Nursing Elites

1. A female patient is concerned about the side effects of oral contraceptives. What should the nurse explain as a common side effect?

• A. Increased energy levels
• B. Decreased libido
• C. Weight gain
• D. Hair loss

Correct answer: C

Rationale: The correct answer is C: Weight gain. Weight gain is a common side effect of oral contraceptives due to hormonal changes. It is essential for healthcare providers to inform patients about this possibility to manage expectations. Choice A, increased energy levels, is not a common side effect of oral contraceptives. Choice B, decreased libido, can be a side effect for some individuals but is not as common as weight gain. Choice D, hair loss, is not typically associated with oral contraceptives. Therefore, it is important for the nurse to address the patient's concerns by discussing the more prevalent side effects like weight gain.

2. In which of the following cases is dehydration more likely to occur?

• A. A 50-year-old woman who is a bodybuilder
• B. A 50-year-old man who is morbidly obese
• C. A 10-year-old child who is thin
• D. A 30-year-old with multiple sclerosis

Correct answer: B

Rationale: Dehydration is more likely to occur in a 50-year-old man who is morbidly obese due to the increased risk of conditions like diabetes and heart disease that can lead to fluid imbalances. Being morbidly obese can also strain the body's systems, increasing the need for water. The other choices are less likely to experience dehydration as a primary concern. While being a bodybuilder may require strict hydration practices, dehydration is more prevalent in individuals with conditions like obesity.

3. In addition to matching ABO antigens, a blood transfusion must also be matched for:

• A. HLA type
• B. Rh antigen
• C. Immunoglobulins
• D. Platelet compatibility

Correct answer: B

Rationale: The correct answer is B: Rh antigen. In addition to ABO antigens, Rh antigen must also be matched for a blood transfusion. Rh antigen compatibility is crucial to prevent adverse reactions. Choice A, HLA type, is not directly related to blood transfusions but plays a role in organ transplantation. Choice C, Immunoglobulins, are not typically matched for blood transfusions. Choice D, Platelet compatibility, while important in specific cases, is not a standard requirement for all blood transfusions.

4. A patient is starting on atorvastatin (Lipitor) for hyperlipidemia. What critical instruction should the nurse provide?

• A. Take the medication at night to reduce the risk of muscle pain and other side effects.
• B. Avoid consuming grapefruit juice while taking this medication.
• C. Take the medication in the morning with breakfast to improve absorption.
• D. Take the medication with a high-fat meal to increase its effectiveness.

Correct answer: A

Rationale: The correct answer is to take the medication at night to reduce the risk of muscle pain and other side effects. Atorvastatin, like other statins, is more effective when taken in the evening as the body produces more cholesterol at night. Taking it with a high-fat meal (choice D) is not recommended as it may reduce the drug's absorption. Grapefruit juice (choice B) should be avoided with atorvastatin as it can increase the risk of side effects. Taking the medication in the morning with breakfast (choice C) is not as effective as taking it at night.

5. In which patient would the manifestation of a headache be a sign of a serious underlying disorder?

• A. A 55-year-old man with new onset of headaches that are worse at night and reported mood swings according to his family
• B. A 30-year-old woman with a unilateral throbbing headache with photophobia and nausea
• C. A 60-year-old man with his head feeling full and throbbing and muscle aching around his neck and shoulders
• D. A 40-year-old woman who experiences food cravings, gets irritable, and then develops a pulsatile-like headache on the right side of her head

Correct answer: A

Rationale: The correct answer is A. New onset headaches in older adults, especially if worse at night, may indicate a serious condition like a brain tumor. Choice B describes symptoms commonly seen in migraines. Choice C describes tension-type headaches. Choice D describes symptoms of a menstrual migraine which is not typically associated with a serious underlying disorder.

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