Nursing Elites

1. Clomiphene is prescribed for a female client to treat infertility. The nurse is providing information to the client and her spouse about the medication and provides the couple with which information?

• A. If the oral tablets are not successful, the medication will be administered intravenously.
• B. The couple should engage in coitus at least every other day during treatment.
• C. The physician should be notified immediately if breast engorgement occurs.
• D. Multiple births occur in a small percentage of clomiphene-facilitated pregnancies.

Correct answer: D

Rationale: The correct answer is that multiple births (usually twins) occur in a small percentage (8% - 10%) of clomiphene-facilitated pregnancies. The couple should be informed about this potential outcome. Clomiphene is available in 50-mg tablets for oral use; there is no intravenous form of the medication. Breast engorgement is a common side effect of clomiphene that typically resolves after discontinuation of the medication. Ovulation usually happens 5 to 10 days after the last dose of clomiphene, and the couple is advised to engage in coitus at least every other day during this time. Therefore, choices A, B, and C are incorrect as they do not provide accurate information regarding clomiphene treatment for infertility.

2. When a person using over-the-counter nasal decongestant drops experiences unrelieved and worsening nasal congestion, what should be instructed?

• A. switch to a stronger dose of the same medication.
• B. discontinue the medication for a few weeks.
• C. continue taking the same medication, but use it more frequently.
• D. use a combination of medications for better relief.

Correct answer: B

Rationale: When a person using over-the-counter nasal decongestant drops experiences unrelieved and worsening nasal congestion, it is crucial to discontinue the medication for a few weeks. Prolonged use of decongestant drops can lead to rebound congestion, which is relieved by stopping the medication for a period of time. Nasal congestion occurs due to various factors like infection, inflammation, or allergy, leading to swelling of the nasal cavity. Nasal decongestants work by stimulating alpha-adrenergic receptors, causing vasoconstriction and shrinking of nasal mucous membranes. However, prolonged use can result in vasodilation, worsening nasal congestion. Switching to a stronger dose of the same medication is not recommended as it can exacerbate the issue. Continuing the same medication more frequently or using a combination of medications are also not advised and may lead to side effects. Educating individuals on proper decongestant use and potential risks of prolonged usage is essential, especially for those with specific health conditions.

3. The client is preparing to undergo a total hysterectomy for advanced cervical cancer. The client is crying and says that she wants to have more children and is unsure if she should have the procedure. What should the nurse do?

• A. Allow the client to honestly discuss her fears and encourage her to talk more with her physician.
• B. Tell her the good things that she will be able to do without more children and encourage her to make a list of positive things.
• C. Explain to the client that her ovaries can be frozen for egg harvesting at a later time and she can find a surrogate.
• D. Advise the client to put off having the surgery until she is sure that she wants to undergo the procedure and notify the surgeon of the decision.

Correct answer: A

Rationale: In this situation, the most appropriate action for the nurse is to allow the client to express her fears and concerns openly. By encouraging her to talk more with her physician, the nurse is promoting effective communication and ensuring that the client receives adequate information to make an informed decision. Option A is correct because it acknowledges the client's emotions and empowers her to seek clarification and support from her healthcare provider. Options B and C do not address the client's emotional needs or provide a solution to her concerns regarding fertility. Option D is not appropriate as it does not prioritize the client's emotional well-being and delays necessary medical treatment for advanced cervical cancer.

4. A female sex worker enters a clinic for treatment of a sexually transmitted disease. This disease is the most prevalent STD in the United States. The nurse can anticipate that the woman has which of the following?

• A. herpes
• B. chlamydia
• C. gonorrhea
• D. syphilis

Correct answer: B

Rationale: The question describes a female sex worker seeking treatment for the most prevalent sexually transmitted disease in the United States. Chlamydia is the correct answer as it is the most common STD in the country according to epidemiological studies. While herpes (choice A) is common, it is not the most prevalent. Gonorrhea (choice C) and syphilis (choice D) are less prevalent compared to chlamydia, making them incorrect choices.

5. When teaching bleeding precautions to a client with leukemia, the PN should include which of the following instructions?

• A. Use a soft toothbrush.
• B. Use dental floss daily.
• C. Hold pressure on any scrapes for 1-2 minutes.
• D. Use a triple-edged razor.

Correct answer: A

Rationale: The correct answer is to 'Use a soft toothbrush.' A soft toothbrush is recommended because it is less likely to cause the gums to bleed in clients with leukemia, who are at risk of bleeding due to overcrowding of white cells at the expense of other cell types like platelets. Choice B, 'Use dental floss daily,' is incorrect because dental floss is contraindicated and can make the gums bleed in clients with leukemia. Choice C, 'Hold pressure on any scrapes for 1-2 minutes,' is incorrect because when clotting is impaired, pressure should be held for 5-10 minutes or longer until the bleeding stops. Choice D, 'Use a triple-edged razor,' is incorrect because an electric razor should be used instead of a triple-edged razor to prevent small cuts and bleeding in clients with leukemia.

Similar Questions