Nursing Elites

1. What aspect of this woman's current health status would contraindicate the use of oral contraceptives?

• A. The woman has a diagnosis of type 2 diabetes.
• B. The woman has asthma and uses inhaled corticosteroids and bronchodilators.
• C. The woman has a family history of breast cancer.
• D. The woman takes an antiplatelet medication for coronary artery disease.

Correct answer: A

Rationale: The correct answer is A. Women with type 2 diabetes are at higher risk of developing cardiovascular complications. Oral contraceptives further increase this risk due to their potential effects on blood pressure, lipid metabolism, and clotting factors. Choice B is incorrect as inhaled corticosteroids and bronchodilators do not contraindicate the use of oral contraceptives. Choice C is incorrect as a family history of breast cancer does not directly contraindicate the use of oral contraceptives. Choice D is also incorrect as taking an antiplatelet medication for coronary artery disease does not necessarily contraindicate the use of oral contraceptives.

2. A male patient is concerned about the risk of prostate cancer while receiving finasteride (Proscar) for benign prostatic hyperplasia (BPH). What should the nurse explain about this risk?

• A. Finasteride has been shown to lower the risk of developing prostate cancer.
• B. Finasteride has no effect on the risk of developing prostate cancer.
• C. Finasteride may increase the risk of developing prostate cancer, so regular screening is important.
• D. Finasteride does not affect the risk of prostate cancer, so regular screening is unnecessary.

Correct answer: A

Rationale: The correct answer is A. Finasteride has been shown to lower the risk of developing prostate cancer. Studies have demonstrated that finasteride can reduce the incidence of prostate cancer. However, it is still recommended to have regular screening to monitor for any potential issues. Choice B is incorrect as finasteride has shown to have a positive effect on reducing prostate cancer risk. Choice C is inaccurate because finasteride decreases, not increases, the risk of prostate cancer. Choice D is incorrect as regular screening is still necessary despite the risk reduction associated with finasteride.

3. A nurse is conducting an assessment on a client who presents with symptoms that are characteristic of amyotrophic lateral sclerosis (ALS). What assessment finding would be expected in this client?

• A. Reduced reflexes in all four limbs
• B. Decreased cognitive function
• C. Involuntary muscle contractions
• D. Hyperreflexia

Correct answer: D

Rationale: The correct answer is D: Hyperreflexia. In amyotrophic lateral sclerosis (ALS), hyperreflexia is a common assessment finding due to the degeneration of upper motor neurons. This results in an overactive reflex response to stimuli. Reduced reflexes in all four limbs (choice A) are not typically seen in ALS; instead, hyperreflexia is more common. Decreased cognitive function (choice B) is not a primary characteristic of ALS. Involuntary muscle contractions (choice C) are more indicative of conditions such as dystonia or myoclonus, not ALS.

4. A 30-year-old man has a history of heart transplant and is receiving long-term steroids to prevent rejection. The patient is due for routine vaccines. Attenuated vaccines are contraindicated in this patient because the antigen is:

• A. live and can cause infection.
• B. mutated and infectious.
• C. inactive but still infectious
• D. pathogenic

Correct answer: A

Rationale: The correct answer is A: live and can cause infection. Patients who are immunocompromised, like those receiving long-term steroids after an organ transplant, should not receive live vaccines because the live attenuated organisms in these vaccines can cause infections in individuals with weakened immune systems. Choice B is incorrect because attenuated vaccines are live but weakened, not mutated. Choice C is incorrect because while inactive, attenuated vaccines are not infectious. Choice D is incorrect because attenuated vaccines are not pathogenic; they are attenuated (weakened) forms of the pathogen.

5. Cellular swelling is:

• A. Irreversible
• B. Evident early in all types of cellular injury
• C. Manifested by decreased intracellular sodium
• D. None of the above is correct

Correct answer: B

Rationale: Cellular swelling is indeed evident early in all types of cellular injury. This occurs due to the influx of water into the cell, leading to swelling. Choice A is incorrect because cellular swelling is reversible if the injury is not severe. Choice C is incorrect because cellular swelling is not manifested by decreased intracellular sodium; in fact, it is associated with increased intracellular sodium due to water influx. Choice D is incorrect as option B is the correct statement.

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