Nursing Elites

1. Which ability should Nurse Rebecca expect from a client in the mild stage of dementia of the Alzheimer’s type?

• A. Remembering the daily schedule
• B. Recalling past events
• C. Coping with anxiety
• D. Solving problems of daily living

Correct answer: B

Rationale: In the mild stage of dementia of the Alzheimer’s type, clients can often recall past events but may have difficulty with new information. Therefore, Nurse Rebecca should expect the client to have the ability to recall past events. Choice A is incorrect because remembering the daily schedule may become challenging as the disease progresses. Choice C is incorrect as clients in the mild stage may experience anxiety, but coping with anxiety is not a specific ability associated with this stage of dementia. Choice D is incorrect as solving problems of daily living becomes more challenging as the disease advances, not in the mild stage.

2. A patient has been prescribed raloxifene (Evista) for the prevention of osteoporosis. What effect should the nurse include in the teaching plan regarding the action of this medication?

• A. Decreases calcium excretion by the kidneys.
• B. Increases intestinal absorption of calcium.
• C. Stimulates bone formation by increasing osteoblast activity.
• D. Selectively binds to estrogen receptors, decreasing bone resorption.

Correct answer: D

Rationale: The correct answer is D: Selectively binds to estrogen receptors, decreasing bone resorption. Raloxifene is a selective estrogen receptor modulator (SERM) that works by binding to estrogen receptors, thereby decreasing bone resorption. This action helps in the prevention and treatment of osteoporosis by preserving bone density. Choices A, B, and C are incorrect because raloxifene does not directly affect calcium excretion by the kidneys, intestinal absorption of calcium, or stimulate bone formation by increasing osteoblast activity.

3. Which electrolyte imbalance does the nurse suspect in a patient with hyperaldosteronism?

• A. Hyponatremia
• B. Hypernatremia
• C. Hyperkalemia
• D. Hypercalcemia

Correct answer: C

Rationale: In a patient with hyperaldosteronism, the nurse would suspect hyperkalemia. Hyperaldosteronism leads to increased potassium excretion, resulting in low potassium levels in the blood. Therefore, choices A (Hyponatremia), B (Hypernatremia), and D (Hypercalcemia) are incorrect. Hyponatremia refers to low sodium levels, Hypernatremia refers to high sodium levels, and Hypercalcemia refers to high calcium levels, none of which are typically associated with hyperaldosteronism.

4. A woman of childbearing age is diagnosed with breast cancer. She is currently taking hormonal contraceptives. What information should the woman be given regarding the hormonal contraceptives?

• A. The hormonal contraceptives do not affect the course of the disease.
• B. The hormonal contraceptives will stimulate uterine bleeding.
• C. The hormonal contraceptives will impair uterine bleeding.
• D. The hormonal contraceptives will stimulate tumor growth.

Correct answer: A

Rationale: The correct answer is A. Hormonal contraceptives should be discontinued in women diagnosed with breast cancer because they can potentially stimulate cancer growth. Choice B is incorrect as hormonal contraceptives do not stimulate uterine bleeding. Choice C is also incorrect as hormonal contraceptives typically do not impair uterine bleeding. Choice D is incorrect because hormonal contraceptives are not meant to stimulate tumor growth.

5. A nurse is teaching a patient about the use of raloxifene (Evista) for the prevention of osteoporosis. What is the primary therapeutic action of this medication?

• A. It decreases the absorption of calcium from the intestines.
• B. It decreases bone resorption and increases bone density.
• C. It increases the excretion of calcium through the kidneys.
• D. It stimulates the formation of new bone.

Correct answer: B

Rationale: The correct answer is B. Raloxifene, a selective estrogen receptor modulator (SERM), works by decreasing bone resorption and increasing bone density. This action helps in preventing osteoporosis by maintaining bone strength. Choice A is incorrect as raloxifene does not affect the absorption of calcium from the intestines. Choice C is incorrect as raloxifene does not increase the excretion of calcium through the kidneys. Choice D is incorrect as raloxifene does not directly stimulate the formation of new bone; instead, it primarily works by reducing bone loss.

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