Nursing Elites

1. In menopausal women, what is the primary goal of estrogen therapy?

• A. To relieve menopausal symptoms
• B. To prevent osteoporosis
• C. To increase calcium absorption
• D. To maintain bone strength

Correct answer: B

Rationale: The primary goal of estrogen therapy in menopausal women is to prevent osteoporosis by maintaining bone density. Estrogen helps in preserving bone mass and reducing the risk of fractures. While estrogen therapy may alleviate some menopausal symptoms, such as hot flashes, its primary focus is on bone health rather than symptom management. Increasing calcium absorption and maintaining bone strength are outcomes of preventing osteoporosis rather than the primary goal of estrogen therapy.

2. After a 27-year-old woman with epilepsy had a generalized seizure, she feels tired and falls asleep. This is:

• A. an ominous sign.
• B. normal and termed the postictal period.
• C. a reflection of an underlying brain tumor.
• D. only worrisome if there are focal neurologic deficits after.

Correct answer: B

Rationale: The correct answer is B: normal and termed the postictal period. The postictal period is a common phase following a seizure where the individual may experience fatigue, confusion, or sleepiness. It is a normal part of the seizure event and does not necessarily indicate a serious issue. Choice A is incorrect because feeling tired and falling asleep after a seizure is not an ominous sign but rather a typical postictal symptom. Choice C is incorrect as there is no indication in the scenario provided that links the symptoms to an underlying brain tumor. Choice D is incorrect because the absence of focal neurologic deficits does not make the postictal period worrisome.

3. Which of the following steps occurs first during hemostasis?

• A. Vascular spasm
• B. Platelet plug
• C. Coagulation
• D. Dissolution of the clot

Correct answer: A

Rationale: Vascular spasm is the initial step in hemostasis, where blood vessels constrict to reduce blood flow to the injured area. This constriction helps limit blood loss until further steps like platelet plug formation and coagulation can take place. Platelet plug formation and coagulation occur after the vascular spasm, making them incorrect choices. Dissolution of the clot happens much later in the healing process, after the injury has sufficiently healed.

4. A 57-year-old male presents to his primary care provider with a red face, hands, feet, ears, headache, and drowsiness. A blood smear reveals an increased number of erythrocytes, indicating:

• A. Leukemia
• B. Sideroblastic anemia
• C. Hemosiderosis
• D. Polycythemia vera

Correct answer: D

Rationale: In this case, the symptoms of a red face, hands, feet, ears, headache, and drowsiness along with an increased number of erythrocytes in the blood smear are indicative of polycythemia vera. This condition is characterized by the overproduction of red blood cells, leading to symptoms related to increased blood volume and viscosity. Leukemia (Choice A) is a cancer of the blood and bone marrow, but the presentation described here is more suggestive of polycythemia vera. Sideroblastic anemia (Choice B) is characterized by abnormal iron deposits in erythroblasts, not an increased number of erythrocytes. Hemosiderosis (Choice C) refers to abnormal accumulation of iron in the body, not an increase in red blood cells as seen in polycythemia vera.

5. When starting on oral contraceptives, what key point should the nurse emphasize about taking the medication consistently?

• A. Oral contraceptives should be taken at the same time each day to maintain stable hormone levels and prevent pregnancy.
• B. Oral contraceptives can be taken at any time of day, as long as the schedule is consistent.
• C. Oral contraceptives should be taken in the morning to avoid nighttime side effects.
• D. Oral contraceptives are effective immediately upon starting, regardless of timing.

Correct answer: A

Rationale: When starting on oral contraceptives, it is crucial to take them at the same time each day to maintain stable hormone levels and ensure their effectiveness in preventing pregnancy. Choice B is incorrect because consistency in timing is essential to maximize contraceptive efficacy. Choice C is incorrect as there is no evidence that taking oral contraceptives in the morning helps avoid nighttime side effects. Choice D is incorrect because oral contraceptives do not provide immediate effectiveness and require consistent use to prevent pregnancy.

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