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. What physiological reaction occurs in the body with the 'Fight or flight' response?

• A. Increased heart rate
• B. Constricted pupils
• C. Decreased blood pressure
• D. Decreased heart rate

Correct answer: A

Rationale: The 'fight or flight' response is a primal physiological reaction that prepares the body to respond to a perceived threat or danger. This response triggers an increase in heart rate to pump more blood to the muscles and vital organs, preparing the body for action. Choice B, 'Constricted pupils,' is part of the 'fight or flight' response as well, as it helps improve focus and vision. Choice C, 'Decreased blood pressure,' is incorrect because blood pressure typically increases to ensure adequate circulation during the 'fight or flight' response. Choice D, 'Decreased heart rate,' is incorrect as the heart rate increases to supply more oxygen and nutrients to the body during times of stress.

3. How should rifampin most likely be administered to a patient diagnosed with tuberculosis?

• A. Orally, with food
• B. Orally, on an empty stomach
• C. Intramuscularly
• D. Intravenously, as a bolus

Correct answer: A

Rationale: Rifampin is typically administered orally, and it is recommended to be taken with food to enhance its absorption and reduce gastrointestinal side effects. Administering rifampin intramuscularly or intravenously is not the standard route of administration for this medication used in tuberculosis treatment.

4. Which of the following nursing diagnoses would provide the most plausible indication for the use of epoetin alfa (Epogen) in a patient with renal failure?

• A. Risk for infection related to decreased erythropoiesis
• B. Activity intolerance related to decreased oxygen-carrying capacity
• C. Powerlessness related to sequelae of renal failure
• D. Ineffective breathing pattern related to inadequate erythropoietin synthesis

Correct answer: B

Rationale: The correct answer is B. In a patient with renal failure, the use of epoetin alfa (Epogen) is primarily aimed at addressing the decreased oxygen-carrying capacity due to impaired erythropoiesis. Epoetin alfa is a medication that stimulates red blood cell production, thereby improving the oxygen-carrying capacity of the blood. This would directly address the activity intolerance commonly seen in patients with renal failure. Choices A, C, and D are incorrect because they do not directly relate to the primary purpose of using epoetin alfa in this context. Risk for infection, powerlessness, and ineffective breathing pattern are important considerations in the care of a patient with renal failure, but they are not the primary indications for using epoetin alfa.

5. When taking medroxyprogesterone acetate (Provera) for the treatment of endometriosis, what important instruction should the nurse provide about taking this medication?

• A. Take the medication at the same time each day to maintain consistent hormone levels.
• B. Medroxyprogesterone should be taken without regard to meals.
• C. Discontinuing medroxyprogesterone should only be done under the guidance of a healthcare provider.
• D. Medroxyprogesterone is typically taken daily rather than weekly for the treatment of endometriosis.

Correct answer: A

Rationale: When taking medroxyprogesterone acetate for endometriosis, it is essential to maintain consistent hormone levels by taking the medication at the same time each day. This consistency helps optimize the effectiveness of the treatment. Choice B is incorrect because medroxyprogesterone should be taken without regard to meals, not necessarily with food. Choice C is incorrect because discontinuing the medication without consulting a healthcare provider can be harmful and may not address side effects appropriately. Choice D is incorrect as medroxyprogesterone is typically taken daily to manage endometriosis symptoms, not weekly, to ensure continuous therapy and symptom control.

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