Nursing Elites

1. What critical point should the nurse include in patient education regarding tamoxifen (Nolvadex) for a patient with breast cancer?

• A. Tamoxifen may increase the risk of venous thromboembolism.
• B. Tamoxifen may cause hot flashes and other menopausal symptoms.
• C. Tamoxifen may cause weight gain and fluid retention.
• D. Tamoxifen may decrease the risk of osteoporosis.

Correct answer: A

Rationale: The correct answer is A. Tamoxifen increases the risk of venous thromboembolism. Patients should be educated about the signs and symptoms of blood clots, such as swelling, redness, and pain in the legs. Choices B, C, and D are incorrect because tamoxifen is not associated with causing hot flashes, weight gain, fluid retention, or decreasing the risk of osteoporosis.

2. A 70-year-old client presents with weakness and sensory loss in the right hand and foot. The client also exhibits speech difficulties. Which condition is the client most likely experiencing?

• A. Transient ischemic attack (TIA)
• B. Brain tumor
• C. Cerebral infarction
• D. Multiple sclerosis

Correct answer: C

Rationale: The correct answer is C: Cerebral infarction (stroke). In this case, the client's symptoms of weakness and sensory loss in the right hand and foot, along with speech difficulties, are indicative of a stroke. These symptoms are commonly seen in individuals experiencing a cerebral infarction, where a blockage in blood flow to the brain leads to neurological deficits. Choices A, B, and D are less likely as transient ischemic attacks (TIAs) typically have temporary symptoms with no permanent damage, brain tumors may present with a different set of symptoms depending on their location, and multiple sclerosis usually presents with a relapsing-remitting pattern of neurological symptoms rather than sudden onset unilateral deficits.

3. Which of the following stores electrolytes and acts as an electrolyte pool?

• A. Brain - Kidneys
• B. Bone - Nails
• C. Bone - Liver
• D. Liver - Pancreas

Correct answer: B

Rationale: Bones store electrolytes and act as a reservoir, maintaining a balance of essential minerals like calcium and phosphate. The correct pair in this context is 'Bone - Nails.' Choices A, C, and D are incorrect because the brain, kidneys, liver, and pancreas perform other functions in the body and are not primarily responsible for storing electrolytes.

4. A patient is being treated with finasteride (Proscar) for benign prostatic hyperplasia (BPH). What expected outcome should the nurse include in the patient teaching?

• A. The medication will cure BPH after treatment is complete.
• B. The effects of the medication may take several weeks or months to become noticeable.
• C. The medication may cause increased hair growth.
• D. The medication may decrease libido.

Correct answer: B

Rationale: The correct answer is B. Finasteride is used to reduce the size of the prostate gland in patients with BPH, leading to decreased urinary frequency and urgency over several weeks or months. Choice A is incorrect because finasteride does not cure BPH but helps manage symptoms. Choice C is incorrect as increased hair growth is associated with another medication called minoxidil, not finasteride. Choice D is incorrect since finasteride may cause a decrease in libido as a side effect.

5. A patient is being treated with raloxifene (Evista) for osteoporosis. What should the nurse teach the patient about this medication?

• A. It is used as a selective estrogen receptor modulator to prevent bone loss.
• B. It works by decreasing bone formation and increasing bone resorption.
• C. It should be taken with food to reduce gastrointestinal side effects.
• D. It may cause weight gain and fluid retention.

Correct answer: C

Rationale: The correct answer is C. Raloxifene is a selective estrogen receptor modulator (SERM) used to prevent bone loss. It should be taken with food to reduce gastrointestinal side effects, not on an empty stomach. Choices A and B are incorrect because raloxifene is indeed a SERM that prevents bone loss, but it does not directly work by increasing bone formation or decreasing bone resorption. Choice D is incorrect as weight gain and fluid retention are not common side effects of raloxifene.

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