Nursing Elites

1. Ivermectin (Stromectol) appears on a list of a patient's recent medications. The nurse who is reviewing the medications is justified in suspecting that the patient may have been receiving treatment for a parasitic infection with

• A. Entamoeba histolytica.
• B. Giardia lamblia.
• C. Strongyloides stercoralis.
• D. Plasmodium falciparum.

Correct answer: C

Rationale: Ivermectin (Stromectol) is commonly used to treat parasitic infections, particularly Strongyloides stercoralis. This parasitic infection is known to respond well to Ivermectin therapy. Entamoeba histolytica causes amoebiasis and is typically treated with antiprotozoal drugs like metronidazole, not Ivermectin. Giardia lamblia is a protozoan parasite causing giardiasis, which is usually treated with medications like metronidazole or tinidazole, not Ivermectin. Plasmodium falciparum is a malaria-causing parasite and is not treated with Ivermectin but with antimalarial medications like chloroquine or artemisinin-based combination therapies.

2. A patient is being educated about sildenafil (Viagra). Which of the following statements by the patient indicates that further teaching is necessary?

• A. I can take this medication with nitroglycerin.
• B. This medication can cause an erection lasting more than 4 hours.
• C. I should not take this medication if I am taking medications containing nitrates.
• D. This medication is safe to take with any over-the-counter medication.

Correct answer: A

Rationale: The correct answer is A because sildenafil should not be taken with medications containing nitrates, such as nitroglycerin, due to the risk of severe hypotension. Choice B is incorrect because priapism (prolonged erection) is a serious side effect but does not require immediate intervention like severe hypotension. Choice C is incorrect as it correctly identifies a contraindication for sildenafil use. Choice D is incorrect because not all over-the-counter medications are safe to take with sildenafil, and interactions can occur.

3. What is the primary cause of angina?

• A. Increased oxygen demand by the heart
• B. Obstruction of the coronary arteries
• C. Lack of oxygen in the lungs
• D. Decreased blood supply to the liver

Correct answer: B

Rationale: The correct answer is B: Obstruction of the coronary arteries. Angina is primarily caused by a reduced blood flow to the heart due to blockages or narrowing in the coronary arteries. Choice A is incorrect because while increased oxygen demand can contribute to angina symptoms, it is not the primary cause. Choice C is incorrect as angina is not caused by a lack of oxygen in the lungs. Choice D is also incorrect as angina is not related to decreased blood supply to the liver.

4. Which term should the nurse use to document a situation in which cells increase in size and function?

• A. Atrophy
• B. Hypertrophy
• C. Metaplasia
• D. Hyperplasia

Correct answer: B

Rationale: Hypertrophy is the correct term used to describe the situation in which cells increase in size and function. Atrophy (Choice A) is the opposite, indicating a decrease in cell size. Metaplasia (Choice C) refers to the reversible replacement of one mature cell type by another. Hyperplasia (Choice D) involves an increase in the number of cells, not just an increase in size and function as in hypertrophy.

5. A 50-year-old woman has had a relapse of her multiple sclerosis (MS) after several years of being symptom-free. Which of the following factors is most likely to have contributed to her relapse?

• A. Emotional stress
• B. Dietary indiscretion
• C. Physical overexertion
• D. Adequate rest and relaxation

Correct answer: C

Rationale: The correct answer is C: Physical overexertion. In individuals with multiple sclerosis (MS), physical overexertion can exacerbate symptoms and contribute to a relapse. It is important for individuals with MS to balance physical activity to avoid triggering symptom reoccurrence. Choices A, B, and D are less likely to have directly contributed to the relapse. Emotional stress and dietary indiscretion may play a role in exacerbating symptoms in some individuals, but physical overexertion is more commonly associated with MS relapses. Adequate rest and relaxation are important for overall well-being but are not typically linked to MS relapses.

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