Nursing Elites

1. When educating a patient starting on oral contraceptives, what should the nurse include regarding the medication's effectiveness?

• A. Oral contraceptives are 100% effective when taken correctly.
• B. Oral contraceptives are effective immediately after starting.
• C. Oral contraceptives are less effective if taken with antibiotics.
• D. Oral contraceptives are less effective if taken with food.

Correct answer: C

Rationale: The correct answer is C. Oral contraceptives can be less effective when taken with certain antibiotics as they may interfere with the contraceptive's efficacy, potentially leading to decreased effectiveness. Therefore, patients should be advised to use additional contraception methods if they are also taking antibiotics. Choice A is incorrect because while oral contraceptives are highly effective, they are not 100% foolproof. Choice B is incorrect as oral contraceptives may take some time to reach their full effectiveness after starting. Choice D is incorrect since taking oral contraceptives with food does not necessarily impact their effectiveness.

2. DiGeorge syndrome is a primary immune deficiency caused by:

• A. Failure of B cells to mature
• B. Congenital lack of thymic tissue
• C. Failure of formed elements of blood to develop
• D. Selective IgG deficiency

Correct answer: B

Rationale: DiGeorge syndrome is caused by a congenital lack of thymic tissue, which plays a crucial role in T cell development and maturation, leading to immune deficiency. Choice A is incorrect because DiGeorge syndrome primarily affects T cells, not B cells. Choice C is incorrect as it is too broad and not specific to the thymus. Choice D is incorrect as selective IgG deficiency is a different condition unrelated to DiGeorge syndrome.

3. A patient is diagnosed with ischemic heart disease. She is prescribed filgrastim (Neupogen). What effect will this medication provide in the treatment of ischemic heart disease?

• A. Increase platelets
• B. Decrease platelets
• C. Promote angiogenesis
• D. Prevent thrombus formation

Correct answer: C

Rationale: Filgrastim (Neupogen) is a medication that promotes the growth of white blood cells. In the context of ischemic heart disease, promoting angiogenesis, the formation of new blood vessels, can improve blood flow to the heart muscle, reducing ischemia and potentially improving cardiac function. Therefore, the correct answer is C. Choices A and B are incorrect because filgrastim does not directly affect platelet levels. Choice D is also incorrect as filgrastim does not prevent thrombus formation.

4. A patient with a history of breast cancer is being prescribed tamoxifen (Nolvadex). The nurse should educate the patient about what potential side effect of this medication?

• A. Increased risk of venous thromboembolism
• B. Increased risk of hot flashes
• C. Increased risk of cataracts
• D. Increased risk of bone fractures

Correct answer: A

Rationale: The correct answer is A: Increased risk of venous thromboembolism. Tamoxifen is known to increase the risk of venous thromboembolism, a serious side effect. Patients should be educated about the signs and symptoms of blood clots such as swelling, redness, warmth, or pain in the affected limb. Choices B, C, and D are incorrect because tamoxifen is not associated with an increased risk of hot flashes, cataracts, or bone fractures.

5. What key contraindication should the nurse emphasize to a patient prescribed sildenafil (Viagra) for erectile dysfunction?

• A. Sildenafil is contraindicated in patients taking nitrates due to the risk of severe hypotension.
• B. Sildenafil should not be taken with food as it can reduce its effectiveness.
• C. Sildenafil is contraindicated in patients with a history of hypertension.
• D. Sildenafil should not be taken with grapefruit juice as it can lead to dangerous side effects.

Correct answer: A

Rationale: The correct answer is A. Sildenafil is contraindicated in patients taking nitrates due to the risk of severe hypotension. Nitrates and sildenafil both cause vasodilation, leading to a synergistic effect that can result in a dangerous drop in blood pressure. Choices B, C, and D are incorrect because there is no specific contraindication for taking sildenafil with food, having a history of hypertension, or taking it with grapefruit juice. The main concern is the concurrent use of nitrates with sildenafil.

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