What critical point should the nurse include in patient education regarding tamoxifen (Nolvadex) for a patient with breast cancer?
- A. Tamoxifen may increase the risk of venous thromboembolism.
- B. Tamoxifen may cause hot flashes and other menopausal symptoms.
- C. Tamoxifen may cause weight gain and fluid retention.
- D. Tamoxifen may decrease the risk of osteoporosis.
Correct Answer: A
Rationale: The correct answer is A. Tamoxifen increases the risk of venous thromboembolism. Patients should be educated about the signs and symptoms of blood clots, such as swelling, redness, and pain in the legs. Choices B, C, and D are incorrect because tamoxifen is not associated with causing hot flashes, weight gain, fluid retention, or decreasing the risk of osteoporosis.
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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 patient with systemic candidiasis has been prescribed flucytosine. The nurse should be aware of the need to administer this drug with which of the following?
- A. Vitamin D and calcium supplements
- B. Fluconazole (Diflucan)
- C. Amphotericin B
- D. Penicillin G
Correct Answer: C
Rationale: The correct answer is C: Amphotericin B. When treating systemic candidiasis, Amphotericin B is the drug of choice, not flucytosine. Amphotericin B is an antifungal medication used to treat severe fungal infections like systemic candidiasis. Choices A, B, and D are incorrect because vitamin D and calcium supplements, fluconazole, and penicillin G are not the drugs of choice for treating systemic candidiasis.
Which of the following is the most appropriate diagnostic method for identifying lung cancer in its early stages?
- A. CT scan
- B. MRI
- C. X-ray
- D. Biopsy
Correct Answer: D
Rationale: A biopsy is the most appropriate method for diagnosing lung cancer in its early stages. A biopsy involves taking a small tissue sample from the lung for examination under a microscope. This method provides a definitive diagnosis by identifying cancerous cells. CT scans, MRIs, and X-rays can help detect abnormalities in the lungs, but a biopsy is necessary to confirm the presence of lung cancer. CT scans offer detailed images of the lung's structure, MRIs use magnetic fields for imaging soft tissues, and X-rays provide a basic view of the lungs, but none of these imaging techniques can definitively confirm the presence of cancer without a biopsy.
What long-term risks should the nurse discuss with a patient starting on hormone replacement therapy (HRT)?
- A. HRT is associated with increased risks of cardiovascular events and breast cancer, so these risks should be discussed with the patient.
- B. HRT can improve mood and energy levels, but it also increases the risk of osteoporosis.
- C. HRT can increase the risk of venous thromboembolism, so patients should undergo regular screening.
- D. HRT decreases the risk of fractures, but it also increases the risk of developing diabetes.
Correct Answer: A
Rationale: The correct answer is A. When starting on hormone replacement therapy (HRT), the nurse should discuss the increased risks of cardiovascular events and breast cancer with the patient. These risks are important to consider to make an informed decision. Choice B is incorrect as HRT does not increase the risk of osteoporosis; in fact, it may help prevent it. Choice C is incorrect as while HRT can increase the risk of venous thromboembolism, regular screening is not the primary focus for discussion. Choice D is incorrect as HRT does not decrease the risk of fractures and is not primarily associated with an increased risk of developing diabetes.
A patient is prescribed acyclovir (Zovirax) for the treatment of genital herpes. What is the expected outcome of this medication?
- A. Decreased testosterone production
- B. Decreased libido
- C. Decreased viral shedding
- D. Decreased bacterial replication
Correct Answer: C
Rationale: The expected outcome of acyclovir (Zovirax) for the treatment of genital herpes is decreased viral shedding. Acyclovir is an antiviral medication that works by inhibiting the replication of the herpes virus, thereby reducing viral shedding and helping to control outbreaks. Choice A, decreased testosterone production, and Choice B, decreased libido, are unrelated outcomes of acyclovir treatment for genital herpes. Choice D, decreased bacterial replication, is also incorrect as acyclovir specifically targets viruses and does not affect bacterial replication.