Nursing Elites

1. What therapeutic effect is expected from 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. Increase in urine flow and relief of urinary obstruction.
• C. Reduction in prostate size and improvement in urinary symptoms.
• 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 is an alpha-blocker that specifically targets alpha-1 receptors in the prostate and bladder neck, causing relaxation of smooth muscles. This relaxation results in improved urinary flow and reduced symptoms of BPH. Choice B is incorrect because while tamsulosin does improve urinary flow, it does not directly increase urine flow. Choice C is incorrect because tamsulosin does not reduce prostate size. Choice D is incorrect as tamsulosin does not have a primary effect on erectile function.

2. A client diagnosed with heart failure displays bilateral pitting edema of the lower extremities. Which of the following terms is used to describe this finding?

• A. Contraindication
• B. Sign
• C. Symptom
• D. Subjective data

Correct answer: B

Rationale: The correct answer is 'B. Sign.' In this scenario, bilateral pitting edema is an objective finding that can be observed by others, making it a sign of heart failure. Choice A, 'Contraindication,' refers to a factor that makes a particular treatment or procedure potentially harmful. Choice C, 'Symptom,' is a subjective indication of a condition experienced by the client. Choice D, 'Subjective data,' is information that is reported by the client but cannot be directly observed or measured.

3. During the home visit of a client with dementia, the nurse notes that an adult daughter persistently corrects her father’s misperceptions of reality, even when the father becomes upset and anxious. Which intervention should the nurse teach the caregiver?

• A. Anxiety-reducing measures
• B. Positive reinforcement
• C. Reality orientation techniques
• D. Validation techniques

Correct answer: D

Rationale: The correct answer is D: Validation techniques. In dementia care, using validation techniques involves acknowledging the person's feelings and reality, even if it differs from actual events or facts. It helps in reducing the client's anxiety and distress. In this scenario, the daughter persistently correcting her father's misperceptions can escalate his anxiety. Teaching the daughter validation techniques will encourage her to validate her father's feelings and perceptions, ultimately promoting a more supportive and less confrontational environment. Choices A, B, and C are incorrect in this context. While anxiety-reducing measures can be beneficial, the primary issue here is the father's misperceptions being consistently corrected. Positive reinforcement focuses on rewarding desired behaviors, which is not directly related to the situation described. Reality orientation techniques involve constantly reminding the person of the correct time, place, and other details, which may not be suitable for someone with dementia experiencing distress.

4. Nurse Isabelle enters the room of a client with a cognitive impairment disorder and asks what day of the week it is, what the date, month, and year are, and where the client is. The nurse is attempting to assess:

• A. confabulation.
• B. delirium.
• C. orientation.
• D. perseveration.

Correct answer: C

Rationale: The correct answer is C: "orientation." Nurse Isabelle is assessing the client's orientation by asking questions about time (day, date, month, year), place, and person. This assessment helps determine the client's awareness of their surroundings and situation. Confabulation (choice A) is the unintentional fabrication of details or events to fill in memory gaps and is not being assessed in this scenario. Delirium (choice B) is a state of acute confusion and disorientation, usually with a rapid onset, which is different from assessing orientation. Perseveration (choice D) refers to the persistent repetition of a response, statement, or behavior and is not the focus of the assessment being conducted by Nurse Isabelle in this situation.

5. A patient has been diagnosed with a fungal infection and is to be treated with itraconazole (Sporanox). Prior to administration, the nurse notes that the patient is taking carbamazepine (Tegretol) for a seizure disorder. Based on this medication regime, which of the following will be true regarding the medications?

• A. The serum level of carbamazepine will be increased.
• B. The patient's carbamazepine should be discontinued.
• C. The patient's antiseizure medication should be changed.
• D. The patient will require a higher dosage of itraconazole (Sporanox).

Correct answer: A

Rationale: When itraconazole is administered with carbamazepine, itraconazole may increase the serum levels of carbamazepine, potentially leading to toxicity. Therefore, choice A is correct. Discontinuing carbamazepine (choice B) or changing the antiseizure medication (choice C) is not necessary unless advised by a healthcare provider. Choice D, requiring a higher dosage of itraconazole, is not accurate in this scenario.

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