Nursing Elites

1. A female patient is prescribed medroxyprogesterone acetate (Provera) for dysfunctional uterine bleeding. What should the nurse include in the patient education?

• A. This medication may cause breakthrough bleeding or spotting.
• B. This medication may cause weight gain.
• C. This medication may increase your risk of developing diabetes.
• D. This medication may increase your risk of breast cancer.

Correct answer: A

Rationale: The correct answer is A. Medroxyprogesterone acetate (Provera) can cause breakthrough bleeding or spotting, which is a common side effect of this medication. Choices B, C, and D are incorrect because weight gain, increased risk of diabetes, and increased risk of breast cancer are not commonly associated side effects of medroxyprogesterone acetate. Therefore, the nurse should focus on educating the patient about the potential for breakthrough bleeding or spotting.

2. When reviewing the purpose/action of neurotransmitters as they interact with different receptors, the nursing instructor gives an example using acetylcholine. When acetylcholine is released at the sinoatrial node in the right atrium of the heart, it is:

• A. positively charged.
• B. inhibitory.
• C. overstimulated.
• D. dormant.

Correct answer: B

Rationale: Acetylcholine acts as an inhibitory neurotransmitter at the sinoatrial node. It slows down the heart rate by decreasing the firing rate of the sinoatrial node, which serves as the heart's natural pacemaker. Neurotransmitters do not have a charge, so choice A is incorrect. Choice C is wrong as overstimulation is not a characteristic of acetylcholine at the sinoatrial node. Choice D is also incorrect because acetylcholine actively influences heart rate regulation when released at the sinoatrial node.

3. Which type of lymphocyte recognizes and eliminates virus-infected cells and cancerous cells?

• A. Neutrophils
• B. Macrophages
• C. Natural killer cells
• D. Langerhans cells

Correct answer: C

Rationale: Natural killer cells are a type of lymphocyte that plays a crucial role in recognizing and eliminating virus-infected cells and cancerous cells. Neutrophils (Choice A) are a type of white blood cell involved in fighting infections, mainly through phagocytosis. Macrophages (Choice B) are another type of white blood cell that engulfs and digests cellular debris and pathogens. Langerhans cells (Choice D) are a type of dendritic cell found in the skin and mucosa, primarily involved in antigen presentation.

4. A patient is starting on atorvastatin (Lipitor) for hyperlipidemia. What important instruction should the nurse provide?

• A. Take the medication at night to reduce the risk of muscle pain.
• B. Avoid consuming grapefruit juice while taking this medication.
• C. Take the medication in the morning with breakfast.
• D. Avoid taking the medication with alcohol to reduce the risk of liver damage.

Correct answer: A

Rationale: The correct answer is A. Atorvastatin should be taken at night to reduce the risk of muscle pain and other side effects. Taking it at night aligns with the body's natural rhythm of cholesterol production, optimizing its effectiveness. Choice B is incorrect because grapefruit juice can increase the risk of side effects by affecting the metabolism of atorvastatin. Choice C is incorrect as taking atorvastatin in the morning does not maximize its effectiveness. Choice D is incorrect because alcohol consumption can increase the risk of liver damage when combined with atorvastatin.

5. In a 41-year-old male patient with a complex medical history diagnosed with secondary hypogonadism, which of the following health problems is the most likely etiology of his diagnosis?

• A. Type 1 diabetes
• B. Mumps
• C. An inflammatory process in the testicles
• D. Testicular trauma

Correct answer: C

Rationale: The correct answer is C: An inflammatory process in the testicles. Secondary hypogonadism in males can be caused by various factors, including an inflammatory process in the testicles. Mumps (choice B) can lead to orchitis but is less common in adults. Type 1 diabetes (choice A) is not a common cause of secondary hypogonadism. Testicular trauma (choice D) can cause primary hypogonadism but is less likely to cause secondary hypogonadism.

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