Nursing Elites

1. A woman is being treated with clomiphene citrate for the treatment of infertility. She states to the nurse that she has seen an increase in vaginal discharge. The nurse knows that this effect is related to:

• A. Increased blood flow to the vaginal area.
• B. Increased cervical mucus production.
• C. Increased production of vaginal secretions.
• D. Increased lubrication in the vaginal canal.

Correct answer: C

Rationale: The correct answer is C: 'Increased production of vaginal secretions.' Clomiphene citrate affects cervical mucus production, leading to an increase in vaginal secretions. This effect is beneficial for fertility as it helps create a more hospitable environment for sperm transport. Choice A, 'Increased blood flow to the vaginal area,' is incorrect as the increase in vaginal discharge is primarily due to changes in cervical mucus. Choice B, 'Increased cervical mucus production,' is partially correct but does not fully explain the increase in vaginal secretions. Choice D, 'Increased lubrication in the vaginal canal,' is not directly related to the effect seen with clomiphene citrate treatment for infertility.

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. Which of the following women is at highest risk for the development of endometrial cancer?

• A. A 50-year-old postmenopausal woman with a history of high-risk human papillomavirus
• B. A 45-year-old woman who is obese and has a menstrual pattern consisting of periods of amenorrhea and infrequent periods
• C. A 40-year-old woman who is overweight and has hypertension
• D. A 55-year-old woman who smokes

Correct answer: B

Rationale: The correct answer is a 45-year-old woman who is obese and has a menstrual pattern consisting of periods of amenorrhea and infrequent periods. Obesity and prolonged exposure to estrogen unopposed by progesterone due to infrequent ovulation are significant risk factors for endometrial cancer. Choices A, C, and D do not directly correlate with the increased risk of endometrial cancer. Postmenopausal status alone (Choice A), overweight with hypertension (Choice C), and smoking (Choice D) are not the primary risk factors for endometrial cancer.

4. A 21-year-old male is being started on zidovudine (AZT) for the treatment of HIV/AIDS. Which of the following statements made by the patient indicates that he has understood the patient teaching?

• A. “AZT inactivates the virus and prevents recurrence of the disease.”
• B. “AZT therapy may result in the development of AZT-resistant strains.”
• C. “AZT slows the progression of the disease but does not cure it.”
• D. “AZT prevents the occurrence of opportunistic infections.”

Correct answer: C

Rationale: The correct answer is C. When the patient states, “AZT slows the progression of the disease but does not cure it,” it shows an understanding that zidovudine (AZT) does not provide a cure for HIV/AIDS but helps in slowing down the progression of the disease. Choice A is incorrect because AZT does not inactivate the virus or prevent recurrence. Choice B is incorrect as AZT resistance can develop with therapy. Choice D is incorrect because while AZT can help prevent opportunistic infections by boosting the immune system, its primary action is not the prevention of opportunistic infections.

5. A patient is being administered chemotherapeutic agents for the treatment of cancer. Which of the following blood cells will be stimulated by the colony-stimulating factors in response to the effects of the chemotherapy?

• A. White blood cells
• B. Red blood cells
• C. Phagocytes
• D. Myocardial cells

Correct answer: A

Rationale: The correct answer is White blood cells. Colony-stimulating factors stimulate the production of white blood cells in response to the effects of chemotherapy, as it can lead to myelosuppression. Red blood cells are not directly stimulated by colony-stimulating factors. Phagocytes are a type of white blood cell involved in immune responses, but they are not specifically stimulated by colony-stimulating factors. Myocardial cells are cardiac muscle cells and are not directly involved in the response to chemotherapy-induced myelosuppression.

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