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 patient is starting on a new oral contraceptive. What should the nurse emphasize about the timing of the medication?

• A. Take the medication at the same time each day to maintain stable hormone levels.
• B. Oral contraceptives should be taken in the morning to avoid nighttime side effects.
• C. Oral contraceptives can be taken at any time of day as long as the schedule is consistent.
• D. Oral contraceptives are effective immediately upon starting, regardless of timing.

Correct answer: A

Rationale: The correct answer is A. It is crucial for patients taking oral contraceptives to take the medication at the same time each day to maintain stable hormone levels and ensure their effectiveness in preventing pregnancy. Choice B is incorrect because there is no specific requirement to take oral contraceptives in the morning. Choice C is incorrect because consistency in timing is essential, but it should be at the same time each day. Choice D is incorrect because oral contraceptives may take some time to reach peak effectiveness, so it is important to emphasize the need for consistent timing.

3. The patient should be taught that an improvement in symptoms will likely be noticed within

• A. 48 hours.
• B. a week to 10 days.
• C. 2 to 3 weeks.
• D. 4 to 6 weeks.

Correct answer: C

Rationale: When taking isoniazid and rifampin for active tuberculosis, patients should be taught that an improvement in symptoms will likely be noticed within 2 to 3 weeks. Choice A (48 hours) is too soon to expect significant improvement in symptoms. Choice B (a week to 10 days) is also too early for noticeable improvement with this medication regimen. Choice D (4 to 6 weeks) is too far out to expect a noticeable improvement in symptoms.

4. Which of the following are characteristic, localized cardinal signs of acute inflammation? (Select ONE that does not apply.)

• A. Redness
• B. Fatigue
• C. Swelling
• D. Warmth

Correct answer: B

Rationale: The correct answers are A, C, and D. Redness, swelling, and warmth are classic signs of acute inflammation. Redness occurs due to increased blood flow, swelling is caused by leakage of fluid into tissues, and warmth is due to the vasodilation and increased blood flow in the affected area. Fatigue is not a cardinal sign of acute inflammation and is not directly associated with the inflammatory response.

5. What is the primary therapeutic action of tamsulosin (Flomax) in a male patient with benign prostatic hyperplasia (BPH)?

• A. Relaxation of the muscles in the prostate and bladder neck, leading to improved urinary flow.
• B. Reduction in prostate size and improvement in urinary symptoms.
• C. Increase in urine flow and relief of urinary obstruction.
• D. Improvement in erectile function.

Correct answer: A

Rationale: The correct answer is A: Relaxation of the muscles in the prostate and bladder neck, leading to improved urinary flow. Tamsulosin, a medication commonly prescribed for BPH, works by selectively blocking alpha-1 adrenergic receptors in the prostate, causing relaxation of smooth muscles in the prostate and bladder neck. This relaxation reduces the constriction in these areas, improving urinary flow and reducing symptoms such as hesitancy, urgency, frequency, and weak stream. Choice B is incorrect because tamsulosin does not directly reduce the size of the prostate. Choice C is incorrect as tamsulosin primarily acts by relaxing muscles rather than directly increasing urine flow. Choice D is incorrect as tamsulosin is not indicated for improving erectile function.

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