Nursing Elites

1. A client with a history of deep vein thrombosis (DVT) is receiving anticoagulant therapy. Which complication should the nurse monitor for?

• A. Pulmonary embolism
• B. Gastrointestinal bleeding
• C. Hemorrhagic stroke
• D. Renal insufficiency

Correct answer: A

Rationale: The correct answer is A, pulmonary embolism. In a client with a history of deep vein thrombosis (DVT) receiving anticoagulant therapy, the nurse should monitor for pulmonary embolism, as it is a serious complication. Pulmonary embolism occurs when a blood clot dislodges from the veins and travels to the lungs, potentially causing life-threatening consequences. Choices B, gastrointestinal bleeding, C, hemorrhagic stroke, and D, renal insufficiency, are not directly associated with deep vein thrombosis or anticoagulant therapy. While these complications may occur in other situations, they are not the primary concern when managing a client with a history of DVT.

2. After experiencing several months of worsening nocturia, a patient has been assessed for benign prostatic hypertrophy (BPH) and has begun drug treatment. In addition to nocturia, what other sign or symptom is most likely to accompany BPH?

• A. Hematuria
• B. Erectile dysfunction
• C. Urinary frequency
• D. Flank pain

Correct answer: A

Rationale: The correct answer is hematuria. Hematuria, which is the presence of blood in the urine, is a common sign associated with benign prostatic hypertrophy (BPH). It can occur due to irritation or damage to the prostate tissue. While urinary frequency and erectile dysfunction can also be seen in BPH patients, hematuria is more specifically linked to prostate issues. Flank pain is not typically a direct symptom of BPH.

3. A 44-year-old man presents with muscle weakness and fatigue. He states that he has experienced difficulty climbing stairs and even holding his arms up to comb his hair. Which test is most likely to help confirm the diagnosis?

• A. Electromyography (EMG)
• B. Nerve conduction studies
• C. Muscle biopsy
• D. Blood test for autoantibodies

Correct answer: A

Rationale: The correct answer is Electromyography (EMG). EMG is commonly used to diagnose conditions involving muscle weakness and fatigue, such as myasthenia gravis. Nerve conduction studies primarily assess nerve function rather than muscle involvement. While a muscle biopsy can provide valuable information, EMG is more specific for evaluating muscle function in this context. A blood test for autoantibodies may be helpful in certain autoimmune conditions but is not the primary test for confirming the diagnosis based on the patient's symptoms of muscle weakness and fatigue.

4. A nurse is administering testosterone to a patient with hypogonadism. What outcome indicates that the treatment is having the desired effect?

• A. Increased libido
• B. Increased muscle mass
• C. Improved secondary sexual characteristics
• D. Decreased sperm count

Correct answer: C

Rationale: The correct answer is C: 'Improved secondary sexual characteristics.' Testosterone therapy in patients with hypogonadism typically leads to improved secondary sexual characteristics, which include increased muscle mass and libido. While increased libido (choice A) and increased muscle mass (choice B) are effects of testosterone therapy, they are more specific outcomes related to secondary sexual characteristics. Decreased sperm count (choice D) would not be an expected outcome of testosterone therapy for hypogonadism, as testosterone is essential for sperm production.

5. A patient is being educated about the use of raloxifene (Evista) for osteoporosis. What is the primary therapeutic action of this medication?

• A. It stimulates the formation of new bone.
• B. It decreases bone resorption and increases bone density.
• C. It increases the excretion of calcium through the kidneys.
• D. It increases calcium absorption in the intestines.

Correct answer: B

Rationale: The correct answer is B: 'It decreases bone resorption and increases bone density.' Raloxifene, a selective estrogen receptor modulator (SERM), works by decreasing bone resorption, which is the breakdown of bone, and increasing bone density. This action helps in preventing bone loss and maintaining bone strength. Choice A is incorrect because raloxifene does not stimulate the formation of new bone but rather prevents its breakdown. Choice C is incorrect as raloxifene does not increase the excretion of calcium but rather helps in maintaining calcium levels in the bones. Choice D is also incorrect as raloxifene does not directly increase calcium absorption in the intestines.

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