Nursing Elites

1. A patient is being educated about the use of raloxifene (Evista) for osteoporosis. What is the primary therapeutic action of this medication?

• A. It stimulates the formation of new bone.
• B. It decreases bone resorption and increases bone density.
• C. It increases the excretion of calcium through the kidneys.
• D. It increases calcium absorption in the intestines.

Correct answer: B

Rationale: The correct answer is B: 'It decreases bone resorption and increases bone density.' Raloxifene, a selective estrogen receptor modulator (SERM), works by decreasing bone resorption, which is the breakdown of bone, and increasing bone density. This action helps in preventing bone loss and maintaining bone strength. Choice A is incorrect because raloxifene does not stimulate the formation of new bone but rather prevents its breakdown. Choice C is incorrect as raloxifene does not increase the excretion of calcium but rather helps in maintaining calcium levels in the bones. Choice D is also incorrect as raloxifene does not directly increase calcium absorption in the intestines.

2. A 25-year-old woman who works as an air traffic controller presents with facial pain and severe headache. She reports that she sometimes feels the pain in her neck or ear and that it is particularly bad during very busy times at the airport. What is the most likely diagnosis?

• A. Migraine headache
• B. Cluster headache
• C. Temporomandibular joint syndrome
• D. Sinus headache

Correct answer: C

Rationale: The most likely diagnosis for the 25-year-old woman who works as an air traffic controller and presents with facial pain and severe headache that sometimes radiates to her neck or ear, aggravated by stress, is Temporomandibular joint syndrome. This syndrome involves pain in the jaw joint and the muscles controlling jaw movement, which can radiate to the surrounding areas like the neck and ear. Stress and clenching of the jaw commonly exacerbate the symptoms. Migraine headache (choice A) typically presents with other symptoms like nausea, sensitivity to light or sound, and can be triggered by various factors, not just stress. Cluster headache (choice B) is characterized by severe, unilateral pain around the eye with associated autonomic symptoms. Sinus headache (choice D) is usually associated with sinus congestion or infection, presenting with facial pressure or pain, often worsened by bending forward.

3. Which of the following describes passive immunity?

• A. Vaccination against the disease
• B. Transfer of antibodies from mother to baby
• C. Cuts or wounds that are infected and heal
• D. Having the disease in question

Correct answer: B

Rationale: Passive immunity is the transfer of pre-formed antibodies from one individual to another, providing immediate but temporary protection. In this case, the correct answer is the transfer of antibodies from the mother to the baby, as it describes the concept of passive immunity. Choice A, vaccination against the disease, refers to active immunity where the individual's immune system is stimulated to produce antibodies. Choice C, cuts or wounds that are infected and heal, is unrelated to immunity. Choice D, having the disease in question, does not describe passive immunity but rather acquiring active immunity through exposure to the pathogen.

4. A patient is prescribed medroxyprogesterone acetate (Provera) for the treatment of endometriosis. What should the nurse teach the patient about the use of this medication?

• A. Medroxyprogesterone should be taken with food to prevent nausea.
• B. Medroxyprogesterone can be taken intermittently when symptoms worsen.
• C. Medroxyprogesterone should be taken at the same time each day to maintain consistent hormone levels.
• D. Medroxyprogesterone should be discontinued if side effects occur.

Correct answer: C

Rationale: The correct answer is C. Medroxyprogesterone should be taken at the same time each day to maintain consistent hormone levels and effectiveness. Taking it at different times can lead to hormonal fluctuations and reduced medication efficacy. Choice A is incorrect because medroxyprogesterone does not need to be taken with food to prevent nausea. Choice B is incorrect as medroxyprogesterone is typically taken continuously rather than intermittently. Choice D is incorrect because side effects should be reported to the healthcare provider for further evaluation and management, not automatically leading to discontinuation of the medication.

5. Which of the following describes the pathophysiology of exercise-induced asthma?

• A. Bronchospasm after exercise
• B. IgE-mediated inflammatory response to antigen
• C. Bronchoconstriction after ingesting high-allergen foods
• D. Increased mucus production due to a genetic mutation

Correct answer: A

Rationale: The correct answer is A: 'Bronchospasm after exercise.' Exercise-induced asthma involves the narrowing of the airways (bronchospasm) triggered by physical activity. This bronchospasm leads to symptoms such as coughing, wheezing, and shortness of breath. Choices B, C, and D are incorrect because exercise-induced asthma is not primarily caused by an IgE-mediated inflammatory response to an antigen, bronchoconstriction after ingesting high-allergen foods, or increased mucus production due to a genetic mutation.

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