Nursing Elites

1. During patient teaching, a young woman asks the nurse the following question: 'If I get pregnant on the 'pill,' should I continue to take it?' What is the nurse's best response?

• A. The pill has no effect on pregnancy.
• B. The pill will cause miscarriage.
• C. This is a personal choice for each woman.
• D. The pill can be harmful to the fetus and should be discontinued.

Correct answer: C

Rationale: The correct answer is 'C: This is a personal choice for each woman.' If a woman becomes pregnant while taking birth control pills, it is generally recommended to discontinue them as they can potentially harm the fetus. However, the decision to continue or discontinue the pill in case of pregnancy is ultimately a personal choice for each woman. Choice A is incorrect because birth control pills are meant to prevent pregnancy, but if a woman becomes pregnant while taking them, the situation changes. Choice B is incorrect because birth control pills do not cause miscarriage; they are intended to prevent pregnancy. Choice D is incorrect because while it is generally advised to discontinue the pill if pregnancy occurs, the decision ultimately depends on the individual circumstances and preferences of the woman.

2. In discussing sex hormone production with the patient, the nurse should describe that testosterone is normally secreted in response to

• A. sexual arousal.
• B. stimulation by luteinizing hormone.
• C. ACTH release by the adrenal cortex.
• D. decreased cortisol levels.

Correct answer: B

Rationale: Testosterone production is regulated by the hypothalamic-pituitary-gonadal axis. Luteinizing hormone (LH) stimulates the Leydig cells in the testes to produce testosterone. Therefore, the correct answer is B. Choice A, 'sexual arousal,' is incorrect because testosterone secretion is not directly linked to arousal but rather to hormonal stimulation. Choice C, 'ACTH release by the adrenal cortex,' is incorrect as testosterone production is not primarily regulated by adrenocorticotropic hormone (ACTH). Choice D, 'decreased cortisol levels,' is also incorrect as cortisol and testosterone are regulated by separate endocrine pathways.

3. During an acute asthma exacerbation, what is the priority nursing intervention for a client with asthma?

• A. Administer corticosteroids to reduce airway inflammation.
• B. Position the client in high-Fowler's position.
• C. Administer short-acting beta-agonists (SABAs) as prescribed.
• D. Obtain a peak flow reading to assess the severity of the exacerbation.

Correct answer: C

Rationale: The priority nursing intervention during an acute asthma exacerbation is to administer short-acting beta-agonists (SABAs) as prescribed. SABAs help in quickly relieving bronchospasm and are considered the first-line treatment for acute exacerbations. Administering corticosteroids, positioning the client, and obtaining a peak flow reading are important interventions but come after administering SABAs in the management of acute asthma exacerbation.

4. A nurse working in a busy orthopedic clinic is asked to perform the Tinel sign on a client having problems in her hand/wrist. In order to test Tinel sign, the nurse should give the client which direction?

• A. Stand tall, arms at your side, shut your eyes; place the tip of your index finger to your nose.
• B. Hold your wrist in complete flexion, keep it in this position for 60 seconds. How does your hand feel after placing it in a neutral position?
• C. I'm going to tap (percuss) over the median nerve in your wrist; tell me what sensation you feel while I am doing this. Does the sensation stay in the wrist or go anywhere else?
• D. I'm going to tap this tuning fork; place it on the side of your thumb, then tell me what you are feeling in your hand and wrist.

Correct answer: C

Rationale: The correct answer is C. The Tinel sign involves percussing over the median nerve in the wrist to test for carpal tunnel syndrome. Choice A is incorrect as it describes a different action unrelated to the Tinel sign. Choice B is also incorrect as it involves holding the wrist in flexion, which is not part of the Tinel sign assessment. Choice D is incorrect as it mentions using a tuning fork on the thumb, which is not the correct technique for assessing the Tinel sign.

5. When starting on oral contraceptives, what key point should the nurse emphasize about taking the medication consistently?

• A. Oral contraceptives should be taken at the same time each day to maintain stable hormone levels and prevent pregnancy.
• B. Oral contraceptives can be taken at any time of day, as long as the schedule is consistent.
• C. Oral contraceptives should be taken in the morning to avoid nighttime side effects.
• D. Oral contraceptives are effective immediately upon starting, regardless of timing.

Correct answer: A

Rationale: When starting on oral contraceptives, it is crucial to take them at the same time each day to maintain stable hormone levels and ensure their effectiveness in preventing pregnancy. Choice B is incorrect because consistency in timing is essential to maximize contraceptive efficacy. Choice C is incorrect as there is no evidence that taking oral contraceptives in the morning helps avoid nighttime side effects. Choice D is incorrect because oral contraceptives do not provide immediate effectiveness and require consistent use to prevent pregnancy.

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