Nursing Elites

1. An older adult patient has asked her primary care provider for a prescription that will help to resolve her “warped toenails.” The care provider has diagnosed the woman with onychomycosis. The nurse should anticipate that this patient will be treated with what drug?

• A. Micafungin (Mycamine)
• B. Terbinafine (Lamisil)
• C. Voriconazole (Vfend)
• D. Fluconazole (Diflucan)

Correct answer: B

Rationale: The correct answer is B: Terbinafine (Lamisil). Terbinafine is commonly used to treat onychomycosis, a fungal infection of the toenails or fingernails. It works by stopping the growth of the fungus. Micafungin (Mycamine) is an antifungal medication used for different types of fungal infections but is not typically used to treat onychomycosis. Voriconazole (Vfend) is another antifungal medication used for specific fungal infections, but it is not a first-line treatment for onychomycosis. Fluconazole (Diflucan) is also an antifungal medication, but it is more commonly used for yeast infections and may not be as effective for treating onychomycosis compared to terbinafine.

2. A patient is starting on alendronate (Fosamax) for the treatment of osteoporosis. What instructions should the nurse provide to ensure the effectiveness of the medication?

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

Correct answer: A

Rationale: The correct answer is A. Alendronate should be taken with a full glass of water, and patients should remain upright for at least 30 minutes to prevent esophageal irritation and ensure proper absorption. Taking the medication with milk (choice B) is not recommended as it may interfere with alendronate absorption. Taking it at bedtime (choice C) is not necessary and may increase the risk of esophageal irritation. Taking the medication with food (choice D) can reduce its absorption and effectiveness.

3. A 25-year-old woman who works as an air traffic controller presents with facial pain and severe headache. She reports that she sometimes feels the pain in her neck or ear and that it is particularly bad during very busy times at the airport. What is the most likely diagnosis?

• A. Migraine headache
• B. Cluster headache
• C. Temporomandibular joint syndrome
• D. Sinus headache

Correct answer: C

Rationale: The most likely diagnosis for the 25-year-old woman who works as an air traffic controller and presents with facial pain and severe headache that sometimes radiates to her neck or ear, aggravated by stress, is Temporomandibular joint syndrome. This syndrome involves pain in the jaw joint and the muscles controlling jaw movement, which can radiate to the surrounding areas like the neck and ear. Stress and clenching of the jaw commonly exacerbate the symptoms. Migraine headache (choice A) typically presents with other symptoms like nausea, sensitivity to light or sound, and can be triggered by various factors, not just stress. Cluster headache (choice B) is characterized by severe, unilateral pain around the eye with associated autonomic symptoms. Sinus headache (choice D) is usually associated with sinus congestion or infection, presenting with facial pressure or pain, often worsened by bending forward.

4. What is the primary function of the kidneys in acid-base balance?

• A. The kidneys remove hydrogen ions and retain bicarbonate ions.
• B. The kidneys convert ammonia into urea, which is excreted in the urine.
• C. The kidneys produce aldosterone to regulate sodium levels.
• D. The kidneys secrete renin to regulate blood pressure.

Correct answer: A

Rationale: The correct answer is A. The kidneys are crucial in maintaining acid-base balance by removing hydrogen ions to decrease acidity and retaining bicarbonate ions to increase alkalinity. Choice B is incorrect because the conversion of ammonia into urea is related to nitrogen waste excretion, not acid-base balance. Choice C is incorrect as aldosterone regulates sodium levels, not acid-base balance. Choice D is also incorrect as renin is involved in regulating blood pressure, not acid-base balance.

5. What is the purpose of the inflammatory response?

• A. Prevents blood from entering the injured tissue
• B. Elevates body temperature to prevent spread of infection
• C. Prevents formation of abscess
• D. Minimizes injury and promotes healing

Correct answer: D

Rationale: The inflammatory response is a protective mechanism triggered by tissue damage or infection. It aims to minimize injury by removing harmful stimuli and initiating the healing process. Choice A is incorrect because blood flow to the injured tissue is actually increased to deliver immune cells and nutrients. Choice B is incorrect because while fever is a response to infection, it is not the primary purpose of the inflammatory response. Choice C is incorrect because abscess formation can occur as part of the inflammatory response in an attempt to contain an infection.

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