Nursing Elites

1. In a postmenopausal woman, what condition can be prevented by administering estradiol (Estraderm)?

• A. Endometriosis
• B. Amenorrhea
• C. Osteoporosis
• D. Uterine cancer

Correct answer: C

Rationale: The correct answer is C: Osteoporosis. Estradiol, a form of estrogen, is used to prevent osteoporosis in postmenopausal women by maintaining bone density. Choice A, Endometriosis, is incorrect as estradiol is not used to prevent or treat this condition. Choice B, Amenorrhea, is not prevented by estradiol but rather may result from hormonal changes. Choice D, Uterine cancer, is not directly prevented by estradiol; in fact, long-term unopposed estrogen use can increase the risk of uterine cancer.

2. A patient was sneezing frequently after a few days of allergic rhinitis, and she noticed her eye became red. She denies any trauma, eye pain, or visual disturbance. Physical examination reveals a subconjunctival hemorrhage. Which statement is accurate pertaining to this case?

• A. The hemorrhage will resolve without treatment within 2 weeks.
• B. The patient should be referred for immediate ophthalmologic examination.
• C. Corticosteroid eye drops will be prescribed to reduce the bleeding.
• D. Antibiotic eye drops will be prescribed to prevent infection.

Correct answer: A

Rationale: The correct answer is A: 'The hemorrhage will resolve without treatment within 2 weeks.' Subconjunctival hemorrhage typically resolves on its own without treatment. It is a self-limiting condition that does not require specific intervention. Choice B is incorrect as immediate ophthalmologic examination is not necessary for subconjunctival hemorrhage unless there are other concerning symptoms or risk factors present. Choice C is incorrect because corticosteroid eye drops are not typically used for subconjunctival hemorrhage. Choice D is also incorrect as antibiotic eye drops are not indicated since subconjunctival hemorrhage is not due to an infection.

3. The parents of a 3-year-old boy have brought him to a pediatrician for assessment of the boy's late ambulation and frequent falls. Subsequent muscle biopsy has confirmed a diagnosis of Duchenne muscular dystrophy. Which teaching point should the physician include when explaining the child's diagnosis to his parents?

• A. Your child may develop breathing difficulties as the disease progresses.
• B. Your child is likely to benefit from physical therapy and exercise.
• C. This condition can be cured with early intervention and treatment.
• D. The disease is caused by inflammation in the muscles, which leads to weakness.

Correct answer: A

Rationale: The correct teaching point that the physician should include when explaining Duchenne muscular dystrophy to the parents is that 'Your child may develop breathing difficulties as the disease progresses.' Duchenne muscular dystrophy is a progressive condition that affects muscle strength, including respiratory muscles, leading to breathing difficulties as the disease advances. Choice B is incorrect because while physical therapy and exercise can help maintain muscle function and mobility, they do not cure the condition. Choice C is incorrect because Duchenne muscular dystrophy is a genetic disorder with no known cure. Choice D is incorrect as Duchenne muscular dystrophy is primarily characterized by a lack of dystrophin protein due to genetic mutations, not inflammation in the muscles.

4. A patient is administered a nucleotide reverse transcriptase inhibitor in combination with a nonnucleotide reverse transcriptase inhibitor. What is the main rationale for administering these medications together?

• A. They improve treatment adherence.
• B. They reduce the duration of illness.
• C. They exhibit synergistic antiviral effects.
• D. They prevent opportunistic infections.

Correct answer: C

Rationale: The main rationale for administering a nucleotide reverse transcriptase inhibitor in combination with a nonnucleotide reverse transcriptase inhibitor is that they exhibit synergistic antiviral effects when used together. This combination enhances their antiviral activity against HIV by targeting different steps in the viral replication cycle. Choice A is incorrect because the rationale for combining these medications is based on their antiviral effects, not treatment adherence. Choice B is incorrect because the primary purpose of combination therapy is not to reduce the duration of illness but to improve treatment efficacy. Choice D is incorrect as the main focus of this combination is not on preventing opportunistic infections but on directly targeting the HIV virus.

5. A 5-month-old child is admitted to the hospital with recurring respiratory infections. A possible cause of this condition is:

• A. Hypergammaglobulinemia
• B. Increased maternal IgG
• C. Immune insufficiency
• D. Decreased maternal antibody breakdown, resulting in hyposensitivity

Correct answer: C

Rationale: Immune insufficiency is a possible cause of recurring respiratory infections in a 5-month-old child. In this scenario, the child's immune system may not be functioning optimally, leading to a susceptibility to infections. Choices A, B, and D are incorrect. Hypergammaglobulinemia refers to high levels of gamma globulins in the blood and is not typically associated with recurring respiratory infections in this context. Increased maternal IgG would provide passive immunity to the child, offering some protection against infections. Decreased maternal antibody breakdown leading to hyposensitivity is not a common cause of recurring respiratory infections in a 5-month-old child.

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