Nursing Elites

1. How does tamsulosin (Flomax) primarily benefit male patients with benign prostatic hyperplasia (BPH)?

• A. Relaxation of the muscles in the prostate and bladder neck, leading to improved urinary flow.
• B. Reduction in prostate size and improvement in urinary symptoms.
• C. Increase in urine flow and relief of urinary obstruction.
• D. Improvement in erectile function.

Correct answer: A

Rationale: The correct answer is A: Tamsulosin works by relaxing the muscles in the prostate and bladder neck, which helps improve urinary flow in patients with BPH. This relaxation reduces the symptoms associated with BPH, such as urinary hesitancy, urgency, and frequency. Choice B is incorrect because tamsulosin does not directly reduce the size of the prostate gland. Choice C is incorrect as while tamsulosin does improve urine flow, its primary mechanism of action is through muscle relaxation rather than directly relieving obstruction. Choice D is incorrect as tamsulosin is not indicated for improving erectile function; its main therapeutic effect is targeted towards urinary symptoms related to BPH.

2. 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.

3. A 50-year-old female was diagnosed with sideroblastic anemia. Which of the following assessment findings would most likely occur?

• A. Bronze-colored skin
• B. Decreased iron
• C. Normochromic erythrocytes
• D. Aplastic bone marrow

Correct answer: A

Rationale: The correct answer is A: 'Bronze-colored skin.' Sideroblastic anemia is characterized by excess iron deposition, leading to bronze-colored skin. This occurs due to the abnormal accumulation of iron in tissues. Choices B, C, and D are incorrect because sideroblastic anemia does not typically present with decreased iron levels, normochromic erythrocytes, or aplastic bone marrow.

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. What important instruction should the nurse provide about taking medroxyprogesterone acetate (Provera) for a patient with endometriosis?

• A. Take the medication at the same time each day to maintain consistent hormone levels.
• B. Medroxyprogesterone should be taken with food to reduce gastrointestinal upset.
• C. Discontinue medroxyprogesterone if side effects occur.
• D. Medroxyprogesterone should be taken once a week to maintain effectiveness.

Correct answer: A

Rationale: The correct answer is to take the medication at the same time each day to maintain consistent hormone levels and effectiveness. This consistency is crucial for achieving therapeutic outcomes. Choice B is incorrect because medroxyprogesterone should be taken at the same time each day, regardless of food intake. Choice C is incorrect because side effects should be reported to the healthcare provider for further evaluation rather than discontinuing the medication abruptly. Choice D is incorrect as medroxyprogesterone is usually taken daily for the prescribed duration.

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