Nursing Elites

1. What instruction should the nurse include in this patient's health education regarding chloroquine phosphate (Aralen) for malaria prophylaxis?

• A. “Take your pill on the same day each week.”
• B. “Watch out for any unusual rash on your trunk and arms, but this isn't cause for concern.”
• C. “Remember to take your chloroquine on an empty stomach.”
• D. “We'll provide you with enough syringes and teach you how to inject the drug.”

Correct answer: A

Rationale: The correct instruction for the nurse to include in this patient's health education regarding chloroquine phosphate (Aralen) for malaria prophylaxis is to “Take your pill on the same day each week.” This is essential because chloroquine is typically taken once a week on the same day to ensure consistent protection against malaria. Choice B is incorrect because while rashes are a possible side effect of chloroquine, they are not a usual occurrence and should be reported to the healthcare provider. Choice C is incorrect because chloroquine does not need to be taken on an empty stomach. Choice D is incorrect as chloroquine is typically administered orally, not by injection.

2. A patient with breast cancer is prescribed tamoxifen (Nolvadex). What should the nurse emphasize during patient education?

• A. Tamoxifen may increase the risk of venous thromboembolism, so patients should be aware of the signs and symptoms of blood clots.
• B. Tamoxifen may cause weight gain, so patients should monitor their diet.
• C. Tamoxifen may cause hot flashes and other menopausal symptoms.
• D. Tamoxifen may decrease the risk of osteoporosis, so patients should ensure adequate calcium intake.

Correct answer: A

Rationale: The correct answer is A. Tamoxifen increases the risk of venous thromboembolism, a serious side effect. Therefore, patients should be educated about the signs and symptoms of blood clots, such as swelling, pain, and redness in the legs, and advised to seek immediate medical attention if they occur. Choice B is incorrect because weight gain is not a significant side effect of tamoxifen. Choice C is incorrect because hot flashes and menopausal symptoms are common side effects of tamoxifen but are not as critical to address as venous thromboembolism. Choice D is incorrect because tamoxifen does not decrease the risk of osteoporosis; in fact, it may increase the risk of bone loss in premenopausal women.

3. What is the best way to prevent transmission of infectious agents?

• A. Take antibiotics daily
• B. Call the practitioner for herbal supplements
• C. Wash hands
• D. Avoid public areas as much as possible

Correct answer: C

Rationale: The correct answer is C: Wash hands. Washing hands is the most effective way to prevent the transmission of infectious agents. Antibiotics are not effective in preventing infections, and their overuse can lead to antibiotic resistance. Calling a practitioner for herbal supplements is not a primary method for preventing the transmission of infectious agents. Avoiding public areas entirely is impractical and not as effective as proper hand hygiene.

4. A patient has been prescribed raloxifene (Evista) for the prevention of osteoporosis. What effect should the nurse include in the teaching plan regarding the action of this medication?

• A. Decreases calcium excretion by the kidneys.
• B. Increases intestinal absorption of calcium.
• C. Stimulates bone formation by increasing osteoblast activity.
• D. Selectively binds to estrogen receptors, decreasing bone resorption.

Correct answer: D

Rationale: The correct answer is D: Selectively binds to estrogen receptors, decreasing bone resorption. Raloxifene is a selective estrogen receptor modulator (SERM) that works by binding to estrogen receptors, thereby decreasing bone resorption. This action helps in the prevention and treatment of osteoporosis by preserving bone density. Choices A, B, and C are incorrect because raloxifene does not directly affect calcium excretion by the kidneys, intestinal absorption of calcium, or stimulate bone formation by increasing osteoblast activity.

5. Which of the following organs are primarily affected by poorly managed hypertension?

• A. The bladder and urethra
• B. The brain and skin
• C. The heart and kidneys
• D. The stomach and intestines

Correct answer: C

Rationale: Poorly managed hypertension primarily affects the heart and kidneys. The heart is at risk of conditions like heart failure due to the increased workload from elevated blood pressure. The kidneys can suffer damage from longstanding hypertension, leading to kidney disease. Choices A, B, and D are incorrect because the bladder, urethra, brain, skin, stomach, and intestines are not the primary organs affected by poorly managed hypertension.

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