Nursing Elites

1. A 37-year-old woman has a 10 pack-year smoking history and has been using oral contraceptives for the past 2 years. The nurse should plan health education interventions knowing that this patient faces an increased risk of

• A. osteoporosis.
• B. dementia.
• C. myocardial infarction.
• D. deep vein thrombosis.

Correct answer: C

Rationale: The correct answer is C: myocardial infarction. Women aged 35 and older who smoke, especially with a history of 10 pack-years like in this case, face an increased risk of cardiovascular disorders, including myocardial infarction, when using oral contraceptives. Choice A, osteoporosis, is incorrect because smoking and oral contraceptives do not significantly increase the risk of osteoporosis. Choice B, dementia, is not directly associated with smoking, oral contraceptives, or their combination. Choice D, deep vein thrombosis, is a risk associated with oral contraceptives, especially in combination with smoking, but the highest increased risk in this case is for myocardial infarction.

2. A newborn is diagnosed with congenital intrinsic factor deficiency. Which of the following types of anemia will the nurse see documented on the chart?

• A. Iron deficiency anemia
• B. Sideroblastic anemia
• C. Pernicious anemia
• D. Hemolytic anemia

Correct answer: C

Rationale: The correct answer is C, Pernicious anemia. Pernicious anemia is associated with a congenital intrinsic factor deficiency, leading to the impaired absorption of vitamin B12. Iron deficiency anemia (Choice A) is not directly related to intrinsic factor deficiency. Sideroblastic anemia (Choice B) is characterized by defective iron uptake by developing erythrocytes and is not linked to intrinsic factor deficiency. Hemolytic anemia (Choice D) involves the premature destruction of red blood cells and is not specifically associated with intrinsic factor deficiency.

3. A nurse is providing education to a patient starting hormone replacement therapy (HRT) for menopausal symptoms. What should the nurse emphasize regarding the long-term risks associated with HRT?

• A. HRT may increase the risk of cardiovascular events, including heart attack and stroke.
• B. HRT may decrease the risk of osteoporosis.
• C. HRT may improve mood and energy levels.
• D. HRT may decrease the risk of breast cancer.

Correct answer: A

Rationale: HRT is associated with an increased risk of cardiovascular events, including heart attack and stroke, particularly with long-term use.

4. Which of the following mediators of inflammation causes increased capillary permeability and pain?

• A. Serotonin
• B. Histamine
• C. Bradykinin
• D. Nitric oxide

Correct answer: C

Rationale: Bradykinin is the correct answer. It is a potent mediator of inflammation that causes increased capillary permeability and is responsible for the pain associated with inflammation. Serotonin and histamine are also mediators of inflammation, but they are not primarily known for increasing capillary permeability or inducing pain. Nitric oxide is involved in various physiological processes but is not a primary mediator of inflammation that causes increased capillary permeability and pain.

5. A nurse is providing care for a 44-year-old male client who is admitted with a diagnosis of fever of unknown origin (FUO). Which characteristic of the client's history is most likely to have a bearing on his current diagnosis?

• A. The client is a smoker.
• B. The client has a history of IV drug use.
• C. The client was treated for an STD 2 years ago.
• D. The client has a family history of cardiac disease.

Correct answer: B

Rationale: A history of IV drug use is significant in cases of fever of unknown origin, as it increases the risk of infections like endocarditis, which can present with persistent fever. Smoking (Choice A) is not directly linked to FUO. While a history of STD treatment (Choice C) may be relevant, it is less likely to be associated with FUO compared to IV drug use. Family history of cardiac disease (Choice D) is not typically a primary factor in the diagnosis of FUO.

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