Nursing Elites

1. A client with a history of smoking presents with a chronic cough and shortness of breath. The nurse should suspect which condition?

• A. Pulmonary fibrosis
• B. Chronic obstructive pulmonary disease (COPD)
• C. Lung cancer
• D. Pulmonary edema

Correct answer: B

Rationale: The correct answer is B: Chronic obstructive pulmonary disease (COPD). COPD is often associated with a chronic cough and shortness of breath, especially in individuals with a history of smoking. Pulmonary fibrosis (choice A) typically presents with progressive dyspnea and dry cough. Lung cancer (choice C) may present with a chronic cough, shortness of breath, and other symptoms like weight loss and hemoptysis. Pulmonary edema (choice D) presents with symptoms such as acute shortness of breath, orthopnea, and pink, frothy sputum.

2. When educating a patient starting on oral contraceptives, what should the nurse include regarding the medication's effectiveness?

• A. Oral contraceptives are 100% effective when taken correctly.
• B. Oral contraceptives are effective immediately after starting.
• C. Oral contraceptives are less effective if taken with antibiotics.
• D. Oral contraceptives are less effective if taken with food.

Correct answer: C

Rationale: The correct answer is C. Oral contraceptives can be less effective when taken with certain antibiotics as they may interfere with the contraceptive's efficacy, potentially leading to decreased effectiveness. Therefore, patients should be advised to use additional contraception methods if they are also taking antibiotics. Choice A is incorrect because while oral contraceptives are highly effective, they are not 100% foolproof. Choice B is incorrect as oral contraceptives may take some time to reach their full effectiveness after starting. Choice D is incorrect since taking oral contraceptives with food does not necessarily impact their effectiveness.

3. A 30-year-old male is being treated with testosterone enanthate for delayed puberty. What side effect should the nurse inform the patient about?

• A. Increased libido
• B. Decreased muscle mass
• C. Breast tenderness
• D. Increased aggression

Correct answer: D

Rationale: The correct side effect that the nurse should inform the patient about when receiving testosterone enanthate therapy for delayed puberty is increased aggression. Testosterone therapy can lead to mood changes, including increased aggression in some individuals. Therefore, it is essential for healthcare providers to educate patients about this potential side effect. Choices A, B, and C are incorrect because testosterone therapy is more likely to increase libido, promote muscle mass growth, and may cause breast tenderness due to hormonal imbalances.

4. A nurse is teaching a patient about the use of testosterone gel for the treatment of hypogonadism. What important instruction should the nurse provide?

• A. Apply the gel after showering, and allow it to dry completely before dressing.
• B. Apply the gel to the genitals for maximum absorption.
• C. Apply the gel before bedtime to enhance absorption during sleep.
• D. Apply the gel to the face and neck for improved results.

Correct answer: A

Rationale: The correct instruction is to apply testosterone gel after showering and allow it to dry completely before dressing. This helps prevent the transfer of the gel to others and ensures proper absorption. Choice B is incorrect because the gel should not be applied to the genitals. Choice C is incorrect as there is no specific benefit to applying the gel before bedtime. Choice D is incorrect as the gel should not be applied to the face and neck for the treatment of hypogonadism.

5. What is a common cause of a pulmonary embolism?

• A. An autoimmune disorder
• B. A venous blood clot from the lower extremity
• C. An increase in intracranial pressure
• D. Hypotension

Correct answer: B

Rationale: A pulmonary embolism is commonly caused by a blood clot that originates in the venous system of the lower extremity and travels to the lungs, blocking blood flow. This clot is known as a venous thromboembolism. An autoimmune disorder (Choice A) is not typically associated with pulmonary embolism. Intracranial pressure (Choice C) refers to pressure inside the skull and is unrelated to pulmonary embolism. Hypotension (Choice D) is low blood pressure and is not a common cause of pulmonary embolism.

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