Nursing Elites

1. What should the nurse include in patient education regarding the effectiveness of oral contraceptives?

• A. Oral contraceptives are highly effective when taken correctly but not 100% foolproof.
• B. Oral contraceptives may take some time to reach full effectiveness after starting.
• C. Oral contraceptives can be less effective if taken with certain antibiotics.
• D. Taking oral contraceptives with food does not significantly affect their efficacy.

Correct answer: C

Rationale: The correct answer is C. Oral contraceptives can be less effective when taken with certain antibiotics due to potential drug interactions that may reduce contraceptive efficacy. It is crucial for patients to be aware of this to consider additional contraceptive measures when prescribed antibiotics. Choice A is incorrect because while oral contraceptives are highly effective when taken correctly, they are not 100% foolproof. Choice B is incorrect as oral contraceptives may take some time to reach their full effectiveness after starting. Choice D is also incorrect as taking oral contraceptives with food does not significantly affect their efficacy.

2. A client with diabetes mellitus has just undergone a right, below-the-knee amputation following gangrene infection. A few days after the amputation, the client confides in the nurse that he still feels his right foot. Knowing the pathophysiologic principles behind this, the nurse can:

• A. administer a psychotropic medication to help the client cope with the sensation of his amputated leg.
• B. explain that many amputees have this sensation and that one theory surmises the end of a regenerating nerve becomes trapped in the scar tissue of the amputation site.
• C. call the physician and request an order for a psychological consult.
• D. educate the client that this area has an unusually abnormal increase in sensitivity to sensation but that it will go away with time.

Correct answer: B

Rationale: The correct answer is B. The sensation of feeling the amputated limb is known as phantom limb pain, which is common after amputation. One theory suggests that it occurs because the end of a regenerating nerve becomes trapped in the scar tissue at the amputation site. Administering psychotropic medication (choice A) is not the first-line treatment for phantom limb pain. Requesting a psychological consult (choice C) is premature without first addressing the known pathophysiological basis of phantom limb pain. Educating the client that the sensitivity will go away with time (choice D) is not entirely accurate as phantom limb pain can persist long-term.

3. What laboratory tests should the nurse monitor regularly when a male patient is receiving androgen therapy?

• A. Monitor liver function tests regularly.
• B. Monitor renal function tests regularly.
• C. Monitor blood glucose levels regularly.
• D. Monitor complete blood count (CBC) regularly.

Correct answer: A

Rationale: The correct answer is to monitor liver function tests regularly when a male patient is receiving androgen therapy. Androgen therapy can impact liver function, making it crucial to monitor liver function tests to assess any potential adverse effects on the liver. Renal function tests (choice B) are not typically affected by androgen therapy and do not need specific monitoring for this treatment. Blood glucose levels (choice C) are more relevant in conditions like diabetes or with medications affecting blood sugar, not typically in androgen therapy. Complete blood count (CBC) (choice D) is not directly impacted by androgen therapy and is not a priority for monitoring in this context.

4. A 35-year-old female is diagnosed with vitamin B12 deficiency anemia (pernicious anemia). How should the nurse respond when the patient asks what causes pernicious anemia? A decrease in ______ is the most likely cause.

• A. Ferritin
• B. Gastric enzymes
• C. Intrinsic factor
• D. Erythropoietin

Correct answer: C

Rationale: Pernicious anemia is primarily caused by a decrease in intrinsic factor. Intrinsic factor is a protein produced by the stomach that is necessary for the absorption of vitamin B12 in the intestines. Without intrinsic factor, vitamin B12 cannot be absorbed properly, leading to anemia. Ferritin is a protein that stores iron in the body and is not directly related to pernicious anemia. Gastric enzymes play a role in digestion but are not the primary cause of pernicious anemia. Erythropoietin is a hormone produced by the kidneys to stimulate red blood cell production and is not linked to pernicious anemia.

5. What assessment is the nurse performing when a client is asked to stand with feet together, eyes open, and hands by the sides, and then asked to close the eyes while the nurse observes for a full minute?

• A. Romberg test
• B. Weber test
• C. Rinne test
• D. Babinski test

Correct answer: A

Rationale: The correct answer is A, Romberg test. The Romberg test is used to assess balance and proprioception. During the test, the client is asked to stand with feet together, eyes open, and hands by the sides to observe their balance. Then, the client is asked to close their eyes while the nurse continues to observe for a full minute. This test helps in detecting any issues with proprioception and balance, which may be compromised in conditions affecting the nervous system. Choices B, C, and D are incorrect because the Weber test is used to assess hearing in each ear, the Rinne test is used to compare air and bone conduction of sound, and the Babinski test is used to assess the integrity of the corticospinal tract.

Similar Questions