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 69-year-old female patient has been diagnosed with malignant melanoma. The care team has collaborated with the patient and her family and agreed on a plan of care that includes administration of interferon alfa-2b. After administering interferon alfa-2b, the oncology nurse should anticipate that the patient may develop which of the following adverse effects?

• A. Profound diaphoresis
• B. Decreased level of consciousness
• C. Flu-like symptoms
• D. Cyanosis and pallor

Correct answer: C

Rationale: After the administration of interferon alfa-2b, the patient may develop flu-like symptoms as an adverse effect. Flu-like symptoms are commonly associated with interferon therapy, including fever, chills, fatigue, and muscle aches. These symptoms usually subside over time. Options A, B, and D are not typically associated with interferon alfa-2b administration. Profound diaphoresis is excessive sweating, decreased level of consciousness indicates neurological issues, and cyanosis and pallor suggest circulatory or respiratory problems, none of which are expected adverse effects of interferon alfa-2b.

3. A patient is prescribed sildenafil (Viagra) for erectile dysfunction. What is a key contraindication that the nurse should review with the patient?

• A. History of hypertension
• B. Use of nitrates
• C. Use of antihypertensive medications
• D. History of peptic ulcer disease

Correct answer: B

Rationale: The correct answer is B: 'Use of nitrates.' Sildenafil (Viagra) is contraindicated in patients taking nitrates due to the risk of severe hypotension. Nitrates and sildenafil both act as vasodilators, and their combined use can lead to a dangerous drop in blood pressure. Choices A, C, and D are incorrect because having a history of hypertension, using antihypertensive medications, or having a history of peptic ulcer disease are not key contraindications for sildenafil use.

4. A patient is starting on finasteride (Proscar) for the treatment of benign prostatic hyperplasia (BPH). What should the nurse include in the patient teaching?

• A. The medication will cure BPH after treatment is complete.
• B. The effects of the medication may take several weeks or months to become noticeable.
• C. The medication may cause increased hair growth.
• D. The medication may decrease libido.

Correct answer: B

Rationale: The correct answer is B. The effects of finasteride in treating BPH may take several weeks or months to become noticeable. It is important for the nurse to educate the patient about this expected time frame to manage expectations. Choice A is incorrect because finasteride does not cure BPH but helps in managing symptoms. Choice C is incorrect as one of the side effects of finasteride is decreased hair growth. Choice D is incorrect as finasteride may cause a decrease in libido as a side effect.

5. Abrupt withdrawal or discontinuation of prednisone can cause:

• A. adrenal crisis.
• B. hypercortisolism.
• C. ACTH stimulation.
• D. thyroid crisis.

Correct answer: A

Rationale: The correct answer is A: adrenal crisis. Abrupt discontinuation of prednisone can lead to adrenal insufficiency, resulting in adrenal crisis. Prednisone is a corticosteroid that suppresses the adrenal glands' ability to produce cortisol. Abrupt withdrawal can cause a sudden drop in cortisol levels, leading to adrenal crisis with symptoms like fatigue, weakness, abdominal pain, and potentially life-threatening low blood pressure. Choices B, C, and D are incorrect because hypercortisolism refers to excess cortisol levels, ACTH stimulation would not result from prednisone withdrawal, and thyroid crisis is not directly related to corticosteroid discontinuation.

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