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 suffers from dysmenorrhea. Which oral medication will be prescribed that has the ability to provide physiological actions on the neuroendocrine control of ovarian function?

• A. Estrogen
• B. Progestins
• C. Naproxen
• D. Ibuprofen

Correct answer: B

Rationale: Progestins are prescribed for dysmenorrhea as they help reduce menstrual pain by inhibiting ovulation and decreasing the production of prostaglandins. Estrogen (Choice A) is not typically used alone in dysmenorrhea treatment as it can worsen symptoms. Naproxen (Choice C) and Ibuprofen (Choice D) are nonsteroidal anti-inflammatory drugs (NSAIDs) commonly used to relieve pain associated with dysmenorrhea, but they do not directly affect the neuroendocrine control of ovarian function like progestins do.

3. What aspect of hormonal contraceptives places a woman at the greatest risk for the development of blood clots?

• A. Hormonal contraceptives increase serum triglyceride and cholesterol levels.
• B. Hormonal contraceptives increase platelet levels.
• C. Hormonal contraceptives increase blood levels of clotting factors.
• D. Hormonal contraceptives cause injury to blood vessel linings.

Correct answer: C

Rationale: The correct answer is C. Hormonal contraceptives increase blood levels of clotting factors, particularly factors II, VII, IX, and X. This elevation in clotting factors can predispose individuals to thromboembolic events, including blood clots. Choices A, B, and D are incorrect because hormonal contraceptives do not have a significant effect on serum triglycerides and cholesterol, platelet levels, or causing direct injury to blood vessel linings as the primary mechanism for clot formation.

4. 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: The correct answer is C, autoimmunity. Autoimmunity refers to the immune system attacking the body's own tissues. Alloimmunity (choice A) is the immune response to tissues of another individual of the same species. Opsonization (choice B) is the process where pathogens are marked for destruction by immune cells. Hypersensitivity (choice D) refers to excessive or inappropriate immune responses.

5. During a clinical assessment of a 68-year-old client who has suffered a head injury, a neurologist suspects that the client has sustained damage to her vagus nerve (CN X). Which assessment finding is most likely to lead the physician to this conclusion?

• A. The client has difficulty swallowing.
• B. The client has loss of gag reflex.
• C. The client has an inability to smell.
• D. The client has impaired eye movement.

Correct answer: B

Rationale: The correct answer is B. Damage to the vagus nerve can result in the loss of the gag reflex, which is a key indicator for the neurologist. Difficulty swallowing (Choice A) is more associated with issues related to the glossopharyngeal nerve (CN IX) and hypoglossal nerve (CN XII). An inability to smell (Choice C) is related to the olfactory nerve (CN I), and impaired eye movement (Choice D) is typically associated with damage to the oculomotor nerve (CN III), trochlear nerve (CN IV), or abducens nerve (CN VI), not the vagus nerve.

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