Nursing Elites

1. A patient with endometriosis is prescribed medroxyprogesterone acetate (Provera). What should the nurse include in the patient education?

• A. Medroxyprogesterone should be taken at the same time each day to maintain consistent hormone levels.
• B. Medroxyprogesterone can be taken with food to reduce gastrointestinal upset.
• C. Medroxyprogesterone should be discontinued if side effects occur.
• D. Medroxyprogesterone should be taken once a week to maintain effectiveness.

Correct answer: A

Rationale: When educating a patient with endometriosis who is prescribed medroxyprogesterone acetate (Provera), the nurse should emphasize the importance of taking the medication at the same time each day. This helps maintain consistent hormone levels and ensures the effectiveness of the treatment. Option A is correct. Option B is incorrect because medroxyprogesterone should be taken consistently, regardless of food intake. Option C is incorrect because discontinuing the medication without consulting a healthcare provider can be harmful. Option D is incorrect because medroxyprogesterone is typically taken daily, not weekly, for the treatment of endometriosis.

2. What best describes sepsis?

• A. An overwhelming allergic reaction
• B. Severe inflammatory response to a pathogen's endotoxins
• C. Unknown causes resulting in hypertension
• D. Poor nursing and health care provider interventions

Correct answer: B

Rationale: The correct answer is B. Sepsis is a severe inflammatory response to a pathogen's endotoxins, leading to widespread infection and organ dysfunction. Choice A is incorrect as sepsis is not primarily an allergic reaction. Choice C is incorrect as sepsis is not characterized by unknown causes resulting in hypertension. Choice D is incorrect as sepsis is a medical condition and not solely caused by poor nursing or healthcare provider interventions.

3. Staff at the care facility note that a woman has started complaining of back pain in recent weeks and occasionally groans in pain. She has many comorbidities that require several prescription medications. The nurse knows that which factor is likely to complicate the clinician's assessment and treatment of the client's pain?

• A. Her advanced age may influence the expression and perception of pain.
• B. Her polypharmacy may complicate the pain management process.
• C. Her underlying conditions may mask or exacerbate the pain.
• D. Her cognitive function may decline, making pain assessment difficult.

Correct answer: B

Rationale: Polypharmacy, or the use of multiple medications, can complicate pain management due to drug interactions and side effects. While advanced age can influence pain perception, it is not the most likely factor to complicate assessment and treatment in this scenario. Underlying conditions may affect pain perception but do not directly complicate the management process. Cognitive decline can hinder pain assessment, but in this case, the focus is on factors directly impacting the treatment process, making option B the most appropriate choice.

4. After teaching the students about B cells, which statement indicates teaching was successful? B cells are originally derived from cells of the:

• A. Bone marrow
• B. Lymph nodes
• C. Gut-associated lymphoid tissue
• D. Thymus

Correct answer: A

Rationale: The correct answer is A: Bone marrow. B cells are originally derived from cells of the bone marrow. Bone marrow is the primary site where B cells develop and mature. Lymph nodes (choice B), gut-associated lymphoid tissue (choice C), and the thymus (choice D) are involved in the immune response but are not the primary site of origin for B cells.

5. The unique clinical presentation of a 3-month-old infant in the emergency department leads the care team to suspect botulism. Which assessment question posed to the parents is likely to be most useful in the differential diagnosis?

• A. Has your child received all recommended vaccinations?
• B. Has your child been feeding poorly or showing signs of constipation?
• C. Has your child been exposed to any sick individuals?
• D. Has your child been displaying signs of respiratory distress?

Correct answer: B

Rationale: The correct answer is B. Poor feeding and constipation are common early symptoms of infant botulism, which is caused by a neurotoxin that impairs muscle function. Option A is unrelated to the presentation of botulism. Option C does not directly relate to the symptoms of botulism. Option D is more indicative of respiratory issues rather than the constellation of symptoms seen in botulism.

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