Nursing Elites

1. A 22-year-old woman began using oral contraceptives several months ago and has presented for an appointment to discuss recent worrisome changes in her health status. Which of the following changes in the woman's health may the nurse potentially attribute to the use of oral contraceptives?

• A. Fatigue
• B. Frequent high blood pressure readings
• C. Frequent headaches without aura
• D. Nausea and vomiting

Correct answer: A

Rationale: The correct answer is A: Fatigue. Oral contraceptives can sometimes cause fatigue as a side effect. Frequent high blood pressure readings and frequent headaches without aura are less likely to be directly related to the use of oral contraceptives. Nausea and vomiting are common side effects of oral contraceptives but are not the changes typically associated with liver function affecting hormone metabolism as in the case of hepatitis C infection.

2. When a healthcare professional is reviewing lab results and notices that the erythrocytes contain an abnormally low concentration of hemoglobin, the healthcare professional calls these erythrocytes:

• A. Hyperchromic
• B. Hypochromic
• C. Macrocytic
• D. Microcytic

Correct answer: B

Rationale: Erythrocytes with an abnormally low concentration of hemoglobin are called hypochromic. Hyperchromic refers to erythrocytes with an abnormally high concentration of hemoglobin. Macrocytic indicates larger than normal red blood cells, while microcytic refers to smaller than normal red blood cells. Therefore, in this scenario, the correct term is hypochromic.

3. A client asks a nurse about the cause of Parkinson's disease. How should the nurse respond?

• A. Parkinson's disease is caused by a lack of dopamine in the brain, which affects movement.
• B. Parkinson's disease is caused by an excess of acetylcholine in the brain, leading to tremors and rigidity.
• C. Parkinson's disease is caused by an autoimmune response that attacks the nervous system.
• D. Parkinson's disease is caused by a bacterial infection that needs to be treated with antibiotics.

Correct answer: A

Rationale: The correct answer is A. Parkinson's disease is caused by a deficiency of dopamine in the brain, which results in the characteristic motor symptoms such as tremors, rigidity, and bradykinesia. Choice B is incorrect because Parkinson's disease is not caused by an excess of acetylcholine. Choice C is incorrect because Parkinson's disease is not an autoimmune disorder. Choice D is incorrect because Parkinson's disease is not caused by a bacterial infection and cannot be treated with antibiotics.

4. A 37-year-old woman has a 10 pack-year smoking history and has been using oral contraceptives for the past 2 years. The nurse should plan health education interventions knowing that this patient faces an increased risk of

• A. osteoporosis.
• B. dementia.
• C. myocardial infarction.
• D. deep vein thrombosis.

Correct answer: C

Rationale: The correct answer is C: myocardial infarction. Women aged 35 and older who smoke, especially with a history of 10 pack-years like in this case, face an increased risk of cardiovascular disorders, including myocardial infarction, when using oral contraceptives. Choice A, osteoporosis, is incorrect because smoking and oral contraceptives do not significantly increase the risk of osteoporosis. Choice B, dementia, is not directly associated with smoking, oral contraceptives, or their combination. Choice D, deep vein thrombosis, is a risk associated with oral contraceptives, especially in combination with smoking, but the highest increased risk in this case is for myocardial infarction.

5. A primiparous woman tells the nurse that she and her partner are highly reluctant to have their infant vaccinated, stating, “We've read that vaccines can potentially cause a lot of harm, so we're not sure we want to take that risk.” How should the nurse respond to this family's concerns?

• A. “Vaccinations are not without some risks, but these are far exceeded by the potential benefits they offer in preventing serious diseases.”
• B. “The potential risks of vaccinations have been investigated and determined to be minimal compared to the benefits of protecting your child from potentially life-threatening diseases.”
• C. “It is important to follow state laws regarding vaccines, but I understand your concerns. Let's discuss the specific risks and benefits of vaccines for your child.”
• D. “Vaccines indeed cause several serious adverse effects, but these are usually treated effectively, and the benefits of vaccination in preventing diseases far outweigh the risks.”

Correct answer: B

Rationale: When addressing concerns about vaccination, it is crucial to provide accurate information to help parents make informed decisions. Choice B is the most appropriate response as it acknowledges the concerns of the family while emphasizing that the potential risks of vaccinations are minimal compared to the significant benefits of protecting the child from serious diseases. This response shows empathy towards the parents' concerns while also highlighting the importance of vaccination in preventing life-threatening illnesses. Choice A is incorrect because it does not emphasize the significant benefits of vaccination in preventing diseases, which may not effectively address the family's concerns. Choice C is incorrect as it focuses more on state laws rather than addressing the family's specific concerns about vaccine safety. Choice D is incorrect as it may increase the family's anxiety by highlighting adverse effects without adequately emphasizing the benefits of vaccination in disease prevention.

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