Nursing Elites

1. A patient has been prescribed sildenafil (Viagra) for erectile dysfunction. What important information should the healthcare provider provide?

• A. This medication can cause sudden hearing loss.
• B. This medication should not be taken more than once a day.
• C. You should avoid taking this medication with high-fat meals.
• D. Avoid taking nitrates while on this medication.

Correct answer: D

Rationale: The correct answer is D. Sildenafil (Viagra) should not be taken with nitrates due to the risk of severe hypotension. Nitrates can potentiate the hypotensive effects of sildenafil, leading to a dangerous drop in blood pressure. Choice A is incorrect because sudden hearing loss is a rare but serious side effect associated with sildenafil, not a common side effect. Choice B is not the most important information related to sildenafil use. While it is generally recommended not to exceed one dose per day, the interaction with nitrates is more critical. Choice C is also important to consider as high-fat meals can delay the onset of action of sildenafil, but it is not as crucial as avoiding nitrates.

2. In the ED, a homeless client is brought in with severe hypothermia. The police officers also state that they found a 'bottle of booze' on the sidewalk next to him. This puts the nurse on high alert since alcohol contributes to hypothermia by:

• A. interfering with the appetite center in the brain, causing the person to not respond to hunger cues.
• B. causing the person to have less insulation from body fat.
• C. dulling mental awareness, impairing judgment to seek shelter.
• D. increasing the basal metabolic rate, leading to faster depletion of ATP.

Correct answer: C

Rationale: Alcohol impairs judgment and dulls mental awareness, making a person less likely to seek shelter when experiencing hypothermia. This impaired judgment can lead to risky behaviors that exacerbate the effects of cold exposure. Choice A is incorrect because alcohol does not directly interfere with the appetite center in the brain to the extent described. Choice B is incorrect as alcohol consumption does not directly impact the amount of body fat present. Choice D is incorrect because alcohol does not increase the basal metabolic rate but rather slows it down.

3. A 10-year-old male is stung by a bee while playing in the yard. He begins itching and develops pain, swelling, redness, and respiratory difficulties. He is suffering from:

• A. Immunodeficiency
• B. Autoimmunity
• C. Anaphylaxis
• D. Tissue-specific hypersensitivity

Correct answer: C

Rationale: The correct answer is C: Anaphylaxis. Anaphylaxis is a severe, immediate allergic reaction mediated by IgE. In this scenario, the symptoms of itching, pain, swelling, redness, and respiratory difficulties following a bee sting are indicative of anaphylaxis. Choice A, Immunodeficiency, refers to a weakened immune system's inability to protect the body from infections and diseases, which is not the case here. Choice B, Autoimmunity, involves the immune system attacking healthy cells and tissues by mistake, which is not the mechanism at play in anaphylaxis. Choice D, Tissue-specific hypersensitivity, does not accurately describe the immediate, systemic reaction seen in anaphylaxis.

4. The nurse is caring for a client with an astrocytoma. The client asks, 'What do astrocytes do in the brain?' What is the nurse's best response?

• A. Astrocytes help to nourish and support neurons in the brain.
• B. Astrocytes are a type of neuron that transmit electrical signals.
• C. Astrocytes are involved in immune responses in the brain.
• D. Astrocytes help regulate blood flow in the brain.

Correct answer: A

Rationale: Astrocytes play a crucial role in supporting and nourishing neurons by providing metabolic support, maintaining the blood-brain barrier, and regulating the chemical environment of the brain. While astrocytes are essential for brain function, they are not neurons and do not transmit electrical signals (Choice B). Astrocytes are not primarily involved in immune responses in the brain (Choice C) or in regulating blood flow in the brain (Choice D), although they indirectly influence blood flow through their support functions.

5. What is the action of amphotericin B?

• A. It binds to ergosterol and forms holes in the membrane.
• B. It binds to an enzyme required for the synthesis of ergosterol.
• C. It disrupts the fungal cell walls rather than the cell membrane.
• D. It inhibits glucan synthetase required for glucan synthesis.

Correct answer: A

Rationale: Amphotericin B is an antifungal medication that acts by binding to ergosterol, a component of fungal cell membranes, forming pores that disrupt the integrity of the membrane. This action leads to leakage of cellular contents and ultimately cell death. Choice B is incorrect as amphotericin B does not bind to an enzyme required for the synthesis of ergosterol. Choice C is incorrect as the drug primarily affects the cell membrane rather than the cell wall. Choice D is also incorrect as amphotericin B does not inhibit glucan synthetase.

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