Nursing Elites

1. What causes atherosclerotic plaques to form initially?

• A. Interruption of blood flow to the brain
• B. Injury to the coronary artery endothelium
• C. Administration of statin medications
• D. Poor dietary modifications

Correct answer: B

Rationale: Atherosclerotic plaques form initially due to injury to the coronary artery endothelium, which triggers a cascade of events leading to plaque buildup. Choice A is incorrect because atherosclerotic plaques do not form due to an interruption of blood flow to the brain. Choice C is incorrect as statin medications are actually used to help lower cholesterol and reduce the risk of plaque formation. Choice D is incorrect as poor dietary modifications can contribute to atherosclerosis but are not the initial cause of plaque formation.

2. A patient has been prescribed raloxifene (Evista) for the prevention of osteoporosis. What effect should the nurse include in the teaching plan regarding the action of this medication?

• A. Decreases calcium excretion by the kidneys.
• B. Increases intestinal absorption of calcium.
• C. Stimulates bone formation by increasing osteoblast activity.
• D. Selectively binds to estrogen receptors, decreasing bone resorption.

Correct answer: D

Rationale: The correct answer is D: Selectively binds to estrogen receptors, decreasing bone resorption. Raloxifene is a selective estrogen receptor modulator (SERM) that works by binding to estrogen receptors, thereby decreasing bone resorption. This action helps in the prevention and treatment of osteoporosis by preserving bone density. Choices A, B, and C are incorrect because raloxifene does not directly affect calcium excretion by the kidneys, intestinal absorption of calcium, or stimulate bone formation by increasing osteoblast activity.

3. A nurse is providing education to a patient starting hormone replacement therapy (HRT) for menopausal symptoms. What should the nurse emphasize regarding the long-term risks associated with HRT?

• A. HRT may increase the risk of cardiovascular events, including heart attack and stroke.
• B. HRT may decrease the risk of osteoporosis.
• C. HRT may improve mood and energy levels.
• D. HRT may decrease the risk of breast cancer.

Correct answer: A

Rationale: HRT is associated with an increased risk of cardiovascular events, including heart attack and stroke, particularly with long-term use.

4. During a well-child checkup, a mother tells Nurse Rio about a recent situation in which her child needed to be disciplined by her husband. The child was slapped in the face for not getting her husband breakfast on Saturday, despite being told on Thursday never to prepare food for him. Nurse Rio analyzes the family system and concludes it is dysfunctional. All of the following factors contribute to this dysfunction except:

• A. Conflictual relationships between parents.
• B. Inconsistent communication patterns.
• C. Rigid, authoritarian roles.
• D. Use of violence to establish control.

Correct answer: C

Rationale: In a dysfunctional family system, conflictual relationships, inconsistent communication patterns, and the use of violence to establish control are factors contributing to dysfunction. However, rigid, authoritarian roles, though also dysfunctional, are not directly linked to the use of violence for control.

5. In which patient is alpha-1 antitrypsin deficiency the likely cause of chronic obstructive pulmonary disease?

• A. A 30-year-old who has smoked for 3 years
• B. A 65-year-old man who worked as a taxi driver most of his life
• C. A 70-year-old woman who smoked for 40 years
• D. A 50-year-old with exposure to secondhand smoke

Correct answer: A

Rationale: The correct answer is A. Alpha-1 antitrypsin deficiency is a genetic condition that can lead to COPD at a young age, even in light smokers. Choice B is less likely as the patient's occupation does not directly correlate with alpha-1 antitrypsin deficiency. Choice C, a 70-year-old woman with a long smoking history, is more likely to have COPD due to smoking rather than alpha-1 antitrypsin deficiency. Choice D, exposure to secondhand smoke, is not a common cause of alpha-1 antitrypsin deficiency-related COPD.

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