A nurse learns that which of the following is the single biggest risk factor for developing cancer?

Choice A rationale:
It is not accurate to state that the patient is at risk for seizures due to fungal infections. While fungal infections can occur in individuals with HIV-1, they are not a primary cause of seizures in this population.
Linking fungal infections directly to seizure risk without clear evidence could cause unnecessary anxiety in the patient. It's important to provide accurate and relevant information to patients.
Choice B rationale:
Responding with "I have no idea why you would be taking this drug" is unprofessional and unhelpful.
Nurses are expected to have a basic understanding of the medications their patients are taking and to be able to provide education and support.
It's essential to demonstrate knowledge and confidence when interacting with patients.
Choice C rationale:
While gabapentin can have mood-elevating effects in some individuals, it is not primarily used as an antidepressant. Mentioning this potential side effect without clarifying the primary purpose of the medication could mislead the patient. It's crucial to prioritize the main indication for the medication to avoid confusion.
Choice D rationale:
This is the most appropriate response because it accurately explains the primary reason for prescribing gabapentin to this patient.
Gabapentin is commonly used to treat neuropathic pain, which is pain caused by nerve damage.
HIV-1 can often lead to neuropathic pain, making gabapentin a valuable treatment option in this population.
Providing clear and accurate information about medication purpose builds trust and understanding between the nurse and the patient.

Choice A rationale:
Prednisone:
Corticosteroid that suppresses the immune system: It's crucial to consult with the primary healthcare provider (PCP) because prednisone can impair wound healing and increase the risk of infection after surgery. The PCP may need to adjust the dosage or temporarily discontinue prednisone prior to surgery.
Potential for adrenal insufficiency: Abrupt cessation of prednisone can lead to adrenal insufficiency, a life-threatening condition. The PCP will provide guidance on how to taper the medication safely before surgery.
Interaction with anesthesia: Prednisone can interact with certain anesthetic agents, potentially increasing the risk of complications. The PCP and anesthesiologist will need to coordinate care to ensure safe medication management during surgery.
Choice B rationale:
Metoprolol:
Beta-blocker that lowers blood pressure and heart rate: While metoprolol is generally safe to continue before surgery, it's still essential to inform the PCP and anesthesiologist about its use. They will monitor heart rate and blood pressure closely during and after surgery, as metoprolol can interact with certain medications used during the procedure.
Choice C rationale:
Warfarin:
Blood thinner that prevents blood clots: Warfarin requires careful management around surgery due to its significant bleeding risk. The PCP will typically recommend holding warfarin for several days before surgery to allow for normalization of blood clotting. They may also bridge with a shorter-acting anticoagulant if necessary.
Potential for bleeding complications: If warfarin is not managed appropriately, it can lead to excessive bleeding during or after surgery. The PCP will closely monitor the patient's INR (international normalized ratio), a measure of blood clotting, to ensure it's within the safe range for surgery.
Choice D rationale:
Insulin:
Hormone that regulates blood sugar: Patients with diabetes who take insulin require careful blood sugar control around surgery to prevent complications. The PCP will provide specific instructions on how to adjust insulin doses before, during, and after surgery, as insulin needs often change due to the stress of surgery and the impact of anesthesia.
Risk of hypoglycemia and hyperglycemia: Both low blood sugar (hypoglycemia) and high blood sugar (hyperglycemia) can have serious consequences during and after surgery. The PCP will work with the patient to manage blood sugar levels and prevent these complications.
Choice E rationale:
Phenytoin:
Anticonvulsant medication that controls seizures: Phenytoin has a narrow therapeutic window, meaning that blood levels must be closely monitored to ensure efficacy and prevent toxicity. Surgery can affect phenytoin levels, so the PCP will likely recommend checking a blood level before surgery and adjusting the dose as needed.
Potential for drug interactions: Phenytoin interacts with many medications, including some commonly used during surgery. The PCP will need to review the patient's medication list carefully and make any necessary adjustments to prevent interactions.
Choice F rationale:
Omega-3 fatty acid:
Generally safe to continue before surgery: Omega-3 fatty acids are not known to have significant interactions with medications used during surgery or to pose risks for wound healing or bleeding. However, it's always best to inform the PCP about any supplements being taken.