Nursing Elites

1. A male patient is being treated with sildenafil (Viagra) for erectile dysfunction. What condition would contraindicate the use of this medication?

• A. Peptic ulcer disease
• B. History of myocardial infarction
• C. Recent use of antihypertensive medications
• D. Use of nitrates

Correct answer: D

Rationale: The correct answer is D: Use of nitrates. Sildenafil (Viagra) is contraindicated in patients taking nitrates due to the risk of severe hypotension. Nitrates and sildenafil both cause vasodilation, and the combination can lead to a dangerous drop in blood pressure. Choice A, peptic ulcer disease, is not a contraindication for sildenafil use. Choice B, a history of myocardial infarction, is not a contraindication unless the patient is also taking nitrates. Choice C, recent use of antihypertensive medications, is not a contraindication but requires caution as the combination can lead to additive effects lowering blood pressure.

2. A report comes back indicating that muscular atrophy has occurred. A nurse recalls that muscular atrophy involves a decrease in muscle cell size:

• A. Number
• B. Size
• C. Vacuoles
• D. Lipofuscin

Correct answer: B

Rationale: The correct answer is B: Size. Muscular atrophy is characterized by a reduction in the size of muscle cells. This decrease in size can be due to various factors such as disuse, aging, or disease. Choice A, Number, is incorrect because muscular atrophy does not involve a decrease in the number of muscle cells but rather their size. Choice C, Vacuoles, is incorrect as vacuoles are not directly related to the definition of muscular atrophy. Choice D, Lipofuscin, is incorrect as lipofuscin is a pigment associated with aging and has no direct connection to the decrease in muscle cell size seen in muscular atrophy.

3. What aspect of hormonal contraceptives places a woman at the greatest risk for the development of blood clots?

• A. Hormonal contraceptives increase serum triglyceride and cholesterol levels.
• B. Hormonal contraceptives increase platelet levels.
• C. Hormonal contraceptives increase blood levels of clotting factors.
• D. Hormonal contraceptives cause injury to blood vessel linings.

Correct answer: C

Rationale: The correct answer is C. Hormonal contraceptives increase blood levels of clotting factors, particularly factors II, VII, IX, and X. This elevation in clotting factors can predispose individuals to thromboembolic events, including blood clots. Choices A, B, and D are incorrect because hormonal contraceptives do not have a significant effect on serum triglycerides and cholesterol, platelet levels, or causing direct injury to blood vessel linings as the primary mechanism for clot formation.

4. 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.

5. In Guillain-Barre syndrome, what pathophysiologic process underlies the deficits that accompany the degeneration of myelin in the peripheral nervous system (PNS)?

• A. The destruction of myelin results in a reduction in Schwann cell production in the client's PNS.
• B. The lack of myelin surrounding nerve cells compromises the axonal transport system.
• C. Without remyelination, the axon will eventually die.
• D. A deficit of myelin makes the client more susceptible to infection by potential pathogens.

Correct answer: C

Rationale: In Guillain-Barre syndrome, the destruction of myelin leads to axonal damage. If remyelination does not occur, the axon will eventually degenerate and die, impacting nerve function. Choice A is incorrect because the destruction of myelin does not affect Schwann cell production. Choice B is incorrect as the lack of myelin directly affects the conduction of nerve impulses, not the axonal transport system. Choice D is incorrect as a deficit of myelin does not predispose the client to infections by potential pathogens.

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