Nursing Elites

1. In a male patient with benign prostatic hyperplasia (BPH) prescribed tamsulosin (Flomax), what is the expected therapeutic effect of this medication?

• A. Decreased urinary frequency and urgency
• B. Increased urinary output
• C. Decreased blood pressure
• D. Increased hair growth

Correct answer: A

Rationale: The correct answer is A: Decreased urinary frequency and urgency. Tamsulosin is prescribed for patients with BPH to relax the muscles in the prostate and bladder neck. This relaxation helps in relieving the symptoms of BPH, such as decreased urinary flow, frequent urination, and urgency. Choice B is incorrect because tamsulosin does not increase urinary output but rather improves the flow of urine by relaxing the muscles. Choice C is incorrect as tamsulosin is not primarily used for reducing blood pressure. Choice D is also incorrect as tamsulosin does not promote increased hair growth.

2. Which individual is likely to have the best prognosis for recovery from his or her insult to the peripheral nervous system? An adult:

• A. client who developed rhabdomyolysis and ischemic injury after a tourniquet application.
• B. who suffered a bone-depth laceration to the shoulder during a knife attack.
• C. who had his forearm partially crushed by gears during an industrial accident.
• D. client who had nerves transected during surgery to remove a tumor from the mandible.

Correct answer: C

Rationale: The correct answer is C. Crushing-type injuries to the peripheral nervous system generally have a better prognosis compared to nerve transections or lacerations. In the scenario provided, the individual who had his forearm partially crushed by gears during an industrial accident is likely to have a better chance of recovery compared to nerve transection (choice D) or laceration (choice B). Rhabdomyolysis and ischemic injury after tourniquet application (choice A) are not directly related to peripheral nerve injury and do not indicate a better prognosis for recovery.

3. A patient presents with a chronic cough, night sweats, and weight loss. A chest X-ray reveals upper lobe cavitary lesions. Which of the following is the most likely diagnosis?

• A. Tuberculosis
• B. Pneumonia
• C. Lung cancer
• D. Sarcoidosis

Correct answer: A

Rationale: The correct answer is A: Tuberculosis. Cavitary lesions in the upper lobes are classic findings seen in tuberculosis. This infectious disease commonly presents with symptoms such as chronic cough, night sweats, and weight loss. Pneumonia (Choice B) typically does not present with cavitary lesions on chest X-ray. Lung cancer (Choice C) may present with similar symptoms but is less likely to cause cavitary lesions in the upper lobes. Sarcoidosis (Choice D) usually presents with bilateral hilar lymphadenopathy and non-caseating granulomas, different from the cavitary lesions described in the case.

4. A patient with a complex medical history is considering the use of oral contraceptives. The nurse should be aware that many antibiotics and antiseizure medications cause what effect when combined with oral contraceptives?

• A. Increased risk of pregnancy
• B. Increased blood pressure
• C. Increased risk of thromboembolism
• D. Increased gastric acid

Correct answer: A

Rationale: The correct answer is A: Increased risk of pregnancy. Certain antibiotics and anticonvulsants can decrease the effectiveness of oral contraceptives by inducing liver enzymes that metabolize the hormones more quickly. This interaction can lead to a decreased contraceptive effect, thereby increasing the risk of pregnancy. Choices B, C, and D are incorrect as they do not directly relate to the effect of antibiotics and antiseizure medications on oral contraceptives.

5. A male patient is receiving testosterone therapy for hypogonadism. What adverse effect should the nurse monitor during this therapy?

• A. Increased risk of cardiovascular events
• B. Increased risk of liver dysfunction
• C. Increased risk of prostate cancer
• D. Increased risk of bone fractures

Correct answer: A

Rationale: The correct answer is A: Increased risk of cardiovascular events. Testosterone therapy can lead to an increased risk of cardiovascular events like heart attacks and strokes, especially in older patients. Choice B, increased risk of liver dysfunction, is not a common adverse effect of testosterone therapy. Choice C, increased risk of prostate cancer, is a concern when using testosterone therapy in patients with existing prostate cancer, but not a general adverse effect. Choice D, increased risk of bone fractures, is not typically associated with testosterone therapy.

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