Nursing Elites

1. For a patient with asthma, what is the primary purpose of prescribing salmeterol?

• A. Relieve acute bronchospasm
• B. Prevent asthma attacks
• C. Suppress cough
• D. Thin respiratory secretions

Correct answer: B

Rationale: Salmeterol is classified as a long-acting beta2-agonist, which is used to prevent asthma attacks by providing extended bronchodilation. It is not typically used for immediate relief of acute bronchospasm or for suppressing cough. Additionally, salmeterol does not have the primary purpose of thinning respiratory secretions.

2. A patient who is diagnosed with cervical cancer that is classified as Tis, N0, M0 asks the nurse what the letters and numbers mean. Which response by the nurse is most appropriate?

• A. The cancer involves only the cervix.
• B. The cancer cells closely resemble normal cells.
• C. Further testing is necessary to determine the spread of the cancer.
• D. Determining the original site of the cervical cancer is challenging.

Correct answer: A

Rationale: The correct response is A: 'The cancer involves only the cervix.' In staging, 'Tis' indicates cancer in situ, which means it is localized to the cervix and not invasive at this time. The differentiation of cancer cells is not part of clinical staging. Since the cancer is in situ, its origin is the cervix. Further testing is not required as the cancer has not spread beyond the cervix. Choice B is incorrect as the staging information provided does not relate to the resemblance of cancer cells to normal cells. Choice C is incorrect because further testing is not necessary as the cancer is localized. Choice D is incorrect because the staging information provided clearly indicates the site of origin as the cervix.

3. A client with a diagnosis of rheumatoid arthritis is experiencing severe pain. Which medication is likely to be prescribed?

• A. Acetaminophen (Tylenol)
• B. Ibuprofen (Advil)
• C. Methotrexate (Rheumatrex)
• D. Prednisone (Deltasone)

Correct answer: C

Rationale: Methotrexate is commonly prescribed for rheumatoid arthritis to reduce inflammation and slow disease progression. It is a disease-modifying antirheumatic drug (DMARD) that helps control symptoms and prevent joint damage in individuals with rheumatoid arthritis. While acetaminophen and ibuprofen are used for pain relief, they are not typically prescribed to address the underlying inflammation and disease progression associated with rheumatoid arthritis. Prednisone may be used for short-term symptom relief or during disease flares, but it is not a first-line treatment for rheumatoid arthritis.

4. In a patient with a history of chronic iron deficiency anemia requiring a recent blood transfusion and an extensive GI work-up, which statement is true based on their medications?

• A. A dedicated small bowel series has a high likelihood of being positive
• B. 81 mg of aspirin per day decreases the benefit of using a COX II inhibitor
• C. The patient should have a provocative arteriogram with heparin infusion to identify the source of blood loss
• D. Hormonal therapy has been shown to be effective in decreasing blood loss due to arteriovenous malformations

Correct answer: B

Rationale: The correct answer is B. Taking even a low dose of aspirin per day, such as 81 mg, can reduce the protective effect on the gastrointestinal mucosa that is gained from using a COX II selective inhibitor. Aspirin can increase the risk of gastrointestinal bleeding, which can counteract the benefits of COX II inhibitors in protecting the stomach lining.

5. A client who has been receiving treatment for depression with a selective serotonin reuptake inhibitor (SSRI) reports experiencing decreased libido. What is the best response by the nurse?

• A. Decreased libido is a common side effect of SSRIs and may improve over time.
• B. I will notify your healthcare provider to discuss possible medication changes.
• C. You should take your medication with food to reduce side effects.
• D. Increase your daily exercise to help manage this side effect.

Correct answer: B

Rationale: When a client reports experiencing decreased libido while taking SSRIs, it is important for the nurse to notify the healthcare provider to discuss potential medication adjustments. This side effect can significantly impact a client's quality of life, and addressing it promptly by involving the healthcare provider is crucial in providing holistic care. Choices A, C, and D do not directly address the issue of decreased libido caused by SSRIs. Simply waiting for improvement over time, altering the administration of medication with food, or increasing exercise are not appropriate strategies for managing this specific side effect.

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