Nursing Elites

1. What is the primary cause of primary hypercholesteremia?

• A. High-density lipoprotein (HDL) defects
• B. Monogenic mutations, sedentary lifestyle, and high cholesterol diet
• C. Polygenic mutations and environmental factors
• D. Low-density lipoprotein (LDL) receptor mutation with defects in breakdown

Correct answer: D

Rationale: The correct answer is 'Low-density lipoprotein (LDL) receptor mutation with defects in breakdown.' Primary hypercholesteremia is mainly caused by mutations in the LDL receptor, leading to impaired clearance of LDL cholesterol from the blood. This results in high levels of LDL cholesterol in the bloodstream. Choices A, B, and C are incorrect because they do not directly relate to the primary cause of primary hypercholesteremia.

2. A patient taking an oral contraceptive missed one pill. What should the nurse teach the patient to do?

• A. Take two pills as soon as you remember, then continue the regular schedule.
• B. Take one pill as soon as you remember, then continue the regular schedule.
• C. Skip the missed pill and continue the regular schedule.
• D. Take two pills immediately, then continue the regular schedule.

Correct answer: A

Rationale: When a patient taking an oral contraceptive misses one pill, the correct action is to take two pills as soon as they remember and then continue the regular schedule. Option A is the correct answer because doubling up the dose helps maintain the effectiveness of the contraceptive. Option B is incorrect because taking only one pill after missing one may decrease contraceptive effectiveness. Option C is wrong as skipping the missed pill can also reduce effectiveness. Option D is inaccurate because taking two pills immediately is not necessary; the patient should take the missed pill as soon as remembered and then resume the regular dosing schedule.

3. When teaching a young woman about the use of hormonal contraceptives, a nurse should emphasize that these drugs are most effective when taken:

• A. Immediately after sexual intercourse.
• B. At the same time each day.
• C. Before going to bed at night.
• D. On an empty stomach.

Correct answer: B

Rationale: The correct answer is B: 'At the same time each day.' Hormonal contraceptives should be taken consistently at the same time each day to maintain stable hormone levels, which is crucial for their effectiveness. Taking them at random times can increase the risk of contraceptive failure. Choices A, C, and D are incorrect because taking hormonal contraceptives immediately after sexual intercourse, before going to bed at night, or on an empty stomach does not align with the recommended usage instructions for these drugs.

4. Which individual is likely to have the best prognosis for recovery from his or her insult to the peripheral nervous system? An adult:

• A. client who developed rhabdomyolysis and ischemic injury after a tourniquet application.
• B. who suffered a bone-depth laceration to the shoulder during a knife attack.
• C. who had his forearm partially crushed by gears during an industrial accident.
• D. client who had nerves transected during surgery to remove a tumor from the mandible.

Correct answer: C

Rationale: The correct answer is C. Crushing-type injuries to the peripheral nervous system generally have a better prognosis compared to nerve transections or lacerations. In the scenario provided, the individual who had his forearm partially crushed by gears during an industrial accident is likely to have a better chance of recovery compared to nerve transection (choice D) or laceration (choice B). Rhabdomyolysis and ischemic injury after tourniquet application (choice A) are not directly related to peripheral nerve injury and do not indicate a better prognosis for recovery.

5. When starting on oral contraceptives, what should the nurse emphasize about the potential interactions with other medications?

• A. Oral contraceptives can be less effective when taken with certain antibiotics.
• B. Oral contraceptives are less effective when taken with food.
• C. Oral contraceptives are effective immediately after starting.
• D. Oral contraceptives have no interactions with other medications.

Correct answer: A

Rationale: The correct answer is A. Oral contraceptives can be less effective when taken with certain antibiotics, so patients should be informed about the potential need for additional contraception. Choice B is incorrect because taking oral contraceptives with food does not affect their effectiveness. Choice C is incorrect because oral contraceptives may take some time to become fully effective. Choice D is incorrect because oral contraceptives can interact with other medications, especially certain antibiotics, affecting their efficacy.

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