Nursing Elites

1. A patient is receiving finasteride (Proscar) for the treatment of benign prostatic hyperplasia. Which of the following is an expected outcome of the medication?

• A. Decrease in the size of the prostate gland.
• B. Improved urinary flow and decreased symptoms of urinary retention.
• C. Increased production of prostate-specific antigen (PSA).
• D. Reduction in the number of nocturnal awakenings.

Correct answer: B

Rationale: The correct answer is B. Finasteride (Proscar) is used in the treatment of benign prostatic hyperplasia to improve urinary flow and decrease symptoms of urinary retention by reducing the size of the prostate gland. Choice A is incorrect because although finasteride may reduce the size of the prostate gland, the expected outcome relevant to the patient's symptoms is improved urinary flow rather than a specific change in gland size. Choice C is incorrect because finasteride actually decreases the production of prostate-specific antigen (PSA) due to its mechanism of action. Choice D is incorrect because although improved urinary flow may lead to a reduction in nocturnal awakenings, the main expected outcome of finasteride treatment is related to urinary symptoms.

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

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

Correct answer: B

Rationale: The correct answer is B: 'Use of nitrates.' Tadalafil (Cialis) is contraindicated in patients taking nitrates due to the risk of severe hypotension. Nitrates and Cialis both cause vasodilation, which can lead to a dangerous drop in blood pressure when used together. Choices A, C, and D are incorrect because a history of hypertension, use of antihypertensive medications, and a history of peptic ulcer disease are not specific contraindications for tadalafil use.

3. 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.

4. Which of the following chronic inflammatory skin diseases is characterized by angiogenesis, immune cell activation (particularly T cells), and keratinocyte proliferation?

• A. Psoriasis
• B. Melanoma
• C. Atopic dermatitis
• D. Urticaria

Correct answer: A

Rationale: Psoriasis is the correct answer because it is a chronic inflammatory skin condition characterized by features such as angiogenesis (formation of new blood vessels), immune cell activation (especially T cells), and excessive keratinocyte proliferation. This results in the typical symptoms seen in psoriasis, such as red, scaly patches on the skin. Melanoma is a type of skin cancer arising from melanocytes, not characterized by the features mentioned. Atopic dermatitis is a different skin condition involving eczematous changes, not specifically associated with the described characteristics of psoriasis. Urticaria is a skin condition characterized by hives and does not involve the same pathophysiological processes as psoriasis.

5. A patient being treated for tuberculosis is determined to be drug resistant. Which of the following medications will the patient be resistant to in the treatment of tuberculosis?

• A. Isoniazid (INH) and rifampin
• B. Carbamazepine (Tegretol) and phenytoin (Dilantin)
• C. Dextroamphetamine (Dexedrine) and doxapram (Dopram)
• D. Propranolol (Inderal) and sotalol (Betapace)

Correct answer: A

Rationale: In the treatment of tuberculosis, drug resistance commonly develops against medications like Isoniazid (INH) and rifampin. These two drugs are key components of the standard anti-tuberculosis treatment regimen. Choices B, C, and D are unrelated medications that are not used in the treatment of tuberculosis. Carbamazepine and phenytoin are anticonvulsants, dextroamphetamine is a stimulant, and propranolol and sotalol are used for cardiovascular conditions.

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