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. A patient taking hormonal contraceptives will soon turn 35 years of age. She is moderately obese and has smoked for 15 years. Which of the following is most important?

• A. Begin an exercise regimen.
• B. Begin smoking cessation.
• C. Begin daily aspirin therapy.
• D. Begin taking a loop diuretic to aid weight loss.

Correct answer: B

Rationale: The most important action for a patient taking hormonal contraceptives, who is nearing 35 years of age, moderately obese, and has a history of smoking for 15 years, is to begin smoking cessation. Women over 35, especially smokers, are at an increased risk of blood clots and cardiovascular issues when using hormonal contraceptives. Smoking cessation is crucial to reduce this risk. Beginning an exercise regimen may be beneficial for overall health but is not as critical as stopping smoking in this scenario. Daily aspirin therapy or taking a loop diuretic are not indicated in this situation and may not address the primary risk associated with hormonal contraceptives and smoking.

3. A client diagnosed with Bell's palsy is receiving discharge teaching from a nurse. Which statement made by the client indicates an understanding of the condition?

• A. I should avoid moving my face excessively to prevent worsening of symptoms.
• B. This condition usually resolves on its own within a few weeks or months.
• C. Bell's palsy is caused by a stroke and requires immediate medical treatment.
• D. I will need to take antiviral medication for the rest of my life to manage this condition.

Correct answer: B

Rationale: The correct answer is B. Bell's palsy typically resolves on its own within a few weeks to months. Choice A is incorrect because gentle facial exercises are often encouraged to prevent muscle weakness. Choice C is incorrect as Bell's palsy is not caused by a stroke but by inflammation of the facial nerve. Choice D is incorrect as antiviral medication is usually given early in the diagnosis but not required for lifelong management.

4. What part of the heart is responsible for starting the electrical impulse to conduct a heart rhythm and contraction of the atria and ventricles?

• A. The Purkinje fibers in the ventricles
• B. The right & left bundle branches
• C. The atrioventricular node
• D. The sinoatrial node in the atrium

Correct answer: D

Rationale: The sinoatrial node (SA node) in the atrium is indeed responsible for initiating the electrical impulse that starts the heart's rhythm. The SA node is known as the heart's natural pacemaker. Choices A, B, and C are incorrect because while the Purkinje fibers, bundle branches, and atrioventricular node play crucial roles in the conduction of the electrical impulse throughout the heart, the SA node is specifically responsible for initiating this impulse.

5. After studying about fungi, which information indicates a correct understanding of fungi? Fungi causing deep or systemic infections:

• A. Are easily treated with penicillin
• B. Are extremely rare
• C. Never occur with other infections
• D. Are commonly opportunistic

Correct answer: D

Rationale: The correct answer is D: 'Are commonly opportunistic.' Fungi causing deep or systemic infections are commonly opportunistic, particularly in individuals with compromised immune systems. Choice A is incorrect because fungi infections are not easily treated with penicillin. Choice B is incorrect as deep or systemic fungal infections are not extremely rare. Choice C is incorrect as fungal infections can co-occur with other infections.

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