The physician plans to prescribe trastuzumab (Herceptin) for the patient with breast cancer. What testing will the physician order before prescribing this medication?

Correct Answer: A

Rationale: Rationale: The correct answer is A) HER2 protein levels. Trastuzumab (Herceptin) is a targeted therapy used in the treatment of breast cancer, specifically in patients who overexpress the HER2 protein. Before prescribing trastuzumab, it is crucial to test for HER2 protein levels to determine if the patient is a suitable candidate for this medication. Option B) BRCA2 gene mutation and C) BRCA1 gene mutation are related to genetic mutations that increase the risk of developing breast cancer but are not directly relevant to the decision of prescribing trastuzumab. These genetic tests are more commonly used in assessing the risk of developing breast cancer rather than guiding treatment decisions. Option D) Stage II cancer identification is important for determining the extent of the disease and planning the overall treatment strategy. However, it does not specifically inform the decision to prescribe trastuzumab based on HER2 protein expression. In an educational context, understanding the rationale behind pre-treatment testing for medications like trastuzumab enhances students' knowledge of personalized medicine and targeted therapies in oncology. It emphasizes the importance of conducting appropriate tests to tailor treatment plans to individual patients, ultimately improving outcomes and minimizing adverse effects.

Correct Answer: D

Rationale: In the context of treating allergic rhinitis, the nurse should expect sympathomimetic/decongestant drugs (Option D) to be ordered first. This is because these drugs provide quick relief of nasal congestion by constricting blood vessels in the nasal passages, reducing swelling and congestion. This immediate relief can help alleviate the discomfort experienced by the patient due to nasal congestion. Corticosteroids (Option A) are often used for allergic rhinitis, but they are typically reserved for persistent or severe cases where inflammation needs to be reduced over time. Immunotherapy (Option B) is a long-term treatment that aims to desensitize the patient to allergens but is not typically the initial therapy. Antipruritic drugs (Option C) may help with itching but do not address the primary symptom of nasal congestion in allergic rhinitis. In an educational context, understanding the rationale behind the choice of initial therapy for allergic rhinitis is crucial for nursing students to provide effective and evidence-based care to their patients. It highlights the importance of assessing the primary symptoms, such as nasal congestion, and selecting the most appropriate treatment to address those symptoms promptly. This knowledge equips nurses with the skills to prioritize interventions and improve patient outcomes in clinical practice.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Chronic rejection. Chronic rejection is a type of rejection that occurs months to years after a transplant and is characterized by a slow and progressive decline in organ function. In the case of the patient experiencing fibrosis and glomerulopathy a year after a kidney transplant, these are indicative of chronic rejection. Acute rejection (option A) typically occurs within the first few weeks to months after a transplant and presents with rapid onset of symptoms. Hyperacute rejection (option D) occurs almost immediately after transplantation due to pre-existing antibodies against the donor organ. Delayed rejection (option C) is not a recognized type of rejection in transplant medicine. Educationally, understanding the different types of rejection post-transplant is crucial for healthcare professionals involved in transplant care. Recognizing the signs and symptoms of each type of rejection allows for early intervention and management to potentially prolong the lifespan of the transplanted organ and improve patient outcomes. It also underscores the importance of close monitoring of transplant patients to detect rejection early.

Correct Answer: C

Rationale: In the context of HIV transmission, the correct option is C: First 2 to 6 months of infection OR 1 year after infection. This option poses the highest risk because during the early stages of HIV infection (acute phase), the viral load in the body is significantly high, making it easier to transmit the virus to others through various routes like sexual intercourse or sharing needles. Option A is less likely to pose the highest risk because transmission can occur to both men and women during sexual intercourse regardless of gender. Option B is also less risky as both hollow-bore needles used for vascular access and IM injections can transmit HIV if contaminated. Option D is less risky compared to option C because perinatal transmission from HIV-infected mothers who are not on antiretroviral therapy poses a higher risk due to increased viral load and lack of preventive measures compared to mothers on antiretroviral therapy. Understanding these scenarios is crucial in pharmacology to emphasize the importance of early detection, treatment, and prevention strategies in reducing HIV transmission risks at different stages of infection. It highlights the significance of educating individuals on safe practices to minimize the spread of HIV.

Correct Answer: C

Rationale: In the context of HIV infection, the most significant factor in determining when to start antiretroviral therapy is the patient's readiness to commit to a complex, lifelong, uncomfortable drug regimen (Option C). This is because adherence to the medication schedule is crucial for the effectiveness of antiretroviral therapy in suppressing the HIV virus and preventing progression to AIDS. Patients who are not ready to commit to this regimen may struggle with adherence, leading to treatment failure, drug resistance, and disease progression. Option A is incorrect because the levels of HIV antibodies do not determine the timing to start antiretroviral therapy. Option B is incorrect because once a patient is diagnosed with HIV infection, the focus shifts to when to initiate treatment rather than confirming the infection. Option D is incorrect because while having a support system is beneficial, it is not the most significant factor in determining the timing of antiretroviral therapy initiation. Educationally, understanding the importance of patient readiness in initiating antiretroviral therapy emphasizes the critical role of patient engagement and adherence in the successful management of HIV infection. It highlights the need for healthcare providers to assess patient readiness, provide education and support, and collaborate with patients to optimize treatment outcomes.