Nursing Elites

1. A 52-year-old has made an appointment with his primary care provider and has reluctantly admitted that his primary health concern is erectile dysfunction (ED). He describes the problem as increasing in severity and consequent distress. Which of the nurse's assessment questions is most likely to address a common cause of ED?

• A. “How would you describe your overall health status?”
• B. “Are you taking any medications for high blood pressure?”
• C. “How has this issue been impacting your relationship?”
• D. “Have you experienced any recent injuries?”

Correct answer: B

Rationale: In the context of erectile dysfunction (ED), medication use is a crucial factor to consider. Many medications, including those used for high blood pressure, can contribute to ED as a side effect. Asking about medication use, particularly for conditions like high blood pressure, can help identify a common cause of ED. Choices A, C, and D do not directly address potential causes related to medication use, making them less likely to reveal a common underlying issue for ED in this case.

2. An oncology nurse is providing care for an adult patient who is currently immunocompromised. The nurse is aware of the physiology involved in hematopoiesis and immune function, including the salient role of cytokines. What is the primary role of cytokines in maintaining homeostasis?

• A. Cytokines perform phagocytosis in response to bacterial and protozoal infections.
• B. Cytokines perform a regulatory role in the development of diverse blood cells.
• C. Cytokines play a significant role in the formation of all blood cells.
• D. Cytokines are produced in response to the presence of antibodies.

Correct answer: B

Rationale: The primary role of cytokines in maintaining homeostasis is to perform a regulatory function in the development of diverse blood cells. Cytokines act as signaling molecules that regulate the immune response and hematopoiesis. Choice A is incorrect because cytokines do not perform phagocytosis; they regulate immune responses. Choice C is incorrect because while cytokines are involved in the formation of some blood cells, they are not considered the basic 'building blocks' of all blood cells. Choice D is incorrect because cytokines are not formed in response to antibodies, but rather play a role in the immune response to various stimuli.

3. A 17-year-old woman has come to the clinic requesting emergency contraception after having unprotected sex 24 hours ago. What medication is the clinician most likely to prescribe?

• A. Levonorgestrel (Plan B)
• B. Mifepristone (RU-486)
• C. Ulipristal acetate (ella)
• D. Estradiol (Estrace)

Correct answer: A

Rationale: The correct answer is A: Levonorgestrel (Plan B). Levonorgestrel is the most commonly prescribed medication for emergency contraception within 72 hours of unprotected intercourse. It is effective when taken within 72 hours after intercourse, with better efficacy the sooner it is taken. Choice B, Mifepristone (RU-486), is not indicated for emergency contraception but is used for medical abortion. Choice C, Ulipristal acetate (ella), is another option for emergency contraception that is effective up to 120 hours after unprotected intercourse. Choice D, Estradiol (Estrace), is not used for emergency contraception.

4. A patient with a history of osteoporosis is prescribed alendronate (Fosamax). What instructions should the nurse provide to ensure the effectiveness of the medication?

• A. Take the medication with a full glass of water and remain upright for at least 30 minutes to prevent esophageal irritation and ensure proper absorption.
• B. Take the medication with milk to enhance calcium absorption.
• C. Take the medication at bedtime to ensure absorption during sleep.
• D. Take the medication with food to prevent nausea.

Correct answer: A

Rationale: The correct answer is A. Alendronate should be taken with a full glass of water and patients should remain upright for at least 30 minutes to prevent esophageal irritation and ensure proper absorption. Taking the medication with milk (choice B) is not recommended as it may interfere with the absorption of alendronate. Taking the medication at bedtime (choice C) is not necessary for optimal absorption. Taking the medication with food (choice D) is also not recommended as food can reduce the absorption of alendronate.

5. A 30-year-old female has suffered a third-degree burn to her hand after spilling hot oil in a kitchen accident. Which teaching point by a member of her care team is most appropriate?

• A. Your hand will likely heal without the need for a skin graft.
• B. You might experience a loss of sensation in your hand after it heals.
• C. Be sure to keep your hand elevated to reduce swelling.
• D. We will need to monitor you for infection as your hand heals.

Correct answer: D

Rationale: In third-degree burns, infection is a major concern due to the extensive damage to the skin. Monitoring for infection is crucial. Choice A is incorrect because third-degree burns often require skin grafts due to the severity of the injury. Choice B is incorrect as loss of sensation is more common in nerve damage and not necessarily in burns. Choice C is incorrect because while elevation can help with swelling in minor burns, it is not the most critical concern in third-degree burns.

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