Nursing Elites

1. Which of the following statements indicates more teaching is needed regarding secondary lymph organs? ________is/are a secondary lymph organ.

• A. The spleen
• B. Peyer's patches
• C. Adenoids
• D. The liver

Correct answer: D

Rationale: The correct answer is D, 'The liver.' The liver is not a secondary lymph organ. Secondary lymph organs are primarily involved in the immune response, such as the spleen, Peyer's patches, and adenoids. The spleen filters blood and is essential for immune function. Peyer's patches are located in the small intestine and help protect against pathogens. Adenoids are located in the throat and play a role in immune defense. Therefore, the liver is the incorrect choice as it is not part of the secondary lymph organ system.

2. On the advice of his brother, a 53-year-old man has made an appointment to request a prescription for Viagra. The nurse who works at the clinic is reviewing the man's medical history and would recognize what health problem as being prohibitive to this treatment?

• A. Type 2 diabetes, treated with metformin
• B. Hypercholesterolemia, treated with simvastatin
• C. Angina, treated with nitroglycerin
• D. Hypertension, treated with metoprolol

Correct answer: C

Rationale: Nitroglycerin is contraindicated with Viagra due to their combined effects on lowering blood pressure, which can result in a severe drop and potentially life-threatening complications. Using both medications together can lead to hypotension, putting the patient at risk. Therefore, the presence of angina treated with nitroglycerin would make prescribing Viagra unsafe. Choices A, B, and D are not directly contraindicated with Viagra and can be managed concurrently with this treatment.

3. A patient is prescribed medroxyprogesterone acetate (Provera) for the treatment of endometriosis. What should the nurse include in the patient teaching?

• A. Take the medication with food to prevent nausea.
• B. Take the medication at the same time each day to maintain consistent hormone levels.
• C. Avoid prolonged sun exposure while taking this medication.
• D. Discontinue the medication if side effects occur.

Correct answer: B

Rationale: The correct answer is to take the medication at the same time each day to maintain consistent hormone levels and effectiveness. This is crucial for the drug to work optimally. Choice A is incorrect because medroxyprogesterone acetate does not necessarily need to be taken with food to prevent nausea. Choice C is not directly related to the medication's administration and is not a common teaching point for this drug. Choice D is incorrect as discontinuing the medication abruptly can lead to adverse effects and is not recommended without consulting a healthcare provider.

4. When treating a patient for a fungal infection with IV amphotericin B, what should the nurse consistently monitor the patient's levels of to prevent drug discomfort?

• A. sodium
• B. hemoglobin
• C. calcium
• D. leukocytes

Correct answer: C

Rationale: When a patient is being treated with IV amphotericin B for a fungal infection, it is crucial to monitor the patient's calcium levels consistently. IV amphotericin B can cause hypokalemia, hypomagnesemia, and most notably, hypocalcemia. Monitoring calcium levels helps prevent drug-related discomfort and adverse effects. Sodium (Choice A), hemoglobin (Choice B), and leukocytes (Choice D) are not the primary parameters to monitor specifically for drug discomfort related to amphotericin B. Therefore, they are incorrect choices.

5. A patient with a diagnosis of renal failure is being treated with epoetin alfa (Epogen). Frequent assessment of which of the following laboratory values should be prioritized before and during treatment?

• A. AST
• B. C-reactive protein
• C. CBC
• D. ALT

Correct answer: A

Rationale: The correct answer is AST. Epoetin alfa is a medication used to treat anemia associated with chronic renal failure. During treatment with epoetin alfa, it is crucial to monitor AST levels as this medication can potentially lead to liver toxicity. Assessing AST levels before and throughout treatment helps in early detection of any liver abnormalities. C-reactive protein is not specifically related to the use of epoetin alfa in renal failure. While CBC (Complete Blood Count) monitoring is essential during treatment with epoetin alfa to evaluate the response to therapy, prioritizing AST assessment is more critical due to the potential for liver toxicity. ALT monitoring is also important but AST is prioritized in this scenario.

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