Nursing Elites

1. A 65-year-old man is prescribed Flomax (Tamsulosin) for Benign Prostatic Hyperplasia. The patient lives in an upstairs apartment. The nurse is most concerned about which side effect of Flomax?

• A. Hypotension
• B. Tachycardia
• C. Back Pain
• D. Difficulty Urinating

Correct answer: A

Rationale: The correct answer is 'Hypotension.' Flomax (Tamsulosin) is known to cause orthostatic hypotension, especially in the elderly, leading to a sudden drop in blood pressure when standing up. This side effect can result in dizziness, falls, and injury, especially concerning for a patient living in an upstairs apartment. Tachycardia (increased heart rate) and back pain are less commonly associated with Flomax use, while difficulty urinating is a symptom that Flomax is intended to improve in patients with Benign Prostatic Hyperplasia.

2. A client asks the nurse about including her 2 and 12-year-old sons in the care of their newborn sister. Which of the following is an appropriate initial statement by the nurse?

• A. Focus on your sons' needs during the first days at home.
• B. Tell each child what he can do to help with the baby.
• C. Suggest that your husband spend more time with the boys.
• D. Ask the children what they would like to do for the newborn.

Correct answer: A

Rationale: It is essential for the nurse to guide the client on the initial steps in involving her 2 and 12-year-old sons in the care of their newborn sister. The most appropriate response is to 'Focus on your sons' needs during the first days at home.' In an expanded family, parents should prioritize reassuring older children that they are loved and as important as the newborn. This response acknowledges the importance of ensuring the well-being and emotional adjustment of the older siblings during the transition period. Choices B, C, and D are less appropriate as they do not directly address the emotional needs and adjustment of the older children during this significant family change.

3. A nurse is caring for a client who was recently diagnosed with breast cancer. The oncologist uses the TNM staging system to classify this case as T2, N2, M0. The nurse understands that TNM stands for:

• A. Tumor, Necrosis, Metastasis
• B. Tumor, Node Involvement, Mastectomy
• C. Tumor, Node Involvement, Metastasis
• D. Therapy, Necrosis, Metastasis

Correct answer: B

Rationale: The TNM staging system is a classification system for determining the size and extent of cancerous tissue. The TNM system helps providers to identify the most accurate forms of treatment. The T stands for tumor, the N stands for node involvement, and the M stands for metastasis. Choice A, 'Tumor, Necrosis, Metastasis,' is incorrect because it does not include the node involvement component. Choice B, 'Tumor, Node Involvement, Mastectomy,' is incorrect as it erroneously includes the treatment approach 'Mastectomy' instead of 'Metastasis.' Choice D, 'Therapy, Necrosis, Metastasis,' is incorrect because it includes 'Therapy' instead of the correct component 'Node Involvement.'

4. A woman in her third trimester complains of severe heartburn. What is appropriate teaching by the nurse to help the woman alleviate these symptoms?

• A. Drink small amounts of liquids frequently
• B. Eat the evening meal at least 2-3 hours before bedtime
• C. Take sodium bicarbonate after each meal
• D. Sleep with head propped on several pillows

Correct answer: D

Rationale: During the third trimester, many women experience heartburn due to the pressure of the growing uterus on the stomach. Elevating the head while sleeping can help prevent gastric contents from refluxing back into the esophagus, thus reducing heartburn symptoms. Drinking small amounts of liquids frequently may exacerbate heartburn by increasing stomach distension. Eating the evening meal just before retiring can also worsen heartburn symptoms as lying down shortly after eating can promote reflux. Taking sodium bicarbonate after each meal is not recommended as it can disrupt the body's natural pH balance and lead to other complications.

5. What preparation should be made for a client undergoing a KUB (Kidney, Ureter, Bladder) radiography test?

• A. Client must be NPO before the examination
• B. Enema should be administered before the examination
• C. Medicate the client with furosemide 20 mg IV 30 minutes before the examination
• D. No special orders are necessary for this examination

Correct answer: D

Rationale: The correct answer is that no special orders are necessary for a KUB radiography test. It is important to inform the client to remove any clothing, jewelry, or objects that may interfere with the test. Option A is incorrect because there is no need for the client to be NPO before this examination. Option B is incorrect as enemas are not routinely administered prior to a KUB radiography test. Option C is incorrect as there is no need to medicate the client with furosemide before this examination.

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