Nursing Elites

1. 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.

2. A woman is being treated with clomiphene citrate for the treatment of infertility. She states to the nurse that she has seen an increase in vaginal discharge. The nurse knows that this effect is related to:

• A. Increased blood flow to the vaginal area.
• B. Increased cervical mucus production.
• C. Increased production of vaginal secretions.
• D. Increased lubrication in the vaginal canal.

Correct answer: C

Rationale: The correct answer is C: 'Increased production of vaginal secretions.' Clomiphene citrate affects cervical mucus production, leading to an increase in vaginal secretions. This effect is beneficial for fertility as it helps create a more hospitable environment for sperm transport. Choice A, 'Increased blood flow to the vaginal area,' is incorrect as the increase in vaginal discharge is primarily due to changes in cervical mucus. Choice B, 'Increased cervical mucus production,' is partially correct but does not fully explain the increase in vaginal secretions. Choice D, 'Increased lubrication in the vaginal canal,' is not directly related to the effect seen with clomiphene citrate treatment for infertility.

3. A patient with an 18 pack per year history presents to a family practice clinic complaining of painless hoarseness and inability to clear mucus. A biopsy of respiratory tract cells is taken and shows that these cells have been replaced by less mature squamous epithelium cells. The nurse knows this type of change is referred to as:

• A. Dysplasia
• B. Metaplasia
• C. Hyperplasia
• D. Coagulation

Correct answer: B

Rationale: Metaplasia is the replacement of one type of cell with another, which can occur in response to chronic irritation, such as from smoking. In this case, the respiratory tract cells being replaced by less mature squamous epithelium cells indicate metaplasia. Dysplasia refers to abnormal development or growth of cells, not replacement; hyperplasia is an increase in the number of cells, not a replacement; and coagulation is a process related to blood clotting, not cell replacement.

4. A 60-year-old man presents with painless hematuria. Which of the following should be the next step in the evaluation?

• A. Urinalysis
• B. Renal ultrasound
• C. Cystoscopy
• D. Intravenous pyelogram

Correct answer: C

Rationale: In a 60-year-old man presenting with painless hematuria, the next step in the evaluation should be cystoscopy. Cystoscopy is recommended to assess the cause of hematuria, particularly to rule out bladder cancer, which is more common in older individuals. Urinalysis (Choice A) can provide initial information but may not definitively diagnose the underlying cause. Renal ultrasound (Choice B) and intravenous pyelogram (Choice D) are imaging studies that may be considered later in the evaluation process but are not the initial step for painless hematuria.

5. In a male patient with benign prostatic hyperplasia (BPH) prescribed tamsulosin (Flomax), what is the expected therapeutic effect of this medication?

• A. Decreased urinary frequency and urgency
• B. Increased urinary output
• C. Decreased blood pressure
• D. Increased hair growth

Correct answer: A

Rationale: The correct answer is A: Decreased urinary frequency and urgency. Tamsulosin is prescribed for patients with BPH to relax the muscles in the prostate and bladder neck. This relaxation helps in relieving the symptoms of BPH, such as decreased urinary flow, frequent urination, and urgency. Choice B is incorrect because tamsulosin does not increase urinary output but rather improves the flow of urine by relaxing the muscles. Choice C is incorrect as tamsulosin is not primarily used for reducing blood pressure. Choice D is also incorrect as tamsulosin does not promote increased hair growth.

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