Nursing Elites

1. Which of the following is likely to increase the risk of sexually transmitted disease?

• A. alcohol use
• B. certain types of sexual practices
• C. oral contraception use
• D. all of the above

Correct answer: D

Rationale: All of the above factors are likely to increase the risk of sexually transmitted diseases (STDs). Alcohol use can impair judgment, leading to risky sexual behavior. Certain types of sexual practices, especially unprotected sex or multiple partners, increase the likelihood of contracting STDs. While oral contraception use does not directly increase the risk of STDs, it does not protect against them either. Therefore, all the choices (alcohol use, certain types of sexual practices, and oral contraception use) can contribute to an increased risk of contracting STDs.

2. When a person using over-the-counter nasal decongestant drops experiences unrelieved and worsening nasal congestion, what should be instructed?

• A. switch to a stronger dose of the same medication.
• B. discontinue the medication for a few weeks.
• C. continue taking the same medication, but use it more frequently.
• D. use a combination of medications for better relief.

Correct answer: B

Rationale: When a person using over-the-counter nasal decongestant drops experiences unrelieved and worsening nasal congestion, it is crucial to discontinue the medication for a few weeks. Prolonged use of decongestant drops can lead to rebound congestion, which is relieved by stopping the medication for a period of time. Nasal congestion occurs due to various factors like infection, inflammation, or allergy, leading to swelling of the nasal cavity. Nasal decongestants work by stimulating alpha-adrenergic receptors, causing vasoconstriction and shrinking of nasal mucous membranes. However, prolonged use can result in vasodilation, worsening nasal congestion. Switching to a stronger dose of the same medication is not recommended as it can exacerbate the issue. Continuing the same medication more frequently or using a combination of medications are also not advised and may lead to side effects. Educating individuals on proper decongestant use and potential risks of prolonged usage is essential, especially for those with specific health conditions.

3. A healthcare professional is reviewing a patient's medical record. The record indicates the patient has limited shoulder flexion on the left. Which plane of movement is limited?

• A. Horizontal
• B. Sagittal
• C. Frontal
• D. Vertical

Correct answer: B

Rationale: The correct answer is 'Sagittal.' The sagittal plane divides the body into left and right halves, and movements in this plane involve flexion and extension. In this case, limited shoulder flexion on the left indicates a restriction in the forward and backward movement of the arm, which occurs in the sagittal plane. Choice A, 'Horizontal,' is incorrect as it refers to movements parallel to the ground. Choice C, 'Frontal,' is incorrect as it involves side-to-side movements. Choice D, 'Vertical,' is incorrect as it typically refers to up and down movements.

4. A nurse has been ordered to administer Morphine to a patient. Which of the following effects is unrelated to Morphine's effects on the patient?

• A. Depressed function of the CNS
• B. Increased blood flow
• C. Decreased venous capacity
• D. Pain relief

Correct answer: C

Rationale: Morphine is a narcotic analgesic that acts centrally to relieve pain by binding to opioid receptors in the CNS, leading to the depressed function of the CNS. Morphine also causes peripheral vasodilation, which can lead to increased blood flow. However, morphine causes venous dilation and increased venous capacity rather than decreased venous capacity. Therefore, the effect of 'Decreased venous capacity' is unrelated to Morphine's effects. Pain relief is a well-known effect of Morphine, as it acts on the CNS to alter the perception of pain.

5. When teaching a client about anti-retroviral therapy for human immunodeficiency virus (HIV), the PN should emphasize:

• A. When started, therapy must not be interrupted to prevent viral resistance.
• B. When started, therapy must not be interrupted to prevent opportunistic infection.
• C. Therapy should not be interrupted for one day each month to prevent toxicity.
• D. Therapy should not be interrupted for one week every three months to prevent toxicity.

Correct answer: A

Rationale: When teaching a client about anti-retroviral therapy for HIV, it is crucial to emphasize that therapy must not be interrupted to prevent viral resistance. HIV mutates rapidly, and any interruption can lead to the emergence of resistant strains, compromising treatment effectiveness. Choice B is incorrect because keeping the virus in check with anti-retrovirals helps the client's immune system fight off opportunistic infections. Choices C and D are incorrect because therapy should not be interrupted for any reason. If toxicity occurs, the healthcare provider may adjust the treatment regimen by prescribing alternative anti-retroviral drugs.

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