Nursing Elites

1. How will taking an oral contraceptive affect the physiologically of an insulin-dependent diabetic patient?

• A. Increase risk of hypoglycemia
• B. Increase heart rate
• C. Increase blood glucose
• D. Increase risk of metabolic alkalosis

Correct answer: C

Rationale: Taking an oral contraceptive can lead to an increase in blood glucose levels in insulin-dependent diabetic patients. This occurs due to the hormonal changes induced by the contraceptive, which can impact insulin sensitivity. Therefore, diabetic patients need to closely monitor their blood glucose levels when starting an oral contraceptive to prevent complications. The other choices are incorrect as oral contraceptives do not typically lead to an increase in heart rate, risk of hypoglycemia, or risk of metabolic alkalosis in this context.

2. A client is brought to the emergency department after a motor vehicle accident in which she suffered a spinal cord injury at the level of C5. Which of the following assessments should be the priority?

• A. Monitoring urinary output
• B. Monitoring heart rate and rhythm
• C. Monitoring respiratory rate
• D. Monitoring the client's pain levels

Correct answer: B

Rationale: The correct answer is monitoring heart rate and rhythm. With a C5 spinal cord injury, monitoring heart rate and rhythm is crucial as it can impact autonomic regulation. This level of injury can affect cardiac function due to the disruption of sympathetic nerve fibers. Monitoring urinary output may be important to assess for urinary retention, but it is not the priority in this scenario. While monitoring respiratory rate is essential in all patients, in this case, cardiovascular stability takes precedence. Pain management is important but is not the priority when assessing a client with a C5 spinal cord injury.

3. A patient is prescribed estradiol (Estrace) for hormone replacement therapy (HRT). What should the nurse monitor during this therapy?

• A. Blood glucose levels
• B. Liver function tests
• C. Kidney function tests
• D. Blood pressure

Correct answer: B

Rationale: During estradiol therapy, monitoring liver function tests is essential due to the potential for liver dysfunction. Estradiol can affect liver function, making it crucial to monitor enzyme levels. Choice A, blood glucose levels, is not directly impacted by estradiol therapy, making it an incorrect choice. Choice C, kidney function tests, is not typically affected by estradiol therapy, so it is not the priority for monitoring. Choice D, blood pressure, is also not the primary parameter to monitor during estradiol therapy unless there are pre-existing conditions that warrant such monitoring.

4. Which of the following is not an autoimmune disease?

• A. Multiple sclerosis
• B. Pernicious anemia
• C. Goodpasture syndrome
• D. Transfusion reaction

Correct answer: D

Rationale: The correct answer is D, Transfusion reaction. Transfusion reaction is not an autoimmune disease because it occurs when the immune system responds to foreign blood cells, not to the body's own cells. Choices A, B, and C (Multiple sclerosis, Pernicious anemia, Goodpasture syndrome) are autoimmune diseases where the immune system mistakenly attacks the body's own tissues or organs.

5. A patient who is being administered isoniazid (INH) for tuberculosis has a yellow color in the sclera of her eye. What other finding would lead you to believe that hepatotoxicity has developed?

• A. Diarrhea
• B. Numbness
• C. Diminished vision
• D. Light-colored stools

Correct answer: A

Rationale: The correct answer is A: Diarrhea. Hepatotoxicity caused by isoniazid can present with various symptoms, including yellow discoloration of the sclera of the eyes, which indicates jaundice. Another common sign of hepatotoxicity is gastrointestinal symptoms such as nausea, vomiting, and diarrhea, which can occur due to liver dysfunction affecting bile production and digestion. Numbness (choice B) is more commonly associated with peripheral neuropathy caused by isoniazid, while diminished vision (choice C) and light-colored stools (choice D) are not typical manifestations of hepatotoxicity.

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