Nursing Elites

1. A client with atrial fibrillation is at risk for which of the following complications?

• A. Deep vein thrombosis (DVT)
• B. Pulmonary embolism
• C. Hypertensive crisis
• D. Myocardial infarction

Correct answer: B

Rationale: Corrected Rationale: A client with atrial fibrillation is at increased risk of thromboembolism due to blood stasis in the atria. This can lead to the formation of blood clots, which may travel to the lungs and cause a pulmonary embolism. Pulmonary embolism is a serious complication of atrial fibrillation. Choices A, C, and D are incorrect because while atrial fibrillation can lead to complications such as stroke or heart failure, it is specifically associated with an increased risk of pulmonary embolism due to the clot formation associated with the condition.

2. A patient is found to have liver disease, resulting in the removal of a lobe of his liver. Adaptation to the reduced size of the liver leads to ___________ of the remaining liver cells.

• A. Metaplasia
• B. Organ atrophy
• C. Compensatory hyperplasia
• D. Physiologic hyperplasia

Correct answer: C

Rationale: Compensatory hyperplasia is the process by which the remaining cells increase in number to adapt to the reduced size of the liver. In this case, after the removal of a lobe of the liver, the remaining cells undergo compensatory hyperplasia to compensate for the lost tissue. Metaplasia refers to the reversible change of one cell type to another, not an increase in cell number. Organ atrophy is the decrease in organ size due to cell shrinkage or loss, which is opposite to an increase in cell number seen in compensatory hyperplasia. Physiologic hyperplasia is the increase in cell number in response to a normal physiological demand, not specifically due to the removal of a portion of the organ.

3. What is the primary action of bisphosphonates when prescribed to a patient with osteoporosis?

• A. It inhibits bone resorption, which helps maintain bone density.
• B. It stimulates new bone formation by increasing osteoblast activity.
• C. It increases calcium absorption in the intestines, which helps build stronger bones.
• D. It decreases calcium excretion by the kidneys, helping to maintain bone density.

Correct answer: A

Rationale: The correct answer is A: "It inhibits bone resorption, which helps maintain bone density." Bisphosphonates work by inhibiting bone resorption carried out by osteoclasts, thereby preventing the breakdown of bones and helping to maintain or increase bone density in patients with osteoporosis. Choices B, C, and D are incorrect because bisphosphonates do not directly stimulate new bone formation, increase calcium absorption in the intestines, or decrease calcium excretion by the kidneys.

4. A nurse is educating a client with peripheral artery disease (PAD). Which statement made by the client indicates a need for further teaching?

• A. I should avoid walking for long periods to prevent leg pain.
• B. I should inspect my feet daily for any sores or wounds.
• C. I should wear compression stockings to improve circulation.
• D. I should avoid smoking to prevent further damage to my arteries.

Correct answer: A

Rationale: The correct answer is A. Walking is crucial in improving circulation in peripheral artery disease; therefore, the client should not avoid walking for long periods. Choices B, C, and D are correct statements for a client with PAD. Inspecting feet daily helps in early detection of sores or wounds, wearing compression stockings improves circulation, and avoiding smoking helps prevent further damage to arteries in PAD.

5. A patient is prescribed medroxyprogesterone acetate (Provera) for the treatment of endometriosis. What should the nurse include in the patient teaching?

• A. Take the medication with food to prevent nausea.
• B. Take the medication at the same time each day to maintain consistent hormone levels.
• C. Avoid prolonged sun exposure while taking this medication.
• D. Discontinue the medication if side effects occur.

Correct answer: B

Rationale: The correct answer is to take the medication at the same time each day to maintain consistent hormone levels and effectiveness. This is crucial for the drug to work optimally. Choice A is incorrect because medroxyprogesterone acetate does not necessarily need to be taken with food to prevent nausea. Choice C is not directly related to the medication's administration and is not a common teaching point for this drug. Choice D is incorrect as discontinuing the medication abruptly can lead to adverse effects and is not recommended without consulting a healthcare provider.

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