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. What should the nurse discuss with a patient with a history of cardiovascular disease regarding the risks of hormone replacement therapy (HRT)?

• A. HRT may increase the risk of cardiovascular events, including heart attack and stroke.
• B. HRT may decrease the risk of osteoporosis.
• C. HRT may improve mood and energy levels.
• D. HRT may decrease the risk of breast cancer.

Correct answer: A

Rationale: The correct answer is A. Hormone replacement therapy (HRT) is associated with an increased risk of cardiovascular events, including heart attack and stroke, especially in patients with a history of cardiovascular disease. Choice B is incorrect because HRT is not typically used to decrease the risk of osteoporosis. Choice C is incorrect as mood and energy level improvements are not the primary risks associated with HRT. Choice D is incorrect because HRT may actually increase the risk of breast cancer in some individuals.

3. What is the primary cause of angina?

• A. Increased oxygen demand by the heart
• B. Obstruction of the coronary arteries
• C. Lack of oxygen in the lungs
• D. Decreased blood supply to the liver

Correct answer: B

Rationale: The correct answer is B: Obstruction of the coronary arteries. Angina is primarily caused by a reduced blood flow to the heart due to blockages or narrowing in the coronary arteries. Choice A is incorrect because while increased oxygen demand can contribute to angina symptoms, it is not the primary cause. Choice C is incorrect as angina is not caused by a lack of oxygen in the lungs. Choice D is also incorrect as angina is not related to decreased blood supply to the liver.

4. A patient who was frequently homeless over the past several years has begun a drug regimen consisting solely of isoniazid (INH). What is this patient's most likely diagnosis?

• A. Active tuberculosis
• B. Latent tuberculosis
• C. Mycobacterium avium complex
• D. Human immunodeficiency virus

Correct answer: A

Rationale: The correct answer is A: Active tuberculosis. Given the patient's history of homelessness and initiation of isoniazid (INH) treatment, the most likely diagnosis is active tuberculosis. Isoniazid is a first-line medication used in the treatment of active tuberculosis. Latent tuberculosis (choice B) would not typically necessitate treatment with isoniazid alone. Mycobacterium avium complex (choice C) is not typically treated with isoniazid alone. Human immunodeficiency virus (choice D) is a risk factor for developing tuberculosis but is not the primary diagnosis in this patient scenario.

5. What is a common factor related to all forms of heart failure?

• A. Peripheral edema
• B. Pulmonary edema
• C. Reduced cardiac output
• D. Jugular vein distention

Correct answer: C

Rationale: The correct answer is C: Reduced cardiac output. All forms of heart failure share this common factor, which occurs when the heart is unable to pump enough blood to meet the body's needs. Choices A, B, and D are incorrect. While peripheral edema and pulmonary edema can be symptoms of heart failure, they are not universal to all forms. Jugular vein distention is a sign of right heart failure, not a common factor across all types of heart failure.

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