Nursing Elites

1. A patient is taking raloxifene (Evista) for osteoporosis. What is the primary therapeutic effect of this medication?

• A. It stimulates the formation of new bone.
• B. It decreases bone resorption and increases bone density.
• C. It increases the excretion of calcium through the kidneys.
• D. It increases calcium absorption in the intestines.

Correct answer: B

Rationale: The correct answer is B. Raloxifene, a selective estrogen receptor modulator (SERM), primarily works by decreasing bone resorption and increasing bone density. This mechanism of action helps in the prevention and treatment of osteoporosis by maintaining or improving bone strength. Choice A is incorrect because raloxifene does not directly stimulate the formation of new bone but rather helps in preserving existing bone. Choice C is incorrect because raloxifene does not increase the excretion of calcium through the kidneys; instead, it acts on bone tissue. Choice D is incorrect as raloxifene does not directly increase calcium absorption in the intestines but rather focuses on bone health.

2. A 30-year-old woman is taking an oral contraceptive and is concerned about the potential side effects. What should the nurse include in the patient education?

• A. Oral contraceptives can cause weight loss and increased energy levels.
• B. Oral contraceptives can cause increased appetite and weight gain.
• C. Oral contraceptives can cause headaches and breast tenderness.
• D. Oral contraceptives have no side effects.

Correct answer: C

Rationale: The correct answer is C: 'Oral contraceptives can cause headaches and breast tenderness.' It is essential for the nurse to educate the patient about common side effects of oral contraceptives, such as headaches and breast tenderness. Choices A, B, and D are incorrect. Weight loss and increased energy levels (Choice A) are not common side effects of oral contraceptives. Similarly, increased appetite and weight gain (Choice B) are not typical side effects. Finally, stating that oral contraceptives have no side effects (Choice D) is inaccurate as they can have various side effects, albeit usually mild and manageable.

3. A patient is being educated about the use of raloxifene (Evista) for osteoporosis. What is the primary therapeutic action of this medication?

• A. It stimulates the formation of new bone.
• B. It decreases bone resorption and increases bone density.
• C. It increases the excretion of calcium through the kidneys.
• D. It increases calcium absorption in the intestines.

Correct answer: B

Rationale: The correct answer is B: 'It decreases bone resorption and increases bone density.' Raloxifene, a selective estrogen receptor modulator (SERM), works by decreasing bone resorption, which is the breakdown of bone, and increasing bone density. This action helps in preventing bone loss and maintaining bone strength. Choice A is incorrect because raloxifene does not stimulate the formation of new bone but rather prevents its breakdown. Choice C is incorrect as raloxifene does not increase the excretion of calcium but rather helps in maintaining calcium levels in the bones. Choice D is also incorrect as raloxifene does not directly increase calcium absorption in the intestines.

4. A client diagnosed with heart failure displays bilateral pitting edema of the lower extremities. Which of the following terms is used to describe this finding?

• A. Contraindication
• B. Sign
• C. Symptom
• D. Subjective data

Correct answer: B

Rationale: The correct answer is 'B. Sign.' In this scenario, bilateral pitting edema is an objective finding that can be observed by others, making it a sign of heart failure. Choice A, 'Contraindication,' refers to a factor that makes a particular treatment or procedure potentially harmful. Choice C, 'Symptom,' is a subjective indication of a condition experienced by the client. Choice D, 'Subjective data,' is information that is reported by the client but cannot be directly observed or measured.

5. A patient with a history of hypertension presents with a severe headache, confusion, and visual disturbances. His blood pressure is 220/120 mm Hg. Which of the following is the most likely diagnosis?

• A. Migraine
• B. Cluster headache
• C. Hypertensive emergency
• D. Tension headache

Correct answer: C

Rationale: A patient with a history of hypertension presenting with a severe headache, confusion, and visual disturbances, along with a blood pressure of 220/120 mm Hg, likely has a hypertensive emergency. In this situation, the severely elevated blood pressure can lead to end-organ damage, causing symptoms such as headache and confusion. Migraine and tension headaches are not associated with such high blood pressure levels. Cluster headaches typically do not present with visual disturbances and confusion in the setting of severe hypertension.

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