Nursing Elites

1. A male patient with benign prostatic hyperplasia (BPH) is being treated with tamsulosin (Flomax). What should the nurse include in the teaching plan for this patient?

• A. Avoid lying down after taking the medication.
• B. Take the medication with meals.
• C. Report any side effects such as dizziness or fainting.
• D. Take the medication at bedtime.

Correct answer: C

Rationale: The correct answer is C: 'Report any side effects such as dizziness or fainting.' Patients taking tamsulosin should be advised to report any side effects, such as dizziness or fainting, which can occur due to orthostatic hypotension. Choices A, B, and D are incorrect because avoiding lying down after taking the medication, taking it with meals, or at bedtime are not specific teaching points related to the potential side effects of tamsulosin.

2. In which of the following patients may the administration of a live vaccine be contraindicated?

• A. Patient with renal insufficiency
• B. Patient with hepatic failure
• C. Patient taking steroid therapy
• D. Patient over the age of 65 years

Correct answer: C

Rationale: The correct answer is C. The administration of live vaccines may be contraindicated in patients taking steroid therapy. Steroids can suppress the immune system, reducing the effectiveness of live vaccines. Patients with renal insufficiency or hepatic failure can typically receive live vaccines as these conditions are not direct contraindications. Age alone, such as being over 65 years old, is not a contraindication for live vaccines unless there are other specific health considerations. Therefore, the patient taking steroid therapy is the most likely candidate for whom the administration of a live vaccine would be contraindicated.

3. What critical point should the nurse include in patient education regarding tamoxifen (Nolvadex) for a patient with breast cancer?

• A. Tamoxifen may increase the risk of venous thromboembolism.
• B. Tamoxifen may cause hot flashes and other menopausal symptoms.
• C. Tamoxifen may cause weight gain and fluid retention.
• D. Tamoxifen may decrease the risk of osteoporosis.

Correct answer: A

Rationale: The correct answer is A. Tamoxifen increases the risk of venous thromboembolism. Patients should be educated about the signs and symptoms of blood clots, such as swelling, redness, and pain in the legs. Choices B, C, and D are incorrect because tamoxifen is not associated with causing hot flashes, weight gain, fluid retention, or decreasing the risk of osteoporosis.

4. When assessing a patient experiencing breakthrough bleeding while taking oral contraceptives, what should the nurse consider?

• A. The possibility of pregnancy
• B. The patient's adherence to the medication schedule
• C. The need for an increased dosage
• D. The effectiveness of the current oral contraceptive

Correct answer: B

Rationale: When a patient on oral contraceptives experiences breakthrough bleeding, it is crucial for the nurse to consider the patient's adherence to the medication schedule. Breakthrough bleeding is often a sign of missed doses or inconsistent use, which can decrease the effectiveness of the oral contraceptive. Considering the possibility of pregnancy (Choice A) is important but secondary to assessing adherence. The need for an increased dosage (Choice C) is not typically the first consideration for breakthrough bleeding. Evaluating the effectiveness of the current oral contraceptive (Choice D) is relevant but should come after assessing adherence to the medication schedule.

5. What causes hepatic encephalopathy?

• A. A brain infection
• B. Increased ammonia levels in the bloodstream
• C. Decreased albumin blood levels
• D. Untreated chronic bronchitis

Correct answer: B

Rationale: Hepatic encephalopathy is caused by increased ammonia levels in the bloodstream. Ammonia, a byproduct of protein metabolism normally processed by the liver, accumulates in the bloodstream when the liver is unable to function properly. This excess ammonia affects brain function, leading to symptoms of hepatic encephalopathy. Choices A, C, and D are incorrect because they do not directly relate to the pathophysiology of hepatic encephalopathy.

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