Nursing Elites

1. A patient with a history of cardiovascular disease is being prescribed hormone replacement therapy (HRT). What should the nurse include in the patient education regarding the risks associated with HRT?

• A. HRT may increase the risk of cardiovascular events, including heart attack and stroke.
• B. HRT may decrease the risk of osteoporosis.
• C. HRT may increase the risk of venous thromboembolism.
• D. HRT may decrease the risk of breast cancer.

Correct answer: A

Rationale: The correct answer is A. Hormone replacement therapy (HRT) is associated with an increased risk of cardiovascular events, including heart attack and stroke, especially in patients with a history of cardiovascular disease. Choice B is incorrect because HRT does not decrease the risk of osteoporosis; in fact, it may increase the risk of certain conditions like venous thromboembolism, as mentioned in choice C. Choice D is also incorrect as HRT has been associated with a slight increase in the risk of breast cancer.

2. A patient has been diagnosed with chronic renal failure. Which of the following agents will assist in raising the patient's hemoglobin levels?

• A. Epoetin alfa (Epogen, Procrit)
• B. Pentoxifylline (Pentoxil)
• C. Estazolam (ProSom)
• D. Dextromethorphan hydrobromide

Correct answer: A

Rationale: The correct answer is A: Epoetin alfa (Epogen, Procrit). Epoetin alfa is a synthetic form of erythropoietin that stimulates red blood cell production and is commonly used to treat anemia in patients with chronic renal failure. By increasing red blood cell production, epoetin alfa helps raise hemoglobin levels in these patients. Pentoxifylline (Choice B) is not indicated for raising hemoglobin levels in chronic renal failure patients; it is a peripheral vasodilator used to improve blood flow. Estazolam (Choice C) is a benzodiazepine used for treating insomnia and has no role in raising hemoglobin levels. Dextromethorphan hydrobromide (Choice D) is a cough suppressant and is not used to raise hemoglobin levels in patients with chronic renal failure.

3. A patient is receiving epoetin alfa (Epogen) for anemia. Which of the following adjunctive therapies is imperative with epoetin alfa?

• A. Potassium supplements
• B. Sodium restriction
• C. Iron supplement
• D. Renal dialysis

Correct answer: C

Rationale: The correct answer is C: Iron supplement. When a patient is receiving epoetin alfa for anemia, it is imperative to provide iron supplementation as epoetin alfa works by stimulating the production of red blood cells, which require iron for hemoglobin synthesis. Therefore, iron supplementation is crucial to support the increased erythropoiesis. Choices A, B, and D are incorrect because potassium supplements, sodium restriction, and renal dialysis are not typically indicated as adjunctive therapies with epoetin alfa for anemia.

4. A patient arrives at her follow-up appointment 1 month post-hysterectomy and complains to the nurse that her scars do not seem to be healing properly. Upon inspection, the nurse notices that the scars are raised but still within the boundaries of the original incisions. The nurse tells the patient this kind of dysfunctional wound healing is called:

• A. Hypertrophic scarring
• B. Dehiscence
• C. Contracture
• D. A keloid

Correct answer: A

Rationale: Hypertrophic scarring occurs when a scar is raised but remains within the boundaries of the original wound, unlike keloids, which extend beyond the wound edges. Dehiscence refers to the separation of wound edges, while contracture involves the tightening or constriction of a scar, leading to limited mobility.

5. When starting on oral contraceptives, what should the nurse emphasize about the potential interactions with other medications?

• A. Oral contraceptives can be less effective when taken with certain antibiotics.
• B. Oral contraceptives are less effective when taken with food.
• C. Oral contraceptives are effective immediately after starting.
• D. Oral contraceptives have no interactions with other medications.

Correct answer: A

Rationale: The correct answer is A. Oral contraceptives can be less effective when taken with certain antibiotics, so patients should be informed about the potential need for additional contraception. Choice B is incorrect because taking oral contraceptives with food does not affect their effectiveness. Choice C is incorrect because oral contraceptives may take some time to become fully effective. Choice D is incorrect because oral contraceptives can interact with other medications, especially certain antibiotics, affecting their efficacy.

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