Nursing Elites

1. A patient with a history of osteoporosis is prescribed alendronate (Fosamax). What instructions should the nurse provide to ensure the effectiveness of the medication?

• A. Take the medication with a full glass of water and remain upright for at least 30 minutes to prevent esophageal irritation and ensure proper absorption.
• B. Take the medication with milk to enhance calcium absorption.
• C. Take the medication at bedtime to ensure absorption during sleep.
• D. Take the medication with food to prevent nausea.

Correct answer: A

Rationale: The correct answer is A. Alendronate should be taken with a full glass of water and patients should remain upright for at least 30 minutes to prevent esophageal irritation and ensure proper absorption. Taking the medication with milk (choice B) is not recommended as it may interfere with the absorption of alendronate. Taking the medication at bedtime (choice C) is not necessary for optimal absorption. Taking the medication with food (choice D) is also not recommended as food can reduce the absorption of alendronate.

2. How often should a patient be administered a tetanus toxoid?

• A. Every year
• B. Every 10 years
• C. Every 2 years
• D. Every 5 years

Correct answer: B

Rationale: Tetanus toxoid should be administered every 10 years to ensure continued protection against tetanus infection. The correct answer is 'Every 10 years.' Choice A ('Every year') is incorrect as the frequency is too frequent. Choice C ('Every 2 years') is incorrect as it is too frequent for tetanus toxoid administration. Choice D ('Every 5 years') is incorrect as it does not align with the recommended interval for tetanus toxoid booster doses.

3. A client has experienced a pontine stroke which has resulted in severe hemiparesis. What priority assessment should the nurse perform prior to allowing the client to eat or drink from the food tray?

• A. Evaluate the client's gag reflex.
• B. Assess the client's bowel sounds.
• C. Check the client's pupil reaction.
• D. Monitor the client's heart rate.

Correct answer: A

Rationale: The correct answer is to evaluate the client's gag reflex. When a client has experienced a stroke resulting in severe hemiparesis, assessing the gag reflex is crucial before allowing them to eat or drink. This assessment helps prevent aspiration, a serious complication that can occur due to impaired swallowing ability. Assessing bowel sounds (Choice B), pupil reaction (Choice C), or heart rate (Choice D) are important assessments but are not the priority in this situation where the risk of aspiration is higher.

4. What action is specific to hormonal contraceptives and should be taught to this woman?

• A. The cervical mucus is altered to prevent sperm penetration.
• B. The release of follicle-stimulating hormone is increased to block fertility.
• C. The maturation of the endometrial lining is activated by the contraceptive.
• D. The pituitary gland increases the synthesis and release of luteinizing hormone.

Correct answer: A

Rationale: The correct action specific to hormonal contraceptives that should be taught to the woman is that they alter cervical mucus to prevent sperm penetration. This mechanism helps in preventing pregnancy by reducing the chances of sperm reaching the egg. Choices B, C, and D are incorrect. Choice B is inaccurate as hormonal contraceptives work by inhibiting ovulation rather than increasing follicle-stimulating hormone release. Choice C is incorrect as hormonal contraceptives do not activate the maturation of the endometrial lining; instead, they modify it to prevent implantation. Choice D is also incorrect as hormonal contraceptives do not stimulate the pituitary gland to increase luteinizing hormone synthesis and release.

5. A patient is being treated with amphotericin B. Which of the following statements indicates that the patient has understood the patient teaching?

• A. “The medication may cause diabetes.”
• B. “The medication will cause liver necrosis.”
• C. “The medication may cause kidney damage.”
• D. “The medication will cause pancreatitis.”

Correct answer: C

Rationale: The correct answer is C: 'The medication may cause kidney damage.' Amphotericin B is known for its potential to cause nephrotoxicity, which can manifest as kidney damage. It is crucial for the patient to be aware of this possible adverse effect. Choices A, B, and D are incorrect because amphotericin B is not typically associated with causing diabetes, liver necrosis, or pancreatitis. Therefore, these statements do not reflect an accurate understanding of the medication's side effects.

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