Nursing Elites

1. 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.

2. An imbalance of which of the following hormones could lead to increased calcium levels in the blood?

• A. Parathyroid hormone
• B. Antidiuretic hormone
• C. Calcitonin
• D. Melatonin

Correct answer: A

Rationale: The correct answer is Parathyroid hormone (Choice A). Parathyroid hormone plays a key role in regulating calcium levels in the blood. When there is an imbalance in parathyroid hormone secretion, it can lead to increased calcium levels in the blood. Antidiuretic hormone (Choice B) is involved in regulating water balance, not calcium levels. Calcitonin (Choice C) helps lower blood calcium levels and is unlikely to cause an increase. Melatonin (Choice D) regulates sleep-wake cycles and does not have a direct effect on calcium levels in the blood.

3. What specific instructions should the nurse provide for proper administration of alendronate (Fosamax) in a patient with osteoporosis?

• A. Take the medication with milk to enhance calcium absorption.
• B. Take the medication with a full glass of water and remain upright for at least 30 minutes.
• C. Take the medication at bedtime to ensure absorption during sleep.
• D. Take the medication with food to prevent gastrointestinal upset.

Correct answer: B

Rationale: The correct answer is to take alendronate with a full glass of water and remain upright for at least 30 minutes. This is essential to prevent esophageal irritation and ensure proper drug absorption. Choice A is incorrect as alendronate should not be taken with milk due to potential interactions. Choice C is incorrect as there is no need to take the medication at bedtime specifically. Choice D is incorrect as taking alendronate with food can decrease its absorption.

4. DiGeorge syndrome is a primary immune deficiency caused by:

• A. Failure of B cells to mature
• B. Congenital lack of thymic tissue
• C. Failure of formed elements of blood to develop
• D. Selective IgG deficiency

Correct answer: B

Rationale: DiGeorge syndrome is caused by a congenital lack of thymic tissue, which plays a crucial role in T cell development and maturation, leading to immune deficiency. Choice A is incorrect because DiGeorge syndrome primarily affects T cells, not B cells. Choice C is incorrect as it is too broad and not specific to the thymus. Choice D is incorrect as selective IgG deficiency is a different condition unrelated to DiGeorge syndrome.

5. What adverse effect should the nurse monitor for during testosterone therapy in a male patient?

• A. Increased risk of cardiovascular events
• B. Increased risk of liver dysfunction
• C. Increased risk of prostate cancer
• D. Increased risk of bone fractures

Correct answer: A

Rationale: The correct answer is A: Increased risk of cardiovascular events. Testosterone therapy can lead to an increased risk of cardiovascular events, such as heart attacks and strokes. This is why nurses should monitor for signs and symptoms of cardiovascular issues during therapy. Choices B, C, and D are incorrect because testosterone therapy is not typically associated with an increased risk of liver dysfunction, prostate cancer, or bone fractures. It is crucial for nurses to prioritize cardiovascular monitoring in patients receiving testosterone therapy.

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