inspection for developing lesions
- B. Lung function testing
- C. Assessment of serum calcium levels
- D. Assessment of arterial blood gases
Correct Answer: C
Rationale: In patients receiving testosterone therapy, the nurse should prioritize assessing serum calcium levels. Testosterone therapy can lead to hypercalcemia, making the evaluation of serum calcium levels crucial. Skin inspection for developing lesions, lung function testing, and arterial blood gas assessment are not the priority assessments for potential adverse effects of testosterone therapy. Skin inspection may be relevant for dermatological side effects, lung function testing and arterial blood gas assessment are not directly related to the common side effects of testosterone therapy.
A patient is being treated with raloxifene (Evista) for osteoporosis. What should the nurse teach the patient about this medication?
- A. It is used as a selective estrogen receptor modulator to prevent bone loss.
- B. It works by decreasing bone formation and increasing bone resorption.
- C. It should be taken with food to reduce gastrointestinal side effects.
- D. It may cause weight gain and fluid retention.
Correct Answer: C
Rationale: The correct answer is C. Raloxifene is a selective estrogen receptor modulator (SERM) used to prevent bone loss. It should be taken with food to reduce gastrointestinal side effects, not on an empty stomach. Choices A and B are incorrect because raloxifene is indeed a SERM that prevents bone loss, but it does not directly work by increasing bone formation or decreasing bone resorption. Choice D is incorrect as weight gain and fluid retention are not common side effects of raloxifene.
A 60-year-old male patient presents with severe and persistent pain in his left leg and hip that worsens with activity. After further evaluation, the patient is diagnosed with osteosarcoma. Which of the following is true about osteosarcoma?
- A. It is more common in children and young adults.
- B. Early diagnosis improves the prognosis.
- C. It is frequently located in the leg bones.
- D. All of the above are true.
Correct Answer: D
Rationale: Osteosarcoma is a type of bone cancer that can be found in any bone but is most commonly located in the long bones of the legs. While it is more prevalent in children and young adults, it can also occur in older individuals like the 60-year-old male patient in this case. Early diagnosis is crucial for a better prognosis in osteosarcoma cases. Therefore, all the statements provided are true regarding osteosarcoma, making option D the correct answer. Option A is accurate as osteosarcoma is more common in children and young adults. Option B is correct as early diagnosis improves the prognosis. Option C is accurate as osteosarcoma is frequently located in the leg bones.