Nursing Elites

1. A patient receiving isoniazid (INH) and rifampin (Rifadin) has a decreased urinary output and decreased sensation in his great toes. Which laboratory values should be assessed?

• A. Hematocrit and hemoglobin
• B. ALT and AST
• C. Urine culture and sensitivity
• D. Erythrocyte count and differential

Correct answer: C

Rationale: In a patient receiving isoniazid (INH) and rifampin (Rifadin) with symptoms of decreased urinary output and decreased sensation in great toes, assessing urine culture and sensitivity is crucial. These symptoms could indicate peripheral neuropathy, a known side effect of isoniazid, and rifampin can cause renal toxicity. Checking for any urinary tract infection or drug-induced nephrotoxicity is important. Choices A, B, and D are incorrect as they do not directly address the symptoms presented by the patient or the potential side effects of the medications mentioned.

2. Which of the following disorders is more likely associated with blood in stool?

• A. Gastroesophageal reflux
• B. Crohn's disease
• C. Irritable bowel syndrome
• D. Colon cancer

Correct answer: D

Rationale: Colon cancer is more likely associated with blood in stool due to the presence of bleeding from the tumor in the colon. Gastroesophageal reflux (Choice A) typically presents with heartburn and regurgitation but not blood in stool. Crohn's disease (Choice B) can cause gastrointestinal symptoms, but bloody stools are more commonly associated with ulcerative colitis. Irritable bowel syndrome (Choice C) is characterized by abdominal pain, bloating, and changes in bowel habits, but it does not typically cause blood in stool. Therefore, the correct answer is D, Colon cancer.

3. A female patient is prescribed medroxyprogesterone acetate (Provera) for dysfunctional uterine bleeding. What should the nurse include in the patient education?

• A. This medication may cause breakthrough bleeding or spotting.
• B. This medication may cause weight gain.
• C. This medication may increase your risk of developing diabetes.
• D. This medication may increase your risk of breast cancer.

Correct answer: A

Rationale: The correct answer is A. Medroxyprogesterone acetate (Provera) can cause breakthrough bleeding or spotting, which is a common side effect of this medication. Choices B, C, and D are incorrect because weight gain, increased risk of diabetes, and increased risk of breast cancer are not commonly associated side effects of medroxyprogesterone acetate. Therefore, the nurse should focus on educating the patient about the potential for breakthrough bleeding or spotting.

4. Which of the following types of vitamin or mineral deficiency can cause megaloblastic anemia and is associated with lower extremity paresthesias?

• A. Vitamin B12
• B. Folate
• C. Iron
• D. Vitamin K

Correct answer: A

Rationale: The correct answer is Vitamin B12. Vitamin B12 deficiency can lead to megaloblastic anemia, a condition characterized by the production of abnormally large and immature red blood cells. Lower extremity paresthesias, such as tingling or numbness, are common neurological symptoms associated with vitamin B12 deficiency. Folate deficiency can also cause megaloblastic anemia but is not typically linked to lower extremity paresthesias. Iron deficiency leads to microcytic anemia, not megaloblastic anemia. Vitamin K deficiency is associated with bleeding tendencies, not megaloblastic anemia or paresthesias.

5. A 52-year-old male patient is taking finasteride (Proscar) for benign prostatic hyperplasia (BPH). What patient teaching should the nurse provide?

• A. Take the medication with food.
• B. Avoid taking NSAIDs while on this medication.
• C. Avoid driving or operating heavy machinery while taking this medication.
• D. Women who are or may become pregnant should not handle crushed or broken tablets.

Correct answer: D

Rationale: The correct answer is D. Finasteride, used for BPH, can be harmful to a developing male fetus. Therefore, women who are or may become pregnant should not handle crushed or broken tablets to avoid potential absorption through the skin. Choice A is incorrect as finasteride can be taken with or without food. Choice B is incorrect because there is no specific interaction between finasteride and NSAIDs mentioned. Choice C is incorrect as finasteride does not typically cause drowsiness or impair mental alertness.

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