Nursing Elites

1. A patient is being treated for a severe fungal infection with amphotericin B. What is the expected length of treatment for this patient?

• A. 1 to 2 weeks
• B. 3 to 6 weeks
• C. 4 to 12 weeks
• D. 15 to 18 weeks

Correct answer: C

Rationale: The correct answer is C: '4 to 12 weeks.' Amphotericin B treatment duration for severe fungal infections typically ranges from 4 to 12 weeks. This extended period is necessary to ensure complete eradication of the fungal infection and prevent relapse. Choices A, B, and D provide durations that are either too short or too long for treating severe fungal infections effectively, making them incorrect.

2. Why does multiple sclerosis manifest as asymmetrical and in different parts of the body?

• A. Autoreactive lymphocytes are causing diffuse patchy damage to the myelin sheath in the central nervous system.
• B. Acetylcholine receptors are destroyed by immunoglobulin G.
• C. Autoreactive T lymphocytes cause progressive loss of neurons in the substantia nigra.
• D. Cortical motor cells degenerate.

Correct answer: C

Rationale: Multiple sclerosis is characterized by the immune system mistakenly attacking the myelin sheath in the central nervous system. This results in the formation of lesions that can occur in different parts of the central nervous system, leading to varied symptoms depending on the location of the damage. Choice A is the correct answer because it accurately describes the pathophysiology of multiple sclerosis. Choices B, C, and D are incorrect because they describe mechanisms or locations that are not associated with the pathogenesis of multiple sclerosis.

3. A patient is prescribed clomiphene citrate (Clomid) for the treatment of infertility. Which of the following statements should be included in the nurse's teaching?

• A. This drug induces ovulation by stimulating gonadotropins.
• B. This drug induces ovulation by inhibiting gonadotropins.
• C. This drug suppresses ovulation by inhibiting gonadotropins.
• D. This drug increases progesterone levels, which maintains pregnancy.

Correct answer: A

Rationale: The correct statement to include in the nurse's teaching is that clomiphene induces ovulation by stimulating the release of gonadotropins, which in turn stimulate the ovaries. Choice B is incorrect because clomiphene does not induce ovulation by inhibiting gonadotropins. Choice C is also incorrect as clomiphene does not suppress ovulation by inhibiting gonadotropins. Choice D is inaccurate as clomiphene does not directly increase progesterone levels to maintain pregnancy.

4. A patient is starting on finasteride (Proscar) for the treatment of benign prostatic hyperplasia (BPH). What should the nurse include in the patient teaching?

• A. The medication will cure BPH after treatment is complete.
• B. The effects of the medication may take several weeks or months to become noticeable.
• C. The medication may cause increased hair growth.
• D. The medication may decrease libido.

Correct answer: B

Rationale: The correct answer is B. The effects of finasteride in treating BPH may take several weeks or months to become noticeable. It is important for the nurse to educate the patient about this expected time frame to manage expectations. Choice A is incorrect because finasteride does not cure BPH but helps in managing symptoms. Choice C is incorrect as one of the side effects of finasteride is decreased hair growth. Choice D is incorrect as finasteride may cause a decrease in libido as a side effect.

5. A patient has been prescribed mifepristone (RU-486) to terminate a pregnancy. How does this drug achieve its therapeutic effect?

• A. By inhibiting the action of progesterone, which is necessary to maintain pregnancy.
• B. By increasing estrogen levels, which induce uterine contractions.
• C. By altering the uterine lining, preventing implantation.
• D. By stimulating uterine contractions, which expel the embryo.

Correct answer: A

Rationale: Mifepristone (RU-486) functions by inhibiting the action of progesterone, a hormone crucial for maintaining pregnancy. By blocking progesterone, mifepristone disrupts the uterine environment necessary for pregnancy continuation, ultimately leading to termination. Choice B is incorrect because mifepristone does not increase estrogen levels; instead, it acts on progesterone. Choice C is incorrect as mifepristone's mechanism does not involve altering the uterine lining to prevent implantation. Choice D is incorrect because mifepristone does not directly stimulate uterine contractions; its primary action is through progesterone inhibition.

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