Nursing Elites

1. A 45-year-old woman has been prescribed conjugated estrogens (Premarin) for the treatment of menopausal symptoms. What should the nurse include in the patient teaching?

• A. Increase fluid intake to prevent dehydration.
• B. Avoid smoking while taking this medication.
• C. Increase the intake of high-calcium foods.
• D. Take the medication at bedtime to prevent insomnia.

Correct answer: B

Rationale: The correct answer is to 'Avoid smoking while taking this medication' because patients taking conjugated estrogens should avoid smoking due to the increased risk of cardiovascular events. Increasing fluid intake to prevent dehydration is a good practice but not specifically related to conjugated estrogens. Increasing the intake of high-calcium foods may be beneficial for bone health but is not directly related to the medication. Taking the medication at bedtime to prevent insomnia is not a specific teaching point for conjugated estrogens.

2. A client with chronic obstructive pulmonary disease (COPD) is admitted to the hospital for pneumonia. Which intervention should the nurse prioritize?

• A. Administer bronchodilators as prescribed.
• B. Monitor oxygen saturation levels continuously.
• C. Administer intravenous antibiotics as prescribed.
• D. Provide respiratory therapy treatments as needed.

Correct answer: C

Rationale: Administering IV antibiotics is crucial for treating pneumonia in a client with COPD. Pneumonia is an infection of the lungs that requires prompt antibiotic therapy to prevent complications and improve outcomes. While bronchodilators may help with COPD symptoms, in the case of pneumonia, addressing the infection is the priority. Continuous monitoring of oxygen saturation is important, but administering antibiotics to treat the underlying infection takes precedence. Respiratory therapy treatments can be beneficial, but they are not the initial priority when managing pneumonia in a client with COPD.

3. Which of the following is a characteristic of disseminated intravascular coagulation (DIC)?

• A. Simultaneous stroke and heart attack
• B. Simultaneous clotting and bleeding
• C. Simultaneous clotting and insulin release
• D. Simultaneous bleeding and vomiting

Correct answer: B

Rationale: Disseminated intravascular coagulation (DIC) is characterized by simultaneous clotting and bleeding throughout the body. This imbalance in the body's clotting system leads to the formation of blood clots in small blood vessels, which can consume clotting factors and platelets, ultimately leading to excessive bleeding. Choices A, C, and D are incorrect because they do not describe the characteristic feature of DIC, which involves both clotting and bleeding.

4. A woman is being treated with clomiphene citrate for the treatment of infertility. She states to the nurse that she has seen an increase in vaginal discharge. The nurse knows that this effect is related to:

• A. Increased blood flow to the vaginal area.
• B. Increased cervical mucus production.
• C. Increased production of vaginal secretions.
• D. Increased lubrication in the vaginal canal.

Correct answer: C

Rationale: The correct answer is C: 'Increased production of vaginal secretions.' Clomiphene citrate affects cervical mucus production, leading to an increase in vaginal secretions. This effect is beneficial for fertility as it helps create a more hospitable environment for sperm transport. Choice A, 'Increased blood flow to the vaginal area,' is incorrect as the increase in vaginal discharge is primarily due to changes in cervical mucus. Choice B, 'Increased cervical mucus production,' is partially correct but does not fully explain the increase in vaginal secretions. Choice D, 'Increased lubrication in the vaginal canal,' is not directly related to the effect seen with clomiphene citrate treatment for infertility.

5. A patient is prescribed sildenafil (Viagra) for erectile dysfunction. What condition would contraindicate the use of this medication?

• A. History of peptic ulcer disease
• B. Use of nitrates
• C. Use of antihypertensive medications
• D. History of hypertension

Correct answer: B

Rationale: The correct answer is B: Use of nitrates. Sildenafil (Viagra) is contraindicated in patients taking nitrates due to the risk of severe hypotension. Nitrates combined with sildenafil can lead to a dangerous drop in blood pressure. Choices A, C, and D are incorrect because a history of peptic ulcer disease, use of antihypertensive medications, or a history of hypertension are not direct contraindications for sildenafil use.

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