Nursing Elites

1. A male patient with benign prostatic hyperplasia (BPH) is prescribed finasteride (Proscar). What therapeutic effect is expected from this medication?

• A. Reduction in prostate size and improvement in urinary symptoms
• B. Increase in urine flow and relief of urinary obstruction
• C. Improvement in erectile function
• D. Relief of pain associated with BPH

Correct answer: A

Rationale: The correct answer is A: Reduction in prostate size and improvement in urinary symptoms. Finasteride works by reducing the size of the prostate gland, which in turn helps alleviate urinary symptoms such as frequency, urgency, weak stream, and incomplete emptying of the bladder. Choice B is incorrect as while finasteride can improve urine flow indirectly by reducing prostate size, it does not directly increase urine flow. Choice C is incorrect because finasteride is not intended to improve erectile function. Choice D is incorrect as finasteride does not primarily provide relief from pain associated with BPH.

2. Abrupt withdrawal or discontinuation of prednisone can cause:

• A. adrenal crisis.
• B. hypercortisolism.
• C. ACTH stimulation.
• D. thyroid crisis.

Correct answer: A

Rationale: The correct answer is A: adrenal crisis. Abrupt discontinuation of prednisone can lead to adrenal insufficiency, resulting in adrenal crisis. Prednisone is a corticosteroid that suppresses the adrenal glands' ability to produce cortisol. Abrupt withdrawal can cause a sudden drop in cortisol levels, leading to adrenal crisis with symptoms like fatigue, weakness, abdominal pain, and potentially life-threatening low blood pressure. Choices B, C, and D are incorrect because hypercortisolism refers to excess cortisol levels, ACTH stimulation would not result from prednisone withdrawal, and thyroid crisis is not directly related to corticosteroid discontinuation.

3. Nurse Isabelle enters the room of a client with a cognitive impairment disorder and asks what day of the week it is, what the date, month, and year are, and where the client is. The nurse is attempting to assess:

• A. confabulation.
• B. delirium.
• C. orientation.
• D. perseveration.

Correct answer: C

Rationale: The correct answer is C: "orientation." Nurse Isabelle is assessing the client's orientation by asking questions about time (day, date, month, year), place, and person. This assessment helps determine the client's awareness of their surroundings and situation. Confabulation (choice A) is the unintentional fabrication of details or events to fill in memory gaps and is not being assessed in this scenario. Delirium (choice B) is a state of acute confusion and disorientation, usually with a rapid onset, which is different from assessing orientation. Perseveration (choice D) refers to the persistent repetition of a response, statement, or behavior and is not the focus of the assessment being conducted by Nurse Isabelle in this situation.

4. When the body produces antibodies against its own tissue, the condition is called

• A. Alloimmunity
• B. Opsonization
• C. Autoimmunity
• D. Hypersensitivity

Correct answer: C

Rationale: The correct answer is C, autoimmunity. Autoimmunity refers to the immune system attacking the body's own tissues. Alloimmunity (choice A) is the immune response to tissues of another individual of the same species. Opsonization (choice B) is the process where pathogens are marked for destruction by immune cells. Hypersensitivity (choice D) refers to excessive or inappropriate immune responses.

5. A patient with a history of breast cancer is being prescribed tamoxifen (Nolvadex). What should the nurse include in the patient education about the use of this medication?

• A. Tamoxifen may increase the risk of venous thromboembolism, so the patient should be aware of the signs and symptoms of blood clots.
• B. Tamoxifen may cause hot flashes, so the patient should be prepared for this side effect.
• C. Tamoxifen may decrease the risk of osteoporosis, so the patient should ensure adequate calcium intake.
• D. Tamoxifen may cause weight gain, so the patient should monitor their diet and exercise regularly.

Correct answer: A

Rationale: The correct answer is A. Tamoxifen is known to increase the risk of venous thromboembolism, a serious side effect. Patients should be educated about the signs and symptoms of blood clots, such as swelling, pain, or redness in the affected limb, and the importance of seeking immediate medical attention if they occur. Choice B is incorrect because hot flashes are a common side effect of tamoxifen but not a critical concern like venous thromboembolism. Choice C is incorrect as tamoxifen is not associated with a decreased risk of osteoporosis. Choice D is incorrect because while weight gain can occur with tamoxifen, it is not as crucial to educate the patient about as the risk of venous thromboembolism.

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