Nursing Elites

1. What should the nurse emphasize regarding the risks associated with hormone replacement therapy (HRT) in a patient with a history of cardiovascular disease?

• A. HRT is associated with an increased risk of cardiovascular events, including heart attack and stroke.
• B. HRT may decrease the risk of osteoporosis.
• C. HRT may improve mood and energy levels.
• D. HRT may increase the risk of venous thromboembolism.

Correct answer: A

Rationale: The correct answer is A because hormone replacement therapy (HRT) is associated with an increased risk of cardiovascular events, including heart attack and stroke, particularly in patients with a history of cardiovascular disease. Choice B is incorrect because HRT does not decrease the risk of osteoporosis; instead, it may have adverse effects on bone health. Choice C is incorrect as the improvement in mood and energy levels is not a significant risk associated with HRT. Choice D is incorrect because while HRT may increase the risk of venous thromboembolism, the question specifically focuses on patients with a history of cardiovascular disease, where the emphasis should be on cardiovascular risks.

2. A 17-year-old woman has come to the clinic requesting emergency contraception after having unprotected sex 24 hours ago. What medication is the clinician most likely to prescribe?

• A. Levonorgestrel (Plan B)
• B. Mifepristone (RU-486)
• C. Ulipristal acetate (ella)
• D. Estradiol (Estrace)

Correct answer: A

Rationale: The correct answer is A: Levonorgestrel (Plan B). Levonorgestrel is the most commonly prescribed medication for emergency contraception within 72 hours of unprotected intercourse. It is effective when taken within 72 hours after intercourse, with better efficacy the sooner it is taken. Choice B, Mifepristone (RU-486), is not indicated for emergency contraception but is used for medical abortion. Choice C, Ulipristal acetate (ella), is another option for emergency contraception that is effective up to 120 hours after unprotected intercourse. Choice D, Estradiol (Estrace), is not used for emergency contraception.

3. Which of the following accurately describes the pathophysiology of asthma?

• A. Chronic inflammation of the bronchial lining
• B. Narrowing of the airway due to bronchoconstriction
• C. Damage to alveoli reducing lung elasticity
• D. Overproduction of mucus by the goblet cells

Correct answer: B

Rationale: The correct answer is B: "Narrowing of the airway due to bronchoconstriction." In asthma, there is an inflammatory response that leads to bronchoconstriction, causing the airways to narrow and making it difficult to breathe. Choice A is incorrect as chronic inflammation is a feature of asthma but not the primary pathophysiological mechanism. Choice C is incorrect as damage to alveoli is more characteristic of conditions like emphysema. Choice D is incorrect as overproduction of mucus is a feature of chronic bronchitis, not asthma.

4. A 70-year-old man has enjoyed good overall health for all of his adult life, but he has been experiencing urinary frequency and dribbling that has culminated in a diagnosis of benign prostatic hypertrophy (BPH). As a result, the patient has been prescribed finasteride (Proscar). When teaching the patient about the potential adverse effects of the drug, the nurse should ensure that he knows about the possibility of

• A. sexual dysfunction.
• B. urethral burning.
• C. kidney stones.
• D. visual disturbances.

Correct answer: A

Rationale: The correct potential adverse effect of finasteride (Proscar) that the nurse should educate the patient about is sexual dysfunction. Finasteride is known to cause sexual side effects such as decreased libido, erectile dysfunction, and ejaculation disorders. Urethral burning, kidney stones, and visual disturbances are not commonly associated with finasteride use, making them incorrect choices for this scenario.

5. What is a characteristic of coronary artery disease (CAD)?

• A. The build-up of infectious by-products in the lymph nodes
• B. Insufficient delivery of oxygenated blood to the myocardium
• C. Insufficient delivery of carbon dioxide to the lungs
• D. The build-up of bile in the stomach and gallbladder

Correct answer: B

Rationale: The correct characteristic of coronary artery disease (CAD) is the insufficient delivery of oxygenated blood to the myocardium. CAD is a condition where the coronary arteries become narrowed or blocked, leading to reduced blood flow to the heart muscle. This lack of oxygenated blood can result in chest pain, known as angina, and if a coronary artery becomes completely blocked, it can cause a heart attack. Choices A, C, and D are incorrect. Choice A refers to an issue related to the lymphatic system, choice C is about gas exchange in the lungs, and choice D describes a problem with bile accumulation in the digestive system, none of which are characteristics of CAD.

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