Nursing Elites

1. In osteoporosis, what is the expected therapeutic action of raloxifene (Evista)?

• A. It decreases bone resorption and increases bone density.
• B. It stimulates the formation of new bone.
• C. It increases calcium absorption in the intestines.
• D. It decreases the excretion of calcium through the kidneys.

Correct answer: A

Rationale: The correct answer is A. Raloxifene works by decreasing bone resorption and increasing bone density. This helps in strengthening bones, reducing the risk of fractures, and improving bone health in patients with osteoporosis. Choice B is incorrect because raloxifene does not directly stimulate the formation of new bone but rather prevents bone loss. Choice C is incorrect as raloxifene does not primarily affect calcium absorption in the intestines. Choice D is also incorrect as raloxifene does not primarily decrease the excretion of calcium through the kidneys.

2. A male patient receiving androgen therapy is concerned about the risk of prostate cancer. What should the nurse explain regarding this risk?

• A. Finasteride has been shown to lower the risk of developing prostate cancer.
• B. Finasteride does not affect the risk of prostate cancer.
• C. Finasteride may increase the risk of developing prostate cancer, so regular screenings are recommended.
• D. Finasteride has no effect on the risk of prostate cancer, so regular screenings are unnecessary.

Correct answer: A

Rationale: The correct answer is A. Finasteride has been shown to lower the risk of developing prostate cancer. However, regular screenings are still recommended to monitor for any potential issues. Choice B is incorrect because finasteride has been associated with a reduced risk of developing prostate cancer. Choice C is incorrect as finasteride is not known to increase the risk of prostate cancer; in fact, it has shown a protective effect. Choice D is incorrect because while finasteride may lower the risk of prostate cancer, regular screenings are still necessary to ensure early detection and treatment if needed.

3. While assessing a critically ill client in the emergency department, the nurse notes on the cardiac monitor an R-on-T premature ventricular beat that develops into ventricular tachycardia (VT). Immediately, the client became unresponsive. The nurse knows that based on pathophysiologic principles, the most likely cause of the unresponsiveness is:

• A. metabolic acidosis that occurs spontaneously following any dysrhythmias.
• B. interruption of the blood/oxygen supply to the brain.
• C. massive cerebrovascular accident (CVA) resulting from increased perfusion.
• D. a blood clot coming from the heart and occluding the carotid arteries.

Correct answer: B

Rationale: The correct answer is B. Ventricular tachycardia (VT) can disrupt the normal heart function, leading to a decreased cardiac output. This decreased output can interrupt the blood supply to the brain, causing the client to become unresponsive. Metabolic acidosis (Choice A) is not the most likely cause of unresponsiveness in this scenario. A massive cerebrovascular accident (CVA) (Choice C) would not result from increased perfusion. A blood clot occluding the carotid arteries (Choice D) may lead to a stroke but is not the most likely cause of sudden unresponsiveness in this situation.

4. What tool is used to determine a client’s level of consciousness?

• A. Magnetic resonance imaging (MRI)
• B. Glasgow Coma Scale (GCS)
• C. Central perfusion pressure (CPP)
• D. Intracranial pressure (ICP) monitoring

Correct answer: B

Rationale: The correct answer is B: Glasgow Coma Scale (GCS). The Glasgow Coma Scale is specifically designed to assess a client's level of consciousness by evaluating verbal, motor, and eye-opening responses. Choice A, Magnetic Resonance Imaging (MRI), is a diagnostic imaging tool that provides detailed images of the body's organs and tissues but is not used to assess consciousness levels. Choice C, Central Perfusion Pressure (CPP), and Choice D, Intracranial Pressure (ICP) monitoring, are related to hemodynamic monitoring and intracranial pressure management, not direct assessment of consciousness.

5. A 10-year-old male presents to his primary care provider reporting wheezing and difficulty breathing. History reveals that both of the child's parents suffer from allergies. Which of the following terms would be used to classify the child?

• A. Desensitized
• B. Atopic
• C. Hyperactive
• D. Autoimmune

Correct answer: B

Rationale: In this case, the correct term to classify the child is 'Atopic.' Atopic individuals have a genetic predisposition to developing allergic conditions, as seen in this patient with a family history of allergies. 'Desensitized' refers to reduced sensitivity to an allergen, which is not the case here. 'Hyperactive' relates to an exaggerated response, and 'Autoimmune' involves the immune system attacking its own cells, neither of which accurately describes the child's classification based on the provided history.

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