Nursing Elites

1. When a child jumps out of the tub, crying and stating her feet are 'burning,' what pathophysiologic principle is responsible for this response?

• A. Pain receptors (nociceptors) have been activated in response to a thermal stimulus.
• B. The child's skin thermal receptors have undergone adaptation.
• C. The child is exhibiting a psychogenic pain response due to anxiety.
• D. The child is experiencing a conditioned pain response based on previous experiences.

Correct answer: A

Rationale: The child's reaction is due to the activation of nociceptors, which are pain receptors that respond to thermal stimuli. This response is an immediate protective mechanism to prevent tissue damage caused by extreme temperatures. Option B is incorrect because adaptation does not explain the child's immediate and intense response. Option C is incorrect as there is a clear physical stimulus present, ruling out a psychogenic response. Option D is incorrect as the child's response is not based on previous experiences but rather on the current thermal stimulus.

2. A 52-year-old male patient is taking finasteride (Proscar) for benign prostatic hyperplasia (BPH). What patient teaching should the nurse provide?

• A. Take the medication with food.
• B. Avoid taking NSAIDs while on this medication.
• C. Avoid driving or operating heavy machinery while taking this medication.
• D. Women who are or may become pregnant should not handle crushed or broken tablets.

Correct answer: D

Rationale: The correct answer is D. Finasteride, used for BPH, can be harmful to a developing male fetus. Therefore, women who are or may become pregnant should not handle crushed or broken tablets to avoid potential absorption through the skin. Choice A is incorrect as finasteride can be taken with or without food. Choice B is incorrect because there is no specific interaction between finasteride and NSAIDs mentioned. Choice C is incorrect as finasteride does not typically cause drowsiness or impair mental alertness.

3. When teaching a patient starting on oral contraceptives, what should the nurse include regarding the medication's effectiveness?

• A. Oral contraceptives are 100% effective when taken correctly.
• B. Oral contraceptives are effective immediately after starting.
• C. Oral contraceptives are less effective if taken with certain antibiotics.
• D. Oral contraceptives are less effective if taken with food.

Correct answer: C

Rationale: The correct answer is C. Oral contraceptives can be less effective when taken with certain antibiotics as they may interfere with the effectiveness of the contraceptive. It is important for patients to be aware of this interaction to consider additional contraceptive methods during antibiotic therapy. Choices A and B are incorrect as no contraceptive method is 100% effective, and oral contraceptives typically require a period of time to reach full effectiveness. Choice D is incorrect as taking oral contraceptives with food does not significantly impact their effectiveness.

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

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

Correct answer: A

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

5. A patient with a history of cardiovascular disease is prescribed hormone replacement therapy (HRT). What should the nurse emphasize regarding the long-term risks associated with HRT?

• A. HRT is associated with an increased risk of cardiovascular events, including heart attack and stroke.
• B. HRT may decrease the risk of osteoporosis.
• C. HRT may improve mood and energy levels.
• D. HRT may increase the risk of breast cancer.

Correct answer: A

Rationale: HRT is associated with an increased risk of cardiovascular events, including heart attack and stroke, particularly in patients with a history of cardiovascular disease.

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