Nursing Elites

1. When starting on oral contraceptives, what should the nurse include in the education regarding the timing of the medication?

• A. Oral contraceptives should be taken at the same time each day to maintain stable hormone levels and prevent pregnancy.
• B. Oral contraceptives can be taken at any time of day, as long as the schedule is consistent.
• C. Oral contraceptives should be taken in the morning to avoid nighttime side effects.
• D. Oral contraceptives are effective immediately upon starting, regardless of timing.

Correct answer: A

Rationale: When educating a patient starting on oral contraceptives, it is essential to stress the importance of taking the medication at the same time each day. This ensures stable hormone levels, improving the effectiveness of the contraceptives in preventing pregnancy. Choice B is incorrect because consistency in timing is crucial for maintaining hormone levels. Choice C is incorrect as there is no specific requirement to take oral contraceptives in the morning to avoid side effects. Choice D is incorrect as oral contraceptives may take some time to become fully effective, and consistent timing is important for their efficacy.

2. A 23-year-old pregnant female visits her primary care provider for her final prenatal checkup. The primary care provider determines that the fetus has developed an infection in utero. Which of the following would be increased in the fetus at birth?

• A. IgG
• B. IgA
• C. IgM
• D. IgD

Correct answer: C

Rationale: The correct answer is IgM. IgM is the first antibody produced in response to an infection and is elevated in a fetus with an in utero infection. IgG is the primary antibody responsible for providing immunity to the fetus and is transferred across the placenta during the third trimester. IgA is mainly found in mucosal areas and colostrum but not significantly elevated in fetal infections. IgD is involved in the development and maturation of B cells but not typically increased in fetal infections.

3. Which of the following tests is recommended for lung cancer screening?

• A. Chest X-ray
• B. Pulmonary function test
• C. Computed tomography (CT) scan
• D. Magnetic resonance imaging

Correct answer: C

Rationale: The correct answer is Computed tomography (CT) scan. When screening for lung cancer, CT scans are recommended over chest X-rays due to their higher sensitivity in detecting lung nodules and early-stage cancers. Pulmonary function tests are not used for screening lung cancer but rather to assess lung function. Magnetic resonance imaging is not the preferred imaging modality for routine lung cancer screening, as CT scans are more commonly used.

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 male patient receiving androgen therapy is concerned about side effects. What is the most serious adverse effect the nurse should monitor for during this therapy?

• A. Increased risk of cardiovascular events
• B. Increased risk of bone fractures
• C. Increased risk of venous thromboembolism
• D. Increased risk of mood changes

Correct answer: A

Rationale: The correct answer is A: Increased risk of cardiovascular events. Androgen therapy can significantly increase the risk of cardiovascular events, such as heart attack and stroke, especially in older patients. Monitoring for signs and symptoms of cardiovascular issues is crucial during this therapy. Choice B, increased risk of bone fractures, is not typically associated with androgen therapy. Choice C, increased risk of venous thromboembolism, is more commonly linked to estrogen therapy rather than androgen therapy. Choice D, increased risk of mood changes, can occur with androgen therapy but is not as serious or life-threatening as cardiovascular events.

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