Nursing Elites

1. A nurse is teaching a patient about the use of raloxifene (Evista) for the prevention of osteoporosis. What is the primary therapeutic action of this medication?

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

Correct answer: B

Rationale: The correct answer is B. Raloxifene, a selective estrogen receptor modulator (SERM), works by decreasing bone resorption and increasing bone density. This action helps in preventing osteoporosis by maintaining bone strength. Choice A is incorrect as raloxifene does not affect the absorption of calcium from the intestines. Choice C is incorrect as raloxifene does not increase the excretion of calcium through the kidneys. Choice D is incorrect as raloxifene does not directly stimulate the formation of new bone; instead, it primarily works by reducing bone loss.

2. Which of the following is a characteristic of the human immunodeficiency virus (HIV), which causes AIDS?

• A. HIV only infects B cells
• B. HIV is a retrovirus
• C. Infection does not require a host cell receptor
• D. After infection, cell death is immediate

Correct answer: B

Rationale: The correct answer is B. HIV is a retrovirus that infects T cells and leads to the gradual destruction of the immune system. Choice A is incorrect because HIV infects T cells primarily, not just B cells. Choice C is incorrect because HIV infection requires host cell receptors for entry. Choice D is incorrect because cell death after HIV infection is not immediate; instead, the virus gradually weakens the immune system over time.

3. Following cardiothoracic surgery where controlled therapeutic hypothermia was utilized to decrease metabolic demands, the nurse responsible for monitoring this client postoperatively should be assessing for which potential complication related to cold cardioplegia?

• A. Thrombocytopenia
• B. Hypokalemia
• C. Hyperglycemia
• D. Coagulopathy

Correct answer: D

Rationale: Coagulopathy is the correct answer. During therapeutic hypothermia, which lowers the body's temperature to reduce metabolic demands post-surgery, coagulopathy, or impaired blood clotting, is a potential complication due to the effects of cold cardioplegia. Thrombocytopenia (choice A) refers to a low platelet count and is not directly related to cold cardioplegia. Hypokalemia (choice B) is a condition of low potassium levels, and hyperglycemia (choice C) is high blood sugar levels, neither of which are primary complications of cold cardioplegia.

4. During a follow-up visit, a patient being treated for latent tuberculosis mentions inconsistent drug intake. What should subsequent health education focus on?

• A. The importance of adhering to the treatment regimen to reduce adverse effects
• B. The necessity of consistently taking the prescribed drugs for TB cure
• C. Matching drug dosages carefully to signs and symptoms
• D. The consequence of nonadherence leading to antiretroviral use

Correct answer: B

Rationale: The correct answer is B because consistent intake of prescribed drugs is crucial for curing tuberculosis. By emphasizing the necessity of following the treatment plan, the patient is more likely to achieve a successful outcome. Choice A is incorrect because it focuses on the risk of adverse effects rather than the primary goal of TB cure. Choice C is incorrect as it does not address the issue of inconsistent drug intake. Choice D is also incorrect as it introduces a different treatment (antiretrovirals) not relevant to latent tuberculosis.

5. A patient taking hormonal contraceptives will soon turn 35 years of age. She is moderately obese and has smoked for 15 years. Which of the following is most important?

• A. Begin an exercise regimen.
• B. Begin smoking cessation.
• C. Begin daily aspirin therapy.
• D. Begin taking a loop diuretic to aid weight loss.

Correct answer: B

Rationale: The most important action for a patient taking hormonal contraceptives, who is nearing 35 years of age, moderately obese, and has a history of smoking for 15 years, is to begin smoking cessation. Women over 35, especially smokers, are at an increased risk of blood clots and cardiovascular issues when using hormonal contraceptives. Smoking cessation is crucial to reduce this risk. Beginning an exercise regimen may be beneficial for overall health but is not as critical as stopping smoking in this scenario. Daily aspirin therapy or taking a loop diuretic are not indicated in this situation and may not address the primary risk associated with hormonal contraceptives and smoking.

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