Nursing Elites

1. A woman is being treated with clomiphene citrate for the treatment of infertility. She states to the nurse that she has seen an increase in vaginal discharge. The nurse knows that this effect is related to:

• A. Increased blood flow to the vaginal area.
• B. Increased cervical mucus production.
• C. Increased production of vaginal secretions.
• D. Increased lubrication in the vaginal canal.

Correct answer: C

Rationale: The correct answer is C: 'Increased production of vaginal secretions.' Clomiphene citrate affects cervical mucus production, leading to an increase in vaginal secretions. This effect is beneficial for fertility as it helps create a more hospitable environment for sperm transport. Choice A, 'Increased blood flow to the vaginal area,' is incorrect as the increase in vaginal discharge is primarily due to changes in cervical mucus. Choice B, 'Increased cervical mucus production,' is partially correct but does not fully explain the increase in vaginal secretions. Choice D, 'Increased lubrication in the vaginal canal,' is not directly related to the effect seen with clomiphene citrate treatment for infertility.

2. A 30-year-old male was diagnosed with HIV. Which of the following treatments would be most effective?

• A. Reverse transcriptase inhibitors
• B. Protease inhibitors
• C. Entrance inhibitors
• D. Highly active antiretroviral therapy

Correct answer: D

Rationale: The correct answer is D: Highly active antiretroviral therapy (HAART). HAART involves a combination of different classes of antiretroviral drugs, which can effectively suppress the HIV virus, reduce the viral load, and improve the immune function. While choices A, B, and C are also used in HIV treatment, the most effective approach is a combination therapy like HAART due to its ability to target the virus at different stages of its life cycle, reducing the risk of drug resistance and improving treatment outcomes.

3. A 43-year-old man has tested positive for systemic candidiasis, and the care team has decided on IV fluconazole as a first-line treatment. When administering this medication, the nurse should

• A. administer the drug with lactated Ringer's.
• B. infuse the drug no faster than 200 mg/h.
• C. avoid administering the drug through a peripheral IV.
• D. administer prophylactic heparin prior to the fluconazole.

Correct answer: C

Rationale: When administering IV fluconazole, the nurse should avoid administering the drug through a peripheral IV. Fluconazole is known to cause phlebitis and tissue irritation if infused through a peripheral IV line. It is recommended to administer fluconazole through a central venous catheter to reduce the risk of complications. Choices A, B, and D are incorrect as there is no specific recommendation to administer the drug with lactated Ringer's, infuse it at a particular rate, or administer prophylactic heparin prior to fluconazole in this scenario.

4. 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.

5. Which of the following is a common cause of secondary hypertension?

• A. Primary aldosteronism
• B. Essential hypertension
• C. White coat hypertension
• D. Prehypertension

Correct answer: A

Rationale: Primary aldosteronism is a common cause of secondary hypertension. In primary aldosteronism, there is an overproduction of aldosterone from the adrenal glands, leading to increased sodium retention and potassium excretion, ultimately resulting in high blood pressure. Essential hypertension (Choice B) is the most common type of hypertension, but it is considered primary hypertension, not secondary. White coat hypertension (Choice C) refers to elevated blood pressure readings in a clinical setting due to anxiety but not in daily life. Prehypertension (Choice D) is a condition where blood pressure levels are elevated but not high enough to be classified as hypertension.

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