Nursing Elites

1. What potential risk should the nurse identify as being associated with infliximab (Remicade) in the treatment of rheumatoid arthritis?

• A. Risk for infection
• B. Risk for decreased level of consciousness
• C. Risk for nephrotoxicity
• D. Risk for hepatotoxicity

Correct answer: A

Rationale: The correct answer is A: Risk for infection. Infliximab (Remicade) is a medication used to treat autoimmune conditions like rheumatoid arthritis. One of the main risks associated with infliximab is an increased susceptibility to infections due to its immunosuppressive effects. This drug works by targeting specific proteins in the body's immune system, which can weaken the body's ability to fight off infections. Choices B, C, and D are incorrect because infliximab is not typically associated with decreased level of consciousness, nephrotoxicity, or hepatotoxicity. It is important for healthcare providers to monitor patients on infliximab for signs of infection and educate them on the importance of infection prevention strategies.

2. When assessing a patient experiencing breakthrough bleeding while taking oral contraceptives, what should the nurse consider?

• A. The possibility of pregnancy
• B. The patient's adherence to the medication schedule
• C. The need for an increased dosage
• D. The effectiveness of the current oral contraceptive

Correct answer: B

Rationale: When a patient on oral contraceptives experiences breakthrough bleeding, it is crucial for the nurse to consider the patient's adherence to the medication schedule. Breakthrough bleeding is often a sign of missed doses or inconsistent use, which can decrease the effectiveness of the oral contraceptive. Considering the possibility of pregnancy (Choice A) is important but secondary to assessing adherence. The need for an increased dosage (Choice C) is not typically the first consideration for breakthrough bleeding. Evaluating the effectiveness of the current oral contraceptive (Choice D) is relevant but should come after assessing adherence to the medication schedule.

3. What typically causes contact dermatitis?

• A. Fungal infection
• B. Long-term disorder from gout
• C. Contact with a skin allergen
• D. Staphylococcal infection

Correct answer: C

Rationale: Contact dermatitis is typically caused by contact with a skin allergen that triggers an allergic reaction. Choice A, fungal infection, is incorrect as contact dermatitis is not caused by fungi. Choice B, long-term disorder from gout, is also incorrect as gout is not typically associated with contact dermatitis. Choice D, Staphylococcal infection, is incorrect as contact dermatitis is primarily an allergic reaction rather than a bacterial infection.

4. A patient with a history of breast cancer is being prescribed tamoxifen (Nolvadex). What should the nurse include in the patient education about the use of this medication?

• A. Tamoxifen may increase the risk of venous thromboembolism, so the patient should be aware of the signs and symptoms of blood clots.
• B. Tamoxifen may cause hot flashes, so the patient should be prepared for this side effect.
• C. Tamoxifen may decrease the risk of osteoporosis, so the patient should ensure adequate calcium intake.
• D. Tamoxifen may cause weight gain, so the patient should monitor their diet and exercise regularly.

Correct answer: A

Rationale: The correct answer is A. Tamoxifen is known to increase the risk of venous thromboembolism, a serious side effect. Patients should be educated about the signs and symptoms of blood clots, such as swelling, pain, or redness in the affected limb, and the importance of seeking immediate medical attention if they occur. Choice B is incorrect because hot flashes are a common side effect of tamoxifen but not a critical concern like venous thromboembolism. Choice C is incorrect as tamoxifen is not associated with a decreased risk of osteoporosis. Choice D is incorrect because while weight gain can occur with tamoxifen, it is not as crucial to educate the patient about as the risk of venous thromboembolism.

5. A 60-year-old male patient presents with severe and persistent pain in his left leg and hip that worsens with activity. After further evaluation, the patient is diagnosed with osteosarcoma. Which of the following is true about osteosarcoma?

• A. It is more common in children and young adults.
• B. Early diagnosis improves the prognosis.
• C. It is frequently located in the leg bones.
• D. All of the above are true.

Correct answer: D

Rationale: Osteosarcoma is a type of bone cancer that can be found in any bone but is most commonly located in the long bones of the legs. While it is more prevalent in children and young adults, it can also occur in older individuals like the 60-year-old male patient in this case. Early diagnosis is crucial for a better prognosis in osteosarcoma cases. Therefore, all the statements provided are true regarding osteosarcoma, making option D the correct answer. Option A is accurate as osteosarcoma is more common in children and young adults. Option B is correct as early diagnosis improves the prognosis. Option C is accurate as osteosarcoma is frequently located in the leg bones.

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