Nursing Elites

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

• A. Tamoxifen may increase the risk of venous thromboembolism, so patients should be educated about the signs and symptoms of blood clots.
• B. Tamoxifen may cause weight gain, so patients should monitor their diet.
• C. Tamoxifen may decrease the risk of osteoporosis, so patients should ensure adequate calcium intake.
• D. Tamoxifen may cause hot flashes and other menopausal symptoms.

Correct answer: A

Rationale: Tamoxifen increases the risk of venous thromboembolism, so patients should be educated about the signs and symptoms of blood clots and the importance of seeking immediate medical attention if they occur.

2. A patient with a history of breast cancer is being prescribed tamoxifen (Nolvadex). What should the nurse 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. Patients should be educated about signs and symptoms of blood clots, such as swelling, pain, or redness in the legs. Choices B, C, and D are incorrect because tamoxifen is not associated with decreasing the risk of osteoporosis, causing hot flashes and menopausal symptoms, or causing weight gain and fluid retention.

3. Which of the following statements characterizes irritable bowel syndrome?

• A. Typically does not cause anemia
• B. Not generally associated with intestinal E. coli
• C. Can be associated with anxiety and/or depression
• D. Not often associated with bloody diarrhea

Correct answer: C

Rationale: Irritable bowel syndrome (IBS) is a gastrointestinal disorder characterized by abdominal pain, bloating, and changes in bowel habits. While IBS can lead to symptoms like diarrhea or constipation, it typically does not cause anemia (choice A), is not generally associated with intestinal E. coli (choice B), and is not often associated with bloody diarrhea (choice D). However, IBS can indeed be associated with anxiety and/or depression (choice C) due to the gut-brain axis, a bidirectional communication system between the gut and the brain. This association is well-documented in IBS patients, highlighting the importance of considering psychological factors in managing the condition.

4. A patient is found to have liver disease, resulting in the removal of a lobe of his liver. Adaptation to the reduced size of the liver leads to ___________ of the remaining liver cells.

• A. Metaplasia
• B. Organ atrophy
• C. Compensatory hyperplasia
• D. Physiologic hyperplasia

Correct answer: C

Rationale: Compensatory hyperplasia is the process by which the remaining cells increase in number to adapt to the reduced size of the liver. In this case, after the removal of a lobe of the liver, the remaining cells undergo compensatory hyperplasia to compensate for the lost tissue. Metaplasia refers to the reversible change of one cell type to another, not an increase in cell number. Organ atrophy is the decrease in organ size due to cell shrinkage or loss, which is opposite to an increase in cell number seen in compensatory hyperplasia. Physiologic hyperplasia is the increase in cell number in response to a normal physiological demand, not specifically due to the removal of a portion of the organ.

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

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

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 combined with sildenafil can lead to a dangerous drop in blood pressure. Choices A, C, and D are incorrect because a history of peptic ulcer disease, use of antihypertensive medications, or a history of hypertension are not direct contraindications for sildenafil use.

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