Nursing Elites

1. Which of the following women are at highest risk for the development of endometrial cancer?

• A. A 50-year-old postmenopausal woman with a history of high-risk human papillomavirus
• B. A 45-year-old woman who is obese and has menstrual irregularities with periods of amenorrhea and infrequent periods.
• C. A 40-year-old woman who is overweight and has hypertension.
• D. A 55-year-old woman who smokes.

Correct answer: B

Rationale: The correct answer is B. Obesity and irregular menstrual cycles, including periods of amenorrhea and infrequent periods, are significant risk factors for the development of endometrial cancer. Choice A is less likely as postmenopausal status reduces the risk. Choice C is not directly associated with a high risk of endometrial cancer. Choice D, smoking, is more strongly linked to other types of cancers like lung cancer rather than endometrial cancer.

2. What is the cause of swelling during acute inflammation?

• A. Collagenase
• B. Fluid exudate
• C. Lymphocytic margination
• D. Anaerobic glycolysis

Correct answer: B

Rationale: Swelling during acute inflammation is primarily caused by the accumulation of fluid exudate in the affected tissues. This fluid exudate contains proteins and cells that leak from blood vessels due to increased vascular permeability. Collagenase (Choice A) is an enzyme that breaks down collagen and is not directly responsible for swelling. Lymphocytic margination (Choice C) is the process where white blood cells line up along the blood vessel walls, which does not directly cause swelling. Anaerobic glycolysis (Choice D) is a metabolic process that occurs in the absence of oxygen and is not related to the mechanism of swelling in acute inflammation.

3. A patient with a history of venous thromboembolism is prescribed hormone replacement therapy (HRT). What should the nurse discuss with the patient regarding the risks of HRT?

• A. HRT is associated with an increased risk of venous thromboembolism, so the patient should be aware of the signs and symptoms of blood clots.
• B. HRT can decrease the risk of osteoporosis, but the patient should also be aware of the increased risk of venous thromboembolism.
• C. HRT may increase the risk of breast cancer, so the patient should undergo regular breast exams.
• D. HRT can improve mood and energy levels, but it also carries a risk of cardiovascular events.

Correct answer: A

Rationale: The correct answer is A. Hormone replacement therapy (HRT) is indeed associated with an increased risk of venous thromboembolism. Therefore, patients should be educated about the signs and symptoms of blood clots and advised to seek immediate medical attention if they occur. Choice B is incorrect because although HRT may decrease the risk of osteoporosis, the focus of concern in this case is the increased risk of venous thromboembolism. Choice C is incorrect as it mentions the risk of breast cancer, which is not the primary concern when discussing HRT with a patient with a history of venous thromboembolism. Choice D is also incorrect as it mentions cardiovascular events, which are not the main focus of risk associated with HRT in this scenario.

4. Which of the following disorders is more likely associated with blood in stool?

• A. Gastroesophageal reflux
• B. Crohn's disease
• C. Irritable bowel syndrome
• D. Colon cancer

Correct answer: D

Rationale: Colon cancer is more likely associated with blood in stool due to the presence of bleeding from the tumor in the colon. Gastroesophageal reflux (Choice A) typically presents with heartburn and regurgitation but not blood in stool. Crohn's disease (Choice B) can cause gastrointestinal symptoms, but bloody stools are more commonly associated with ulcerative colitis. Irritable bowel syndrome (Choice C) is characterized by abdominal pain, bloating, and changes in bowel habits, but it does not typically cause blood in stool. Therefore, the correct answer is D, Colon cancer.

5. When educating a patient starting on oral contraceptives, what should the nurse include regarding the medication's effectiveness?

• A. Oral contraceptives are 100% effective when taken correctly.
• B. Oral contraceptives are effective immediately after starting.
• C. Oral contraceptives are less effective if taken with antibiotics.
• D. Oral contraceptives are less effective if taken with food.

Correct answer: C

Rationale: The correct answer is C. Oral contraceptives can be less effective when taken with certain antibiotics as they may interfere with the contraceptive's efficacy, potentially leading to decreased effectiveness. Therefore, patients should be advised to use additional contraception methods if they are also taking antibiotics. Choice A is incorrect because while oral contraceptives are highly effective, they are not 100% foolproof. Choice B is incorrect as oral contraceptives may take some time to reach their full effectiveness after starting. Choice D is incorrect since taking oral contraceptives with food does not necessarily impact their effectiveness.

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