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. How can a colony-stimulating factor affect the patient's erythrocyte count?

• A. It stimulates the growth of red blood cells.
• B. It suppresses T-cell production.
• C. It inhibits protein synthesis.
• D. It stimulates antibody production.

Correct answer: A

Rationale: Colony-stimulating factors are substances that stimulate the production of blood cells in the bone marrow. Erythrocytes are red blood cells, so a colony-stimulating factor would specifically stimulate the growth of red blood cells, leading to an increase in the patient's erythrocyte count. Choice B is incorrect because colony-stimulating factors do not suppress T-cell production. Choice C is incorrect because colony-stimulating factors do not inhibit protein synthesis. Choice D is incorrect because colony-stimulating factors do not stimulate antibody production; they primarily affect the production of blood cells.

3. 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.

4. A male patient with hypogonadism is receiving testosterone therapy. What is the most serious adverse effect the nurse should monitor for?

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

Correct answer: B

Rationale: The correct answer is B: Increased risk of cardiovascular events. Testosterone therapy can lead to an increased risk of cardiovascular events such as heart attacks and strokes, especially in older patients. Monitoring for signs and symptoms of cardiovascular issues is crucial when administering testosterone therapy. Choices A, C, and D are incorrect because testosterone therapy does not typically lead to an increased risk of breast cancer, liver dysfunction, or prostate cancer.

5. A woman with severe visual and auditory deficits is able to identify individuals by running her fingers lightly over her face. Which source is most likely to provide the input that allows for the woman's unique ability?

• A. Special somatic afferent fibers
• B. General somatic afferents
• C. Special visceral afferent cells
• D. General visceral afferent neurons

Correct answer: C

Rationale: The correct answer is C, special visceral afferent cells. These cells are responsible for functions like taste and smell. In individuals with severe visual and auditory deficits, their other sensory abilities, such as touch, can be heightened. Special somatic afferent fibers (choice A) are involved in sensations like touch and vibration from the skin and muscles, but they are not specific to the face. General somatic afferents (choice B) transmit sensory information from the skin, muscles, and joints, but they are not specialized for the unique ability described. General visceral afferent neurons (choice D) are responsible for transmitting sensory information from internal organs, not relevant to the woman's ability to identify individuals through touch on her face.

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