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 patient being treated for tuberculosis is determined to be drug resistant. Which of the following medications will the patient be resistant to in the treatment of tuberculosis?

• A. Isoniazid (INH) and rifampin
• B. Carbamazepine (Tegretol) and phenytoin (Dilantin)
• C. Dextroamphetamine (Dexedrine) and doxapram (Dopram)
• D. Propranolol (Inderal) and sotalol (Betapace)

Correct answer: A

Rationale: In the treatment of tuberculosis, drug resistance commonly develops against medications like Isoniazid (INH) and rifampin. These two drugs are key components of the standard anti-tuberculosis treatment regimen. Choices B, C, and D are unrelated medications that are not used in the treatment of tuberculosis. Carbamazepine and phenytoin are anticonvulsants, dextroamphetamine is a stimulant, and propranolol and sotalol are used for cardiovascular conditions.

3. A 60-year-old male client with a long history of back pain has had little success with a variety of analgesic regimens that his family physician has prescribed. He has recently been diagnosed with a chronic pain disorder. Which teaching points about chronic pain would his physician most likely emphasize to the client?

• A. Chronic pain is often difficult to treat and requires a multimodal approach.
• B. Chronic pain indicates that an underlying injury has not healed properly.
• C. Chronic pain can be managed with a single long-term medication.
• D. Chronic pain is typically less severe than acute pain but lasts longer.

Correct answer: A

Rationale: The correct answer is A. Chronic pain is often complex and challenging to treat, necessitating a multimodal approach that may include medication, physical therapy, and behavioral therapy. Choice B is incorrect because chronic pain does not always indicate that an underlying injury has not healed properly; it can persist even after the initial injury has healed. Choice C is incorrect as chronic pain management usually involves a combination of treatments rather than relying solely on a single long-term medication. Choice D is incorrect because chronic pain is not necessarily less severe than acute pain; it can vary in intensity and duration depending on the individual and underlying condition.

4. An oncology nurse is providing care for an adult patient who is currently immunocompromised. The nurse is aware of the physiology involved in hematopoiesis and immune function, including the salient role of cytokines. What is the primary role of cytokines in maintaining homeostasis?

• A. Cytokines perform phagocytosis in response to bacterial and protozoal infections.
• B. Cytokines perform a regulatory role in the development of diverse blood cells.
• C. Cytokines play a significant role in the formation of all blood cells.
• D. Cytokines are produced in response to the presence of antibodies.

Correct answer: B

Rationale: The primary role of cytokines in maintaining homeostasis is to perform a regulatory function in the development of diverse blood cells. Cytokines act as signaling molecules that regulate the immune response and hematopoiesis. Choice A is incorrect because cytokines do not perform phagocytosis; they regulate immune responses. Choice C is incorrect because while cytokines are involved in the formation of some blood cells, they are not considered the basic 'building blocks' of all blood cells. Choice D is incorrect because cytokines are not formed in response to antibodies, but rather play a role in the immune response to various stimuli.

5. What specific instructions should the nurse provide to ensure proper administration of alendronate (Fosamax) for the treatment of osteoporosis?

• A. Take the medication with a full glass of water and remain upright for at least 30 minutes.
• B. Take the medication at bedtime to ensure absorption during sleep.
• C. Take the medication with milk to enhance calcium absorption.
• D. Take the medication with food to prevent gastrointestinal upset.

Correct answer: A

Rationale: The correct answer is to take the medication with a full glass of water and remain upright for at least 30 minutes. This is important to prevent esophageal irritation and ensure proper absorption. Choice B is incorrect because alendronate should be taken in the morning on an empty stomach, at least 30 minutes before eating or drinking anything other than water. Choice C is incorrect because alendronate should not be taken with milk as it can interfere with its absorption. Choice D is incorrect because alendronate should be taken on an empty stomach, not with food.

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