Nursing Elites

1. A nurse is caring for a postmenopausal client prescribed the aromatase inhibitor anastrozole for the treatment of breast cancer. Which of the following should the nurse inform the client she may experience?

• A. Weight gain
• B. Muscle and joint pain
• C. Night sweats
• D. Increased appetite

Correct answer: B

Rationale: The correct answer is B: Muscle and joint pain. Muscle and joint pain are common side effects of aromatase inhibitors like anastrozole. These side effects can be managed with analgesics as prescribed by the healthcare provider. Weight gain (choice A) is not typically associated with anastrozole. Night sweats (choice C) are also not commonly reported with this medication. Increased appetite (choice D) is not a common side effect of anastrozole.

2. A client is being educated by a nurse about the use of bupropion. Which of the following should be included?

• A. It can cause weight gain
• B. It may increase seizure risk
• C. It is an SSRI
• D. It has no side effects

Correct answer: B

Rationale: The correct answer is B. Bupropion may lower the seizure threshold, increasing the risk of seizures, especially in clients with a history of seizures. Choice A is incorrect because bupropion is associated with weight loss rather than weight gain. Choice C is incorrect as bupropion is not an SSRI; it is an aminoketone antidepressant. Choice D is incorrect as bupropion, like all medications, can have side effects, and it is essential for clients to be aware of them.

3. A nurse is providing education to a client in the first trimester of pregnancy. What information should the nurse include regarding the cause of indigestion and heartburn?

• A. Estrogen causes increased appetite
• B. Progesterone causes relaxation of the cardiac sphincter allowing acid to reflux
• C. HCG hormone leads to increased gastric acidity
• D. The uterus compresses the stomach early in pregnancy

Correct answer: B

Rationale: The correct answer is B. Progesterone causes relaxation of the smooth muscles in the body, including the cardiac sphincter. This relaxation allows stomach acid to reflux into the esophagus, leading to heartburn during pregnancy. Choices A, C, and D are incorrect because they do not directly relate to the physiological mechanism that causes heartburn during pregnancy. Estrogen causing increased appetite (Choice A) is not directly linked to heartburn. HCG hormone increasing gastric acidity (Choice C) is not the primary cause of heartburn during pregnancy. The uterus compressing the stomach early in pregnancy (Choice D) may contribute to feelings of fullness or bloating but is not the main cause of heartburn.

4. A nurse is providing teaching to a client with a new diagnosis of diabetes mellitus. Which instruction should the nurse give to the client to monitor for hypoglycemia?

• A. Monitor for polyuria
• B. Monitor for diaphoresis
• C. Monitor for abdominal pain
• D. Monitor for thirst

Correct answer: B

Rationale: The correct answer is B: 'Monitor for diaphoresis.' Diaphoresis, which refers to excessive sweating, is a common symptom of hypoglycemia. It indicates a low blood sugar level and should prompt immediate treatment. Polyuria (excessive urination), abdominal pain, and thirst are not typically associated with hypoglycemia. Polyuria is more commonly linked to hyperglycemia, while abdominal pain and thirst are not specific symptoms of hypoglycemia.

5. A nurse is providing teaching to a client who has a new prescription for warfarin. Which of the following statements by the client indicates a need for further teaching?

• A. I will take ibuprofen for headaches.
• B. I will use an electric razor to shave.
• C. I will avoid eating large amounts of leafy green vegetables.
• D. I will have my blood levels checked regularly.

Correct answer: A

Rationale: The correct answer is A. Ibuprofen can increase the risk of bleeding when taken with warfarin, as both medications affect clotting. The client should use alternative pain relievers like acetaminophen. Choice B is correct as using an electric razor is a safe choice to prevent cuts that could lead to bleeding. Choice C is correct as warfarin interacts with vitamin K found in leafy green vegetables. Choice D is correct as regular blood level checks are necessary to monitor the effects and adjust the warfarin dosage if needed.

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