Nursing Elites

1. A patient with breast cancer is prescribed tamoxifen (Nolvadex). What critical information should the nurse provide during patient education?

• A. Tamoxifen may increase the risk of venous thromboembolism, so patients should be educated about the signs and symptoms of blood clots.
• B. Tamoxifen may decrease the risk of osteoporosis, so adequate calcium intake is important.
• C. Tamoxifen may cause weight gain, so patients should monitor their diet.
• D. Tamoxifen may increase the risk of breast cancer, so regular mammograms are essential.

Correct answer: A

Rationale: When a patient is prescribed tamoxifen, a critical piece of information that the nurse should provide during patient education is that tamoxifen may increase the risk of venous thromboembolism. Therefore, patients should be educated about the signs and symptoms of blood clots and advised to seek immediate medical attention if they occur. Choice B is incorrect because tamoxifen does not decrease the risk of osteoporosis. Choice C is incorrect as weight gain is a possible side effect of tamoxifen, but it is not a critical piece of information compared to the risk of venous thromboembolism. Choice D is incorrect because tamoxifen is actually used to treat breast cancer, not increase its risk.

2. A 21-year-old female was recently diagnosed with iron deficiency anemia. In addition to fatigue and weakness, which of the following clinical signs and symptoms would she most likely exhibit?

• A. Hyperactivity
• B. Spoon-shaped nails
• C. Gait problems
• D. Petechiae

Correct answer: B

Rationale: The correct answer is B: Spoon-shaped nails. In iron deficiency anemia, spoon-shaped nails (koilonychia) are a common symptom due to changes in the nail bed. This condition is known as Plummer-Vinson syndrome. While fatigue and weakness are common in iron deficiency anemia, hyperactivity (choice A) is not typically associated with this condition. Gait problems (choice C) and petechiae (choice D) are more commonly seen in other medical conditions and are not characteristic of iron deficiency anemia.

3. Which of the following is a cause of hypothyroidism?

• A. Overproduction of cortisol
• B. Autoimmune destruction of the thyroid gland
• C. Overactivity of the thyroid gland
• D. Insufficient iodine intake

Correct answer: B

Rationale: The correct answer is B: Autoimmune destruction of the thyroid gland. In hypothyroidism, the thyroid gland does not produce enough hormones to meet the body's needs. This can be due to autoimmune destruction of the thyroid gland, where the body's immune system mistakenly attacks the thyroid tissue. Choices A, C, and D are incorrect. Overproduction of cortisol is associated with conditions like Cushing's syndrome, overactivity of the thyroid gland is a characteristic of hyperthyroidism, and insufficient iodine intake can lead to goiter but not necessarily hypothyroidism.

4. Which of the following factors are known to contribute to an individual's ability to adapt to stress? (Select ONE that does not apply.)

• A. Ethnicity
• B. Age
• C. Socioeconomic status
• D. Gender

Correct answer: A

Rationale: The correct factors that contribute to an individual's ability to adapt to stress are age, socioeconomic status, and gender. Age can influence coping mechanisms and resilience. Socioeconomic status can impact access to resources and support systems. Gender differences can also play a role in how individuals experience and manage stress. Ethnicity, while important in other contexts, is not directly mentioned in the provided rationale and is not one of the factors listed as contributing to an individual's ability to adapt to stress.

5. A 25-year-old just had a colonoscopy and was diagnosed with Crohn disease. Which of the following is consistent with this diagnosis?

• A. Right lower quadrant cramping
• B. Severe bloody diarrhea
• C. Nausea and vomiting
• D. Mostly affects the rectum

Correct answer: A

Rationale: Crohn's disease is a type of inflammatory bowel disease that can affect any part of the digestive tract. Right lower quadrant cramping is consistent with Crohn's disease as it commonly involves the terminal ileum, which is located in the right lower quadrant of the abdomen. Severe bloody diarrhea is more characteristic of ulcerative colitis, another type of inflammatory bowel disease. Nausea and vomiting are not specific symptoms of Crohn's disease. Crohn's disease can affect any part of the digestive tract, not just the rectum, so it is not accurate to say it mostly affects the rectum.

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