Nursing Elites

1. A 30-year-old woman is taking an oral contraceptive and is concerned about the potential side effects. What should the nurse include in the patient education?

• A. Oral contraceptives can cause weight loss and increased energy levels.
• B. Oral contraceptives can cause increased appetite and weight gain.
• C. Oral contraceptives can cause headaches and breast tenderness.
• D. Oral contraceptives have no side effects.

Correct answer: C

Rationale: The correct answer is C: 'Oral contraceptives can cause headaches and breast tenderness.' It is essential for the nurse to educate the patient about common side effects of oral contraceptives, such as headaches and breast tenderness. Choices A, B, and D are incorrect. Weight loss and increased energy levels (Choice A) are not common side effects of oral contraceptives. Similarly, increased appetite and weight gain (Choice B) are not typical side effects. Finally, stating that oral contraceptives have no side effects (Choice D) is inaccurate as they can have various side effects, albeit usually mild and manageable.

2. A patient has been diagnosed with chronic renal failure. Which of the following agents will assist in raising the patient's hemoglobin levels?

• A. Epoetin alfa (Epogen, Procrit)
• B. Pentoxifylline (Pentoxil)
• C. Estazolam (ProSom)
• D. Dextromethorphan hydrobromide

Correct answer: A

Rationale: The correct answer is A: Epoetin alfa (Epogen, Procrit). Epoetin alfa is a synthetic form of erythropoietin that stimulates red blood cell production and is commonly used to treat anemia in patients with chronic renal failure. By increasing red blood cell production, epoetin alfa helps raise hemoglobin levels in these patients. Pentoxifylline (Choice B) is not indicated for raising hemoglobin levels in chronic renal failure patients; it is a peripheral vasodilator used to improve blood flow. Estazolam (Choice C) is a benzodiazepine used for treating insomnia and has no role in raising hemoglobin levels. Dextromethorphan hydrobromide (Choice D) is a cough suppressant and is not used to raise hemoglobin levels in patients with chronic renal failure.

3. What clinical manifestations would the nurse expect to find in a client who is experiencing anaphylaxis?

• A. Dilated bronchioles, constriction of peripheral blood vessels, decreased capillary permeability
• B. Asthma, deep vein thrombosis, hepatic encephalopathy
• C. Narrowing of the bronchioles, dilation of the peripheral blood vessels, increased capillary permeability
• D. Left-sided heart failure, pulmonary embolism, urinary tract infection

Correct answer: C

Rationale: In anaphylaxis, the client would present with narrowing of the bronchioles, dilation of the peripheral blood vessels, and increased capillary permeability. These manifestations lead to symptoms such as difficulty breathing, low blood pressure, and swelling. Choices A, B, and D are incorrect because they do not describe the typical clinical manifestations of anaphylaxis.

4. A male patient receiving androgen therapy is concerned about side effects. What adverse effect should the nurse monitor for during this therapy?

• A. Increased risk of liver dysfunction
• B. Increased risk of cardiovascular events
• C. Increased risk of prostate cancer
• D. Increased risk of bone fractures

Correct answer: B

Rationale: The correct answer is B: Increased risk of cardiovascular events. Androgen therapy can lead to an increased risk of cardiovascular events such as heart attack and stroke, especially in older patients. Choice A is incorrect because androgen therapy usually does not significantly increase the risk of liver dysfunction. Choice C is incorrect as androgen therapy does not increase the risk of prostate cancer; in fact, it is sometimes used in the treatment of prostate cancer. Choice D is also incorrect as androgen therapy is more likely to improve bone density and reduce the risk of fractures.

5. What should the nurse teach the boy about anabolic steroid abuse?

• A. The ability of anabolic steroids to build muscle is greatly exaggerated in the media.
• B. Anabolic steroids are universally dangerous but are especially harmful to adolescents.
• C. The muscle mass resulting from steroid use will atrophy unless doses are continually increased.
• D. Anabolic steroids will reduce the boy's ability to perform weight-bearing exercise later in life.

Correct answer: B

Rationale: The correct answer is B because anabolic steroids are indeed universally dangerous, but they pose greater risks to adolescents due to their impact on growth and development. Choice A is incorrect because anabolic steroids do have the potential to build muscle mass, though not to the extent often portrayed in the media. Choice C is incorrect as muscle mass gained from steroid use may persist for a period even after discontinuation. Choice D is incorrect as anabolic steroids can enhance muscle performance initially, though long-term use can have adverse effects on health and not specifically on the ability to perform weight-bearing exercises.

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