A patient has been diagnosed with cytomegalovirus (CMV). Which of the following drugs would be ineffective in the treatment of this disease?

Correct Answer: A

Rationale: In the treatment of cytomegalovirus (CMV), the drug Ribavirin (Rebetol) would be ineffective. Ribavirin is an antiviral medication used primarily for the treatment of hepatitis C and respiratory syncytial virus (RSV) infections but is not effective against CMV. Ganciclovir (Cytovene) IV, Foscarnet (Foscavir) IV, and Valganciclovir hydrochloride (Valcyte) are all effective against CMV. Ganciclovir and Valganciclovir are nucleoside analogues that inhibit viral DNA synthesis, while Foscarnet is a pyrophosphate analogue that works by directly inhibiting viral DNA polymerase. Educationally, understanding the mechanisms of action of antiviral drugs is crucial in pharmacology. Knowing which drugs are effective against specific viruses, like CMV, helps healthcare providers make informed decisions when selecting the most appropriate treatment for their patients. It also highlights the importance of accurate diagnosis and targeted therapy to achieve optimal patient outcomes.

Correct Answer: C

Rationale: In this scenario, option C is correct, which states that the nurse should avoid administering the fluconazole through a peripheral IV. The rationale behind this is that fluconazole is an irritant to veins and can cause phlebitis or thrombophlebitis if administered through a peripheral IV line. It is recommended to administer fluconazole through a central venous catheter to reduce the risk of venous irritation and potential complications. Option A is incorrect because lactated Ringer's is not specifically indicated or contraindicated for the administration of fluconazole. Option B is also incorrect as there is no specific maximum infusion rate mentioned for fluconazole, but it should be administered at a rate that is safe and appropriate for the patient. Option D is incorrect as there is no requirement for prophylactic heparin administration prior to fluconazole infusion. From an educational perspective, understanding the appropriate administration route and potential side effects of medications is crucial for nurses to ensure safe and effective patient care. It is important to be aware of best practices in medication administration to prevent complications and promote positive patient outcomes.

Correct Answer: A

Rationale: In this scenario, the nurse would determine the efficacy of mebendazole treatment for roundworm by referencing liver enzymes. Mebendazole is an anthelmintic medication commonly used to treat parasitic infections like roundworm. The rationale behind checking liver enzymes is that mebendazole can cause hepatotoxicity as a rare adverse effect. By monitoring liver enzymes, the nurse can assess if the medication is causing any liver damage, ensuring the child's safety during treatment. Option B, stool for ova and parasites, is used to diagnose the presence of parasites in the stool before treatment initiation, not to monitor treatment efficacy. Colonoscopy or sigmoidoscopy (Option C) and rectal swab for culture (Option D) are invasive procedures not typically used to assess the effectiveness of anthelmintic treatment in cases of roundworm. In an educational context, understanding the rationale for monitoring liver enzymes during anthelmintic therapy emphasizes the importance of medication safety and the need for appropriate monitoring to prevent or detect adverse effects. It also highlights the significance of selecting the right diagnostic tests to evaluate treatment outcomes accurately, thus promoting evidence-based and patient-centered care in pharmacology practice.

Correct Answer: D

Rationale: In this question, the correct answer is D) Pharyngeal efferent neurons. These neurons are responsible for controlling the muscles involved in swallowing and moving the head from side to side. When a nursing student has difficulty moving her head from side to side, it indicates a problem with the pharyngeal efferent neurons specifically. Option A) General visceral efferent neurons are responsible for innervating smooth muscles and glands. They are not directly involved in controlling head movements. Option B) Preganglionic neurons are part of the autonomic nervous system and are involved in transmitting signals from the central nervous system to the ganglia. They are not directly related to head movements. Option C) Parasympathetic postganglionic neurons are involved in the parasympathetic division of the autonomic nervous system, controlling rest and digest functions. They are not responsible for head movements. Educationally, understanding the function of different types of neurons is crucial for nursing students as it helps them identify and address neurological issues effectively in patients. This knowledge is essential for providing safe and competent care to individuals experiencing problems related to neuronal function.

Correct Answer: B

Rationale: In this scenario, option B, a 33-year-old female with a postoperative deep vein thrombosis and pulmonary embolism, is most likely to have a fever. Postoperative patients are at risk for fever due to the body's response to surgical trauma, anesthesia, and the healing process. Additionally, deep vein thrombosis and pulmonary embolism can trigger an inflammatory response, leading to fever as a symptom. Option A, the 71-year-old female with limited mobility, COPD, and vascular dementia, is less likely to have a fever related to her noninfectious diagnoses unless she develops a secondary infection like pneumonia. Option C, the 51-year-old obese male with hepatic encephalopathy secondary to alcohol abuse, is more likely to present with altered mental status and liver-related symptoms rather than fever. Option D, the 71-year-old male with congestive heart failure and peripheral edema, is less likely to have a fever unless there is an underlying infection or inflammatory condition. In an educational context, understanding the relationship between different medical conditions and fever is crucial for nurses and healthcare providers to assess and manage patients effectively. Recognizing the potential causes of fever in various clinical scenarios helps in providing appropriate care and interventions to address the underlying issues.