Nursing Elites

1. What is the primary therapeutic action of tamsulosin (Flomax) in a male patient with benign prostatic hyperplasia (BPH)?

• A. Relaxation of the muscles in the prostate and bladder neck, leading to improved urinary flow.
• B. Reduction in prostate size and improvement in urinary symptoms.
• C. Increase in urine flow and relief of urinary obstruction.
• D. Improvement in erectile function.

Correct answer: A

Rationale: The correct answer is A: Relaxation of the muscles in the prostate and bladder neck, leading to improved urinary flow. Tamsulosin, a medication commonly prescribed for BPH, works by selectively blocking alpha-1 adrenergic receptors in the prostate, causing relaxation of smooth muscles in the prostate and bladder neck. This relaxation reduces the constriction in these areas, improving urinary flow and reducing symptoms such as hesitancy, urgency, frequency, and weak stream. Choice B is incorrect because tamsulosin does not directly reduce the size of the prostate. Choice C is incorrect as tamsulosin primarily acts by relaxing muscles rather than directly increasing urine flow. Choice D is incorrect as tamsulosin is not indicated for improving erectile function.

2. Which of the following is a common cause of mechanical small intestine obstruction?

• A. Infection
• B. Postoperative adhesions
• C. Tumors
• D. Foreign body

Correct answer: B

Rationale: Postoperative adhesions are a common cause of mechanical small intestine obstruction. Adhesions can form after abdominal surgery, causing bands of scar tissue that may twist or pull the intestines, leading to obstruction. This is a more common cause compared to infection, tumors, or foreign bodies. Infection may lead to inflammation but is not a typical cause of mechanical obstruction. Tumors and foreign bodies can cause blockages but are less common than postoperative adhesions.

3. A male patient is receiving androgen therapy for the treatment of hypogonadism. What adverse effect should the nurse monitor for during this treatment?

• A. Liver dysfunction
• B. Kidney dysfunction
• C. Heart failure
• D. Pulmonary embolism

Correct answer: A

Rationale: The correct adverse effect to monitor for during androgen therapy for hypogonadism is liver dysfunction. Androgen therapy can lead to hepatotoxicity, so monitoring liver function tests is crucial during treatment. Kidney dysfunction (Choice B), heart failure (Choice C), and pulmonary embolism (Choice D) are not commonly associated with androgen therapy and are less likely adverse effects compared to liver dysfunction.

4. In discussing sex hormone production with the patient, the nurse should describe that testosterone is normally secreted in response to

• A. sexual arousal.
• B. stimulation by luteinizing hormone.
• C. ACTH release by the adrenal cortex.
• D. decreased cortisol levels.

Correct answer: B

Rationale: Testosterone production is regulated by the hypothalamic-pituitary-gonadal axis. Luteinizing hormone (LH) stimulates the Leydig cells in the testes to produce testosterone. Therefore, the correct answer is B. Choice A, 'sexual arousal,' is incorrect because testosterone secretion is not directly linked to arousal but rather to hormonal stimulation. Choice C, 'ACTH release by the adrenal cortex,' is incorrect as testosterone production is not primarily regulated by adrenocorticotropic hormone (ACTH). Choice D, 'decreased cortisol levels,' is also incorrect as cortisol and testosterone are regulated by separate endocrine pathways.

5. A patient with a history of venous thromboembolism is prescribed hormone replacement therapy (HRT). What should the nurse discuss with the patient regarding the risks of HRT?

• A. HRT is associated with an increased risk of venous thromboembolism, so the patient should be aware of the signs and symptoms of blood clots.
• B. HRT can decrease the risk of osteoporosis, but the patient should also be aware of the increased risk of venous thromboembolism.
• C. HRT may increase the risk of breast cancer, so the patient should undergo regular breast exams.
• D. HRT can improve mood and energy levels, but it also carries a risk of cardiovascular events.

Correct answer: A

Rationale: The correct answer is A. Hormone replacement therapy (HRT) is indeed associated with an increased risk of venous thromboembolism. Therefore, patients should be educated about the signs and symptoms of blood clots and advised to seek immediate medical attention if they occur. Choice B is incorrect because although HRT may decrease the risk of osteoporosis, the focus of concern in this case is the increased risk of venous thromboembolism. Choice C is incorrect as it mentions the risk of breast cancer, which is not the primary concern when discussing HRT with a patient with a history of venous thromboembolism. Choice D is also incorrect as it mentions cardiovascular events, which are not the main focus of risk associated with HRT in this scenario.

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