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 patient is starting on medroxyprogesterone acetate (Provera) for endometriosis. What should the nurse include in the patient teaching?

• A. Take the medication with food to prevent nausea.
• B. Take the medication at the same time each day to maintain consistent hormone levels.
• C. Avoid prolonged sun exposure while taking this medication.
• D. Discontinue the medication if side effects occur.

Correct answer: B

Rationale: The correct answer is B. Patients starting on medroxyprogesterone acetate (Provera) for endometriosis should be instructed to take the medication at the same time each day to maintain consistent hormone levels and effectiveness. Choice A is incorrect because medroxyprogesterone acetate can be taken with or without food. Choice C is unrelated to the medication and not a specific concern with its use. Choice D is incorrect as patients should not discontinue the medication without consulting their healthcare provider, even if side effects occur.

3. 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.

4. A patient is prescribed tadalafil (Cialis) for erectile dysfunction. What critical contraindication should the nurse discuss with the patient?

• A. Use of nitrates
• B. Use of antihypertensive medications
• C. History of hypertension
• D. History of peptic ulcer disease

Correct answer: A

Rationale: The correct answer is A: Use of nitrates. Tadalafil (Cialis) is contraindicated in patients taking nitrates due to the risk of severe hypotension. Nitrates potentiate the hypotensive effects of tadalafil, leading to a potentially life-threatening drop in blood pressure. Choices B, C, and D are incorrect because antihypertensive medications, history of hypertension, and history of peptic ulcer disease are not critical contraindications for tadalafil use. While caution may be needed in patients with certain conditions, the highest priority is addressing the interaction with nitrates.

5. What occurs in a client with polycythemia?

• A. Deficient plasma in the blood
• B. Increased lymphatic fluid being produced
• C. Increased red blood cells being produced
• D. Deficient number of red blood cells

Correct answer: C

Rationale: The correct answer is C: Increased red blood cells being produced. Polycythemia is a condition characterized by an elevated number of red blood cells in the blood. This increased concentration of red blood cells can lead to blood thickening and potentially result in complications such as blood clots. Choices A, B, and D are incorrect because polycythemia does not involve deficient plasma, increased lymphatic fluid production, or a deficient number of red blood cells.

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