Nursing Elites

1. A patient is prescribed 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 calcium absorption in the intestines.
• D. It increases the excretion of calcium through the kidneys.

Correct answer: B

Rationale: The correct answer is B. Raloxifene works by decreasing bone resorption and increasing bone density, which helps in the prevention and treatment of osteoporosis. Choice A is incorrect as raloxifene does not directly stimulate the formation of new bone. Choice C is incorrect because raloxifene does not primarily affect calcium absorption in the intestines. Choice D is incorrect as raloxifene does not increase the excretion of calcium through the kidneys.

2. A healthcare professional is documenting the recent vital signs for several clients on an acute medical ward of a hospital. Which hospital client with a noninfectious diagnosis would be most likely to have a fever?

• A. A 71-year-old female with limited mobility, chronic obstructive pulmonary disease (COPD), and vascular dementia
• B. A 33-year-old female with a postoperative deep vein thrombosis and pulmonary embolism
• C. A 51-year-old obese male with hepatic encephalopathy secondary to alcohol abuse
• D. A 71-year-old male with congestive heart failure and peripheral edema

Correct answer: B

Rationale: The correct answer is B. Pulmonary emboli can produce fever even without infection. This is known as a noninfectious cause of fever. Choices A, C, and D do not typically present with fever as a prominent symptom. Limited mobility, COPD, vascular dementia, hepatic encephalopathy, alcohol abuse, congestive heart failure, and peripheral edema are not directly associated with causing fever in the absence of infection, unlike pulmonary embolism.

3. Which of the following birthmarks usually fade or regress as the child gets older?

• A. Hemangiomas
• B. Congenital dermal melanocytosis (i.e., Mongolian spots)
• C. Macular stains
• D. Hemangiomas, congenital dermal melanocytosis (i.e., Mongolian spots), and macular stains

Correct answer: D

Rationale: The correct answer is D. Hemangiomas, congenital dermal melanocytosis (i.e., Mongolian spots), and macular stains are birthmarks that usually fade or regress as the child gets older. Hemangiomas are vascular birthmarks that often shrink and fade over time. Congenital dermal melanocytosis (Mongolian spots) are blue-gray birthmarks commonly found on the lower back and buttocks of infants, which typically fade by adolescence. Macular stains, also known as salmon patches, are pink or red birthmarks that usually fade within the first few years of life. Choice D is correct because all the mentioned birthmarks tend to diminish as the child grows, unlike choices A, B, and C which do not fade or regress with age.

4. A patient taking oral contraceptives reports breakthrough bleeding. What should the nurse assess in this patient?

• A. Adherence to the medication schedule
• B. The possibility of pregnancy
• C. The need for an increased dosage
• D. The effectiveness of the current oral contraceptive

Correct answer: A

Rationale: When a patient on oral contraceptives experiences breakthrough bleeding, the nurse should assess the patient's adherence to the medication schedule. Breakthrough bleeding can be a sign of missed doses or inconsistent timing, which can decrease the effectiveness of oral contraceptives. Assessing the patient's adherence helps in ensuring proper use of the medication. Choices B, C, and D are incorrect because breakthrough bleeding is more likely related to adherence issues rather than pregnancy, the need for increased dosage, or the effectiveness of the current oral contraceptive.

5. A 52-year-old has made an appointment with his primary care provider and has reluctantly admitted that his primary health concern is erectile dysfunction (ED). He describes the problem as increasing in severity and consequent distress. Which of the nurse's assessment questions is most likely to address a common cause of ED?

• A. “How would you describe your overall health status?”
• B. “Are you taking any medications for high blood pressure?”
• C. “How has this issue been impacting your relationship?”
• D. “Have you experienced any recent injuries?”

Correct answer: B

Rationale: In the context of erectile dysfunction (ED), medication use is a crucial factor to consider. Many medications, including those used for high blood pressure, can contribute to ED as a side effect. Asking about medication use, particularly for conditions like high blood pressure, can help identify a common cause of ED. Choices A, C, and D do not directly address potential causes related to medication use, making them less likely to reveal a common underlying issue for ED in this case.

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