Nursing Elites

1. Which of the following disorders is more likely associated with blood in stool?

• A. Gastroesophageal reflux
• B. Crohn's disease
• C. Irritable bowel syndrome
• D. Colon cancer

Correct answer: D

Rationale: Colon cancer is more likely associated with blood in stool due to the presence of bleeding from the tumor in the colon. Gastroesophageal reflux (Choice A) typically presents with heartburn and regurgitation but not blood in stool. Crohn's disease (Choice B) can cause gastrointestinal symptoms, but bloody stools are more commonly associated with ulcerative colitis. Irritable bowel syndrome (Choice C) is characterized by abdominal pain, bloating, and changes in bowel habits, but it does not typically cause blood in stool. Therefore, the correct answer is D, Colon cancer.

2. Which of the following is a clinical manifestation of hyperthyroidism?

• A. Tachycardia
• B. Constipation
• C. Weight gain
• D. Fatigue

Correct answer: A

Rationale: The correct answer is A: Tachycardia. Tachycardia, which is an increased heart rate, is a classic clinical manifestation of hyperthyroidism. In hyperthyroidism, there is an excess production of thyroid hormones, leading to an increased metabolic rate. This increased metabolism can cause symptoms such as a rapid heart rate. Choices B, C, and D are incorrect because constipation, weight gain, and fatigue are more commonly associated with hypothyroidism, where there is a deficiency of thyroid hormones leading to a slower metabolic rate.

3. An older adult man has moved to a long-term care facility, and the nurse is performing medication reconciliation. The resident's current medication regimen includes alfuzosin (Uroxatral). After considering the most likely indication for this drug, what potential problem should the nurse include in the resident's interdisciplinary plan of care?

• A. Impaired urinary elimination
• B. Ineffective sexual pattern
• C. Sexual dysfunction
• D. Functional urinary incontinence

Correct answer: C

Rationale: The correct answer is C, 'Sexual dysfunction.' Alfuzosin is commonly prescribed for benign prostatic hyperplasia (BPH), a condition that can lead to sexual dysfunction in older men. It is important to include this potential problem in the interdisciplinary plan of care to address the impact of the medication on the resident's sexual health. Choices A, B, and D are incorrect because while alfuzosin can affect urinary function, the primary concern related to this medication in this scenario is sexual dysfunction due to its indication for BPH.

4. What important point should the nurse emphasize about taking oral contraceptives consistently?

• A. Oral contraceptives must be taken at the same time each day to maintain consistent hormone levels and ensure effectiveness in preventing pregnancy.
• B. Oral contraceptives should be taken in the morning to avoid side effects at night.
• C. Oral contraceptives should be taken with food to enhance absorption.
• D. Oral contraceptives can be skipped occasionally without significant consequences.

Correct answer: A

Rationale: The correct answer is A. It is crucial for patients taking oral contraceptives to take them at the same time each day to maintain consistent hormone levels, which is essential for their effectiveness in preventing pregnancy. Choice B is incorrect as the timing of the medication is more about consistency than avoiding side effects at night. Choice C is incorrect as oral contraceptives do not necessarily need to be taken with food for absorption. Choice D is incorrect because skipping oral contraceptives occasionally can significantly reduce their effectiveness in preventing pregnancy.

5. What therapeutic effect is expected from tamsulosin (Flomax) in a male patient with benign prostatic hyperplasia (BPH)?

• A. Relaxation of the muscles in the prostate and bladder neck, leading to improved urinary flow.
• B. Increase in urine flow and relief of urinary obstruction.
• C. Reduction in prostate size and improvement in urinary symptoms.
• D. Improvement in erectile function.

Correct answer: A

Rationale: The correct answer is A: 'Relaxation of the muscles in the prostate and bladder neck, leading to improved urinary flow.' Tamsulosin is an alpha-blocker that specifically targets alpha-1 receptors in the prostate and bladder neck, causing relaxation of smooth muscles. This relaxation results in improved urinary flow and reduced symptoms of BPH. Choice B is incorrect because while tamsulosin does improve urinary flow, it does not directly increase urine flow. Choice C is incorrect because tamsulosin does not reduce prostate size. Choice D is incorrect as tamsulosin does not have a primary effect on erectile function.

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