Nursing Elites

1. A patient taking oral contraceptives reports breakthrough bleeding. What should the nurse assess in this patient?

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

Correct answer: A

Rationale: When a patient on oral contraceptives experiences breakthrough bleeding, the nurse should assess the patient's adherence to the medication schedule. Breakthrough bleeding can be a sign of missed doses or inconsistent timing, which can decrease the effectiveness of oral contraceptives. Assessing the patient's adherence helps in ensuring proper use of the medication. Choices B, C, and D are incorrect because breakthrough bleeding is more likely related to adherence issues rather than pregnancy, the need for increased dosage, or the effectiveness of the current oral contraceptive.

2. An immunology nurse is caring for a patient. While planning care, which principle will the nurse remember? The primary role of IgA1 is to prevent infections in the:

• A. Blood
• B. Kidneys
• C. Lungs
• D. Mucous membranes

Correct answer: A

Rationale: The correct answer is A: Blood. IgA1 is mainly found in the blood and plays a crucial role in preventing infections by neutralizing pathogens. While IgA1 can be present in other body areas, its primary function is associated with preventing infections in the blood. Choices B, C, and D are incorrect as IgA1 is not primarily associated with the kidneys, lungs, or mucous membranes.

3. A male patient is receiving androgen therapy for the treatment of hypogonadism. What adverse effect should the nurse monitor for during this treatment?

• A. Liver dysfunction
• B. Kidney dysfunction
• C. Heart failure
• D. Pulmonary embolism

Correct answer: A

Rationale: The correct adverse effect to monitor for during androgen therapy for hypogonadism is liver dysfunction. Androgen therapy can lead to hepatotoxicity, so monitoring liver function tests is crucial during treatment. Kidney dysfunction (Choice B), heart failure (Choice C), and pulmonary embolism (Choice D) are not commonly associated with androgen therapy and are less likely adverse effects compared to liver dysfunction.

4. A patient has been prescribed an estrogen-progestin oral contraceptive. The nurse should emphasize that the risk of thrombophlebitis is most likely in patients who:

• A. Are diabetic.
• B. Smoke cigarettes.
• C. Have a history of hypertension.
• D. Are older than 40.

Correct answer: B

Rationale: The correct answer is B: Smoke cigarettes. Smoking is a significant risk factor for thrombophlebitis, especially when combined with estrogen-progestin contraceptives. Choice A, being diabetic, does not directly increase the risk of thrombophlebitis in this context. Choice C, having a history of hypertension, is not a primary risk factor for thrombophlebitis. Choice D, being older than 40, is not the most likely factor associated with an increased risk of thrombophlebitis in patients taking estrogen-progestin oral contraceptives.

5. A nurse is providing discharge teaching to a patient who will be taking sildenafil (Viagra). Which of the following should the nurse include in the instructions?

• A. Take this medication 1 hour before sexual activity.
• B. Do not take more than one dose in a 24-hour period.
• C. Seek immediate medical attention if you experience vision or hearing loss.
• D. Take this medication on an empty stomach.

Correct answer: B

Rationale: The correct answer is B: 'Do not take more than one dose in a 24-hour period.' It is essential for the nurse to emphasize this instruction to prevent potential adverse effects from taking multiple doses of sildenafil. Choice A is incorrect because sildenafil should be taken approximately 30 minutes to 4 hours before sexual activity, not specifically 1 hour before. Choice C is important but not the priority; while vision or hearing loss are potential serious side effects of sildenafil, the immediate concern should be focused on dose frequency. Choice D is incorrect as sildenafil can be taken with or without food.

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