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. The parents of a 3-year-old boy have brought him to a pediatrician for assessment of the boy's late ambulation and frequent falls. Subsequent muscle biopsy has confirmed a diagnosis of Duchenne muscular dystrophy. Which teaching point should the physician include when explaining the child's diagnosis to his parents?

• A. Your child may develop breathing difficulties as the disease progresses.
• B. Your child is likely to benefit from physical therapy and exercise.
• C. This condition can be cured with early intervention and treatment.
• D. The disease is caused by inflammation in the muscles, which leads to weakness.

Correct answer: A

Rationale: The correct teaching point that the physician should include when explaining Duchenne muscular dystrophy to the parents is that 'Your child may develop breathing difficulties as the disease progresses.' Duchenne muscular dystrophy is a progressive condition that affects muscle strength, including respiratory muscles, leading to breathing difficulties as the disease advances. Choice B is incorrect because while physical therapy and exercise can help maintain muscle function and mobility, they do not cure the condition. Choice C is incorrect because Duchenne muscular dystrophy is a genetic disorder with no known cure. Choice D is incorrect as Duchenne muscular dystrophy is primarily characterized by a lack of dystrophin protein due to genetic mutations, not inflammation in the muscles.

3. A patient with severe peripheral vascular disease has developed signs of dry gangrene on the great toe of one foot. Which of the following pathophysiologic processes most likely contributed to this diagnosis?

• A. Inappropriate activation of apoptosis
• B. Bacterial invasion
• C. Impaired arterial blood supply
• D. Metaplastic cellular changes

Correct answer: C

Rationale: The correct answer is C: Impaired arterial blood supply. Dry gangrene is typically caused by impaired arterial blood supply, leading to tissue death without bacterial infection. Choices A, B, and D are incorrect. Inappropriate activation of apoptosis is not a common cause of dry gangrene. Bacterial invasion usually leads to wet gangrene, not dry gangrene. Metaplastic cellular changes are not directly associated with the development of dry gangrene.

4. A 1-year-old child will receive her scheduled MMR vaccination shortly. The nurse should teach the child's parents that she may develop what possible adverse effect related to the administration of this vaccine?

• A. Cough and fever
• B. Pallor and listlessness
• C. Serum sickness
• D. Nausea and vomiting

Correct answer: A

Rationale: The correct answer is A: Cough and fever. After receiving the MMR vaccine, some children may experience mild adverse effects such as a low-grade fever and a mild cough. These symptoms are normal reactions to the vaccine and indicate that the child's immune system is responding appropriately. Choices B, C, and D are incorrect because pallor and listlessness, serum sickness, nausea, and vomiting are not common adverse effects associated with the MMR vaccine in children.

5. A 22-year-old woman began using oral contraceptives several months ago and has presented for an appointment to discuss recent worrisome changes in her health status. Which of the following changes in the woman's health may the nurse potentially attribute to the use of oral contraceptives?

• A. Fatigue
• B. Frequent high blood pressure readings
• C. Frequent headaches without aura
• D. Nausea and vomiting

Correct answer: A

Rationale: The correct answer is A: Fatigue. Oral contraceptives can sometimes cause fatigue as a side effect. Frequent high blood pressure readings and frequent headaches without aura are less likely to be directly related to the use of oral contraceptives. Nausea and vomiting are common side effects of oral contraceptives but are not the changes typically associated with liver function affecting hormone metabolism as in the case of hepatitis C infection.

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