Nursing Elites

1. A 20-year-old college student has presented to the campus medical clinic seeking to begin oral contraceptive therapy. The nurse has recognized the need for adequate health education related to the patient's request. The nurse should emphasize the fact that successful prevention of pregnancy depends primarily on the patient's

• A. current health status.
• B. vigilant adherence to the drug regimen.
• C. knowledge of sexual health.
• D. risk factors for adverse effects.

Correct answer: B

Rationale: The correct answer is B: 'vigilant adherence to the drug regimen.' When initiating oral contraceptive therapy, the success of preventing pregnancy relies heavily on the patient's commitment to following the prescribed regimen consistently. Compliance with taking the oral contraceptives as directed is crucial for their effectiveness. Choice A, 'current health status,' is not the primary factor for successful prevention of pregnancy with oral contraceptives. Choice C, 'knowledge of sexual health,' while important, is not the primary determinant of contraceptive efficacy. Choice D, 'risk factors for adverse effects,' though relevant for monitoring and managing side effects, is not the primary focus for ensuring contraceptive success.

2. A client with a pneumothorax is receiving oxygen therapy. Which assessment finding would indicate that the treatment is effective?

• A. Increased respiratory rate
• B. Decreased oxygen saturation levels
• C. Improved breath sounds on the affected side
• D. Increased dyspnea and chest pain

Correct answer: C

Rationale: In a client with a pneumothorax receiving oxygen therapy, improved breath sounds on the affected side would indicate effective treatment. This finding suggests that the collapsed lung is re-expanding, allowing air to flow more freely in and out of the affected area. Choices A, B, and D are incorrect: Increased respiratory rate, decreased oxygen saturation levels, and increased dyspnea and chest pain are signs of ineffective treatment or worsening of the condition in a client with a pneumothorax.

3. A patient taking an oral contraceptive missed one pill. What should the nurse teach the patient to do?

• A. Take two pills as soon as you remember, then continue the regular schedule.
• B. Take one pill as soon as you remember, then continue the regular schedule.
• C. Skip the missed pill and continue the regular schedule.
• D. Take two pills immediately, then continue the regular schedule.

Correct answer: A

Rationale: When a patient taking an oral contraceptive misses one pill, the correct action is to take two pills as soon as they remember and then continue the regular schedule. Option A is the correct answer because doubling up the dose helps maintain the effectiveness of the contraceptive. Option B is incorrect because taking only one pill after missing one may decrease contraceptive effectiveness. Option C is wrong as skipping the missed pill can also reduce effectiveness. Option D is inaccurate because taking two pills immediately is not necessary; the patient should take the missed pill as soon as remembered and then resume the regular dosing schedule.

4. How should the nurse respond to a 72-year-old patient diagnosed with benign prostatic hypertrophy (BPH) who is skeptical about tamsulosin (Flomax) for symptom relief?

• A. “Flomax can increase the amount of urine your kidneys produce, resulting in better urine flow.”
• B. “Flomax can relax your prostate and your bladder neck, making it easier to pass urine.”
• C. “Flomax makes your urine less alkaline, reducing the irritation that makes your prostate swell.”
• D. “Flomax increases the strength of your bladder muscle and results in a stronger flow of urine.”

Correct answer: B

Rationale: The correct response is choice B because it explains the mechanism of action of Flomax, which helps the patient understand how the medication works. By stating that Flomax relaxes the prostate and bladder neck, making it easier to pass urine, the nurse is addressing the patient's concerns about symptom relief. Choices A, C, and D provide inaccurate information about Flomax's mechanism of action and do not directly address the patient's skepticism or concerns.

5. A patient with a history of cardiovascular disease is being prescribed hormone replacement therapy (HRT). What should the nurse include in the patient education regarding the risks associated with HRT?

• A. HRT may increase the risk of cardiovascular events, including heart attack and stroke.
• B. HRT may decrease the risk of osteoporosis.
• C. HRT may increase the risk of venous thromboembolism.
• D. HRT may decrease the risk of breast cancer.

Correct answer: A

Rationale: The correct answer is A. Hormone replacement therapy (HRT) is associated with an increased risk of cardiovascular events, including heart attack and stroke, especially in patients with a history of cardiovascular disease. Choice B is incorrect because HRT does not decrease the risk of osteoporosis; in fact, it may increase the risk of certain conditions like venous thromboembolism, as mentioned in choice C. Choice D is also incorrect as HRT has been associated with a slight increase in the risk of breast cancer.

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