Nursing Elites

1. Not realizing that its surface was hot, a woman has quickly withdrawn her hand from the surface of a bowl that she was removing from a microwave. Which phenomena has facilitated the rapid movement of her hand in response to the painful stimulus?

• A. Crossed-extensor reflex
• B. Flexor reflex
• C. Withdrawal reflex
• D. Stretch reflex

Correct answer: C

Rationale: The withdrawal reflex is a protective response that allows a person to quickly remove their hand from a painful stimulus.

2. A client with multiple sclerosis (MS) is frustrated by tremors associated with the disease. How should the nurse explain why these tremors occur? Due to the demyelination of neurons that occurs in MS:

• A. there is an imbalance in acetylcholine and dopamine, leading to tremors.
• B. there is a disruption in nerve impulse conduction, causing tremors.
• C. muscles are unable to receive impulses, resulting in tremors.
• D. the reflex arc is disrupted, leading to muscle tremors.

Correct answer: B

Rationale: In multiple sclerosis (MS), demyelination of neurons disrupts nerve impulse conduction. This disruption in nerve impulses can lead to tremors, explaining why the client experiences tremors in MS. Choice A is incorrect because tremors in MS are primarily due to nerve conduction issues, not an imbalance in acetylcholine and dopamine. Choice C is incorrect as it oversimplifies the process; the issue lies in nerve impulses, not the muscle's ability to receive them. Choice D is incorrect as the primary cause of tremors in MS is the disruption in nerve impulse conduction, not the reflex arc being disrupted.

3. A patient with breast cancer is prescribed tamoxifen (Nolvadex). What important information should the nurse provide during patient education?

• A. Tamoxifen may increase the risk of venous thromboembolism, so patients should be educated about the signs and symptoms of blood clots.
• B. Tamoxifen may cause weight gain, so patients should monitor their diet.
• C. Tamoxifen may decrease the risk of osteoporosis, so patients should ensure adequate calcium intake.
• D. Tamoxifen may increase the risk of breast cancer, so regular mammograms are essential.

Correct answer: A

Rationale: The correct answer is A. Tamoxifen increases the risk of venous thromboembolism, a serious side effect, so patients should be educated about the signs and symptoms of blood clots. This information is crucial as early recognition and prompt treatment of blood clots can prevent complications. Choices B, C, and D are incorrect because tamoxifen is not associated with causing weight gain, decreasing the risk of osteoporosis, or increasing the risk of breast cancer. Providing accurate information is essential for patient safety and understanding.

4. Why is testosterone therapy prescribed for a 70-year-old man being treated for osteoporosis?

• A. To increase bone density
• B. To reduce the risk of fractures
• C. To enhance sexual performance
• D. To restore testosterone levels

Correct answer: D

Rationale: The primary reason for prescribing testosterone therapy for osteoporosis in men is to restore testosterone levels, not specifically to increase bone density. Testosterone plays a crucial role in maintaining bone density, so by restoring testosterone levels, it indirectly helps in maintaining bone density. Choices A and B are partially correct but do not address the primary reason for testosterone therapy in this context. Choice C is incorrect as the main focus of testosterone therapy in osteoporosis treatment is not related to enhancing sexual performance.

5. A patient is starting on oral contraceptives. What should the nurse emphasize about the importance of taking the medication at the same time each day?

• A. Taking the medication at the same time each day helps maintain stable hormone levels and ensures effectiveness.
• B. Taking the medication at the same time each day reduces the risk of breakthrough bleeding.
• C. Taking the medication at the same time each day ensures consistent absorption and effectiveness.
• D. Taking the medication at the same time each day is important, but missing a dose occasionally is not a concern.

Correct answer: A

Rationale: The correct answer is A. Taking oral contraceptives at the same time each day helps maintain stable hormone levels and ensures their effectiveness in preventing pregnancy. Choice B is incorrect because the primary emphasis of consistent timing is on hormone levels and effectiveness, not on reducing breakthrough bleeding. Choice C is incorrect because while consistent absorption is a factor, the main focus is on maintaining stable hormone levels. Choice D is incorrect as missing doses can significantly impact contraceptive efficacy.

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