Nursing Elites

1. A patient with a history of venous thromboembolism is being considered for hormone replacement therapy (HRT). What should the nurse discuss with the patient regarding the risks of HRT?

• A. Discuss the potential for increased bone density.
• B. Discuss the potential for an increased risk of cardiovascular events.
• C. Discuss the potential for a reduced risk of breast cancer.
• D. Discuss the potential for improved mood and energy levels.

Correct answer: B

Rationale: The correct answer is B because hormone replacement therapy (HRT) is associated with an increased risk of cardiovascular events, including venous thromboembolism. Patients with a history of venous thromboembolism are at higher risk, so discussing this potential risk is crucial. Choice A, increased bone density, is not a major risk of HRT. Choice C, reduced risk of breast cancer, is not a common discussion point regarding HRT risks. Choice D, improved mood and energy levels, is more related to the benefits of HRT rather than its risks.

2. Which electrolyte imbalance does the nurse suspect in a patient with hyperaldosteronism?

• A. Hyponatremia
• B. Hypernatremia
• C. Hyperkalemia
• D. Hypercalcemia

Correct answer: C

Rationale: In a patient with hyperaldosteronism, the nurse would suspect hyperkalemia. Hyperaldosteronism leads to increased potassium excretion, resulting in low potassium levels in the blood. Therefore, choices A (Hyponatremia), B (Hypernatremia), and D (Hypercalcemia) are incorrect. Hyponatremia refers to low sodium levels, Hypernatremia refers to high sodium levels, and Hypercalcemia refers to high calcium levels, none of which are typically associated with hyperaldosteronism.

3. A hemoglobin electrophoresis is done to evaluate for sickle cell disease. The report reveals the person has HbAS, which means the person:

• A. is normal with no sickle cell disease.
• B. is a sickle cell carrier.
• C. has sickle cell anemia.
• D. has thalassemia.

Correct answer: B

Rationale: The correct answer is that the person is a sickle cell carrier. In HbAS, 'Hb' stands for hemoglobin, 'A' indicates normal hemoglobin, and 'S' indicates the sickle cell trait. Individuals with HbAS are carriers of the sickle cell trait but do not have sickle cell disease. Choice A is incorrect because having the sickle cell trait means carrying the gene for sickle cell disease. Choice C is incorrect as sickle cell anemia is a different condition where individuals have two copies of the abnormal hemoglobin gene, resulting in the disease. Choice D is incorrect because thalassemia is a separate genetic disorder affecting the production of hemoglobin, not related to the sickle cell trait.

4. A patient is prescribed medroxyprogesterone acetate (Provera) for endometriosis. What should the nurse teach the patient about the proper use of this medication?

• A. Take the medication at the same time each day to maintain consistent hormone levels.
• B. Avoid prolonged sun exposure while taking this medication.
• C. Discontinue the medication if side effects occur.
• D. Apply the medication once a week.

Correct answer: A

Rationale: The correct answer is to take the medication at the same time each day to maintain consistent hormone levels and effectiveness. Consistency in timing helps regulate the hormone levels in the body, ensuring the medication's optimal benefit. Choice B is incorrect as there is no specific need to avoid sun exposure with this medication. Choice C is incorrect because discontinuing the medication without consulting the healthcare provider may not be safe. Choice D is incorrect as medroxyprogesterone acetate is typically taken orally and not applied topically once a week.

5. Which scenario would be an example of a child born with congenital insensitivity to pain?

• A. A child who does not cry when injured and fails to respond to painful stimuli.
• B. A child who cries excessively and has a heightened response to pain.
• C. A child who experiences pain but has difficulty expressing it.
• D. A child who is sensitive to minor stimuli but has a delayed response to severe pain.

Correct answer: A

Rationale: The correct scenario depicting a child with congenital insensitivity to pain is when the child does not cry when injured and fails to respond to painful stimuli. This condition is characterized by the inability to feel and react to pain, resulting in a lack of typical responses such as crying or withdrawal when hurt. Choice B is incorrect as it describes a child with heightened pain sensitivity, opposite to the insensitivity seen in the condition. Choice C is incorrect as it suggests the child feels pain but struggles to communicate it, which is not the case with congenital insensitivity to pain. Choice D is incorrect as it describes a child who is sensitive to minor stimuli and has delayed responses to severe pain, which is not indicative of congenital insensitivity to pain.

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