Nursing Elites

1. What key contraindication should the nurse emphasize to a patient prescribed sildenafil (Viagra) for erectile dysfunction?

• A. Sildenafil is contraindicated in patients taking nitrates due to the risk of severe hypotension.
• B. Sildenafil should not be taken with food as it can reduce its effectiveness.
• C. Sildenafil is contraindicated in patients with a history of hypertension.
• D. Sildenafil should not be taken with grapefruit juice as it can lead to dangerous side effects.

Correct answer: A

Rationale: The correct answer is A. Sildenafil is contraindicated in patients taking nitrates due to the risk of severe hypotension. Nitrates and sildenafil both cause vasodilation, leading to a synergistic effect that can result in a dangerous drop in blood pressure. Choices B, C, and D are incorrect because there is no specific contraindication for taking sildenafil with food, having a history of hypertension, or taking it with grapefruit juice. The main concern is the concurrent use of nitrates with sildenafil.

2. Stress-induced cortisol hormone secretion is associated with:

• A. Increased growth hormone level
• B. Regulation of the stress response
• C. Increased thyroid-stimulating hormone
• D. Depressed adrenal gland function

Correct answer: B

Rationale: The correct answer is B: Regulation of the stress response. Cortisol plays a crucial role in regulating the body's response to stress by modulating various physiological processes. Choices A, C, and D are incorrect because stress-induced cortisol hormone secretion is not directly associated with increased growth hormone levels, increased thyroid-stimulating hormone, or depressed adrenal gland function.

3. A 75-year-old male presents with chest pain on exertion. The chest pain is most likely due to hypoxic injury secondary to:

• A. Malnutrition
• B. Free radicals
• C. Ischemia
• D. Chemical toxicity

Correct answer: C

Rationale: The correct answer is C: Ischemia. In this scenario, the 75-year-old male experiences chest pain on exertion, which is indicative of angina. Angina is primarily caused by reduced blood flow to the heart muscle, leading to hypoxic injury. This condition is known as ischemia. Options A, B, and D are incorrect. Malnutrition does not typically cause chest pain related to exertion. Free radicals and chemical toxicity are not common causes of chest pain in the context described. Therefore, the most likely cause of chest pain in this case is ischemia due to reduced blood flow.

4. Cellular swelling is:

• A. Irreversible
• B. Evident early in all types of cellular injury
• C. Manifested by decreased intracellular sodium
• D. None of the above is correct

Correct answer: B

Rationale: Cellular swelling is indeed evident early in all types of cellular injury. This occurs due to the influx of water into the cell, leading to swelling. Choice A is incorrect because cellular swelling is reversible if the injury is not severe. Choice C is incorrect because cellular swelling is not manifested by decreased intracellular sodium; in fact, it is associated with increased intracellular sodium due to water influx. Choice D is incorrect as option B is the correct statement.

5. A patient is receiving intravenous amphotericin. Which of the following assessments warrants the discontinuation of the antifungal agent?

• A. Sodium level of 138 mEq/L
• B. Hematocrit of 39%
• C. Blood urea nitrogen of 60 mg/dL
• D. AST level of 10 Unit/L

Correct answer: C

Rationale: Intravenous amphotericin can cause nephrotoxicity, leading to increased blood urea nitrogen levels. Elevated blood urea nitrogen (BUN) indicates impaired renal function, which is a known adverse effect of amphotericin. Therefore, a BUN level of 60 mg/dL warrants the discontinuation of the antifungal agent. The other options, such as a sodium level of 138 mEq/L, hematocrit of 39%, and AST level of 10 Unit/L, are within normal ranges and not indicative of the need to discontinue amphotericin therapy.

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