Nokea
Which of the following wounds is most likely to heal by secondary intention?
- A. A finger laceration received while cutting onions
- B. A stage IV pressure ulcer that developed in a nursing home
- C. A needlestick injury received while administering parenteral medication
- D. An incision from an open appendectomy
Correct Answer: B
Rationale: A stage IV pressure ulcer is a deep wound involving tissue loss that typically heals by secondary intention. This process involves the wound healing from the bottom up with granulation tissue and often results in significant scarring. Choice A, a finger laceration, would generally heal by primary intention due to its clean edges and minimal tissue loss. Choice C, a needlestick injury, is likely to be sutured and heal by primary intention since it is a small, clean wound. Choice D, an incision from an open appendectomy, is usually closed with sutures and heals by primary intention as well.
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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.
A patient is taking alendronate (Fosamax) for the treatment of osteoporosis. What instructions should the nurse provide to ensure the effectiveness of the medication?
- A. Take the medication with food to avoid gastrointestinal upset.
- B. Take the medication in the morning with a full glass of water and remain upright for at least 30 minutes.
- C. Take the medication before bed to ensure absorption during sleep.
- D. Take the medication with milk to enhance calcium absorption.
Correct Answer: B
Rationale: The correct answer is B. Alendronate should be taken in the morning with a full glass of water and the patient should remain upright for at least 30 minutes. This is important to prevent esophageal irritation and ensure proper absorption of the medication. Choice A is incorrect because alendronate should not be taken with food as it can decrease its absorption. Choice C is incorrect as taking the medication before bed increases the risk of esophageal irritation and reduces absorption due to lying down. Choice D is also incorrect because taking alendronate with milk or other calcium-rich foods can decrease its absorption.
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 52-year-old male patient is taking finasteride (Proscar) for benign prostatic hyperplasia (BPH). What patient teaching should the nurse provide?
- A. Take the medication with food.
- B. Avoid taking NSAIDs while on this medication.
- C. Avoid driving or operating heavy machinery while taking this medication.
- D. Women who are or may become pregnant should not handle crushed or broken tablets.
Correct Answer: D
Rationale: The correct answer is D. Finasteride, used for BPH, can be harmful to a developing male fetus. Therefore, women who are or may become pregnant should not handle crushed or broken tablets to avoid potential absorption through the skin. Choice A is incorrect as finasteride can be taken with or without food. Choice B is incorrect because there is no specific interaction between finasteride and NSAIDs mentioned. Choice C is incorrect as finasteride does not typically cause drowsiness or impair mental alertness.