Nursing Elites

1. What is a critical point the nurse should include in patient education for a patient prescribed tamoxifen (Nolvadex)?

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

Correct answer: A

Rationale: The critical point the nurse should include in patient education for a patient prescribed tamoxifen is that it may increase the risk of venous thromboembolism. This is crucial information because tamoxifen is known to promote blood clot formation, and patients need to be aware of the signs and symptoms of blood clots to seek prompt medical attention. Choices B, C, and D are incorrect as tamoxifen is not associated with decreasing the risk of osteoporosis, causing hot flashes and other menopausal symptoms, or directly causing weight gain and fluid retention.

2. Which of the following imbalances is found in clients with syndrome of inappropriate antidiuretic hormone (SIADH)?

• A. Decreased insulin production
• B. Decreased antidiuretic hormone (ADH) production
• C. Increased secretion of antidiuretic hormone (ADH)
• D. Increased production of insulin

Correct answer: C

Rationale: The correct answer is C: Increased secretion of antidiuretic hormone (ADH). Syndrome of inappropriate antidiuretic hormone (SIADH) is characterized by the excessive release of ADH, which leads to water retention and dilution of blood sodium levels. Choices A, B, and D are incorrect because SIADH is not associated with decreased insulin production, decreased ADH production, or increased production of insulin.

3. 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.

4. A patient suffers from dysmenorrhea. Which oral medication will be prescribed that has the ability to provide physiological actions on the neuroendocrine control of ovarian function?

• A. Estrogen
• B. Progestins
• C. Naproxen
• D. Ibuprofen

Correct answer: B

Rationale: Progestins are prescribed for dysmenorrhea as they help reduce menstrual pain by inhibiting ovulation and decreasing the production of prostaglandins. Estrogen (Choice A) is not typically used alone in dysmenorrhea treatment as it can worsen symptoms. Naproxen (Choice C) and Ibuprofen (Choice D) are nonsteroidal anti-inflammatory drugs (NSAIDs) commonly used to relieve pain associated with dysmenorrhea, but they do not directly affect the neuroendocrine control of ovarian function like progestins do.

5. A patient is prescribed sildenafil (Viagra) for erectile dysfunction. What is a key contraindication that the nurse should review with the patient?

• A. History of hypertension
• B. Use of nitrates
• C. Use of antihypertensive medications
• D. History of peptic ulcer disease

Correct answer: B

Rationale: The correct answer is B: 'Use of nitrates.' Sildenafil (Viagra) is contraindicated in patients taking nitrates due to the risk of severe hypotension. Nitrates and sildenafil both act as vasodilators, and their combined use can lead to a dangerous drop in blood pressure. Choices A, C, and D are incorrect because having a history of hypertension, using antihypertensive medications, or having a history of peptic ulcer disease are not key contraindications for sildenafil use.

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