Nursing Elites

1. If the client's dorsal columns are not functioning, the nurse will observe which response during neuro testing, where the nurse asks the client to close his eyes and then proceeds to touch corresponding parts of the body on each side simultaneously with two sharp points?

• A. The client will not be able to distinguish between the two points.
• B. The client will feel only one point of contact.
• C. The client will accurately identify both points.
• D. The client will report no sensation in the touched areas.

Correct answer: A

Rationale: If the client's dorsal columns are not functioning, the ability to distinguish between two closely spaced points is impaired. This results in the client not being able to differentiate between the two points when touched simultaneously. Choice B is incorrect because the client feeling only one point suggests an intact dorsal column function. Choice C is incorrect as accurately identifying both points indicates normal discrimination ability. Choice D is incorrect as reporting no sensation does not correspond to the specific impairment related to dorsal column dysfunction.

2. Pain in the lower extremities due to peripheral artery disease usually worsens:

• A. with rest because blood flow increases.
• B. with elevation of the extremity because blood is diverted away.
• C. when the leg is in a dependent position because blood pools.
• D. when the leg is touched or massaged because cytokines are released.

Correct answer: B

Rationale: In peripheral artery disease, pain in the lower extremities worsens with the elevation of the extremity because it diverts blood flow away from the affected area, exacerbating the pain. Choices A, C, and D are incorrect. Resting doesn't increase blood flow, a dependent position doesn't lead to blood pooling in this context, and pain worsening due to touch or massage is not a typical feature of peripheral artery disease.

3. A nurse is teaching a young adult patient about oral contraceptives, which the patient will soon begin taking. The patient's primary concern is the effectiveness of the medication in preventing pregnancy. The nurse should teach the patient that oral contraceptives, when taken consistently, are how effective in preventing pregnancy?

• A. Between 96% and 98%
• B. Approximately 98.5%
• C. Highly effective, but partially dependent on genetic factors
• D. Nearly 100%

Correct answer: D

Rationale: When taken correctly, estrogen–progestin contraceptive preparations are nearly 100% effective in preventing pregnancy. Choices A, B, and C are incorrect. Choice A suggests a range below the actual effectiveness, choice B provides a specific percentage that is not accurate, and choice C introduces the concept of genetic factors which is not relevant to the effectiveness of oral contraceptives.

4. A patient is taking medroxyprogesterone acetate (Provera) for the treatment of endometriosis. What should the nurse teach the patient about this medication?

• A. Medroxyprogesterone should be taken with food to prevent nausea.
• B. Medroxyprogesterone should be taken at the same time each day to maintain consistent hormone levels.
• C. Medroxyprogesterone can be taken intermittently when symptoms worsen.
• D. Medroxyprogesterone should be stopped if side effects occur.

Correct answer: B

Rationale: The correct answer is B. Medroxyprogesterone should be taken at the same time each day to maintain consistent hormone levels and effectiveness. Choice A is incorrect because medroxyprogesterone does not necessarily need to be taken with food. Choice C is incorrect as it is typically prescribed continuously rather than intermittently. Choice D is incorrect because patients should not stop the medication if side effects occur without consulting their healthcare provider.

5. 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.

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