Nursing Elites

1. A patient with a history of breast cancer is being prescribed tamoxifen (Nolvadex). What is a critical point the nurse should include in the patient education?

• A. Tamoxifen may increase the risk of venous thromboembolism.
• B. Tamoxifen may decrease the risk of osteoporosis.
• C. Tamoxifen may cause hot flashes and other menopausal symptoms.
• D. Tamoxifen may cause weight gain and fluid retention.

Correct answer: A

Rationale: The correct answer is A. Tamoxifen increases the risk of venous thromboembolism, so patients should be educated about the signs and symptoms of blood clots. Choice B is incorrect because tamoxifen does not decrease the risk of osteoporosis. Choice C is incorrect as tamoxifen may cause hot flashes and other menopausal symptoms but this is not the critical point for patient education. Choice D is incorrect as tamoxifen may cause weight gain and fluid retention, but it is not the critical point that the nurse should focus on in patient education.

2. When the body produces antibodies against its own tissue, the condition is called:

• A. Alloimmunity
• B. Opsonization
• C. Autoimmunity
• D. Hypersensitivity

Correct answer: C

Rationale: Autoimmunity is the correct term for a condition where the body's immune system mistakenly targets its own tissues. Alloimmunity (Choice A) refers to an immune response against foreign tissue. Opsonization (Choice B) is a process where pathogens are marked for destruction by immune cells. Hypersensitivity (Choice D) involves an exaggerated immune response against antigens.

3. A patient with erectile dysfunction is prescribed sildenafil (Viagra). What condition would contraindicate the use of this medication?

• A. History of hypertension
• B. Use of nitrates
• C. Recent 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 cause vasodilation, and their combined use can lead to a dangerous drop in blood pressure. Choices A, C, and D are incorrect because a history of hypertension, recent use of antihypertensive medications, or a history of peptic ulcer disease are not direct contraindications for using sildenafil.

4. What important instruction should the nurse provide about taking medroxyprogesterone acetate (Provera) for a patient with endometriosis?

• A. Take the medication at the same time each day to maintain consistent hormone levels.
• B. Medroxyprogesterone should be taken with food to reduce gastrointestinal upset.
• C. Discontinue medroxyprogesterone if side effects occur.
• D. Medroxyprogesterone should be taken once a week to maintain effectiveness.

Correct answer: A

Rationale: The correct answer is to take the medication at the same time each day to maintain consistent hormone levels and effectiveness. This consistency is crucial for achieving therapeutic outcomes. Choice B is incorrect because medroxyprogesterone should be taken at the same time each day, regardless of food intake. Choice C is incorrect because side effects should be reported to the healthcare provider for further evaluation rather than discontinuing the medication abruptly. Choice D is incorrect as medroxyprogesterone is usually taken daily for the prescribed duration.

5. What type of immunity will the hepatitis B series provide a nursing student scheduled to receive it?

• A. Active immunity
• B. Passive immunity
• C. Innate immunity
• D. Natural immunity

Correct answer: A

Rationale: The correct answer is active immunity. The hepatitis B series immunization will provide active immunity, where the individual's immune system is stimulated to produce antibodies against the hepatitis B virus. This type of immunity is long-lasting and provides protection against future exposures. Passive immunity (choice B) involves the transfer of pre-formed antibodies and is temporary. Innate immunity (choice C) is the body's natural defense mechanisms, present at birth. Natural immunity (choice D) refers to immunity acquired through normal life processes, such as recovering from an infection.

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