Nursing Elites

1. A nurse is providing education to a patient starting hormone replacement therapy (HRT) for menopausal symptoms. What should the nurse emphasize regarding the long-term risks associated with HRT?

• A. HRT may increase the 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 decrease 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 with long-term use.

2. Which of the following hormones do the kidneys secrete to increase red blood cell production?

• A. Erythropoietin
• B. Insulin and glycogen
• C. Testosterone
• D. Thyroid stimulating hormone

Correct answer: A

Rationale: The correct answer is A: Erythropoietin. The kidneys produce erythropoietin to stimulate the production of red blood cells. Insulin and glycogen are not hormones secreted by the kidneys; insulin is produced by the pancreas, and glycogen is a stored form of glucose. Testosterone is a hormone primarily produced by the testes in males and to a lesser extent in females. Thyroid stimulating hormone is produced by the pituitary gland to regulate thyroid function, not red blood cell production.

3. When assessing for potential signs and symptoms of cryptococcosis in a patient with HIV being treated with Amphotericin B, the nurse should prioritize what assessment?

• A. Neurological assessment
• B. Functional assessment
• C. Nutritional assessment
• D. Cardiac assessment

Correct answer: A

Rationale: In a patient with cryptococcosis and HIV, neurological assessment should be prioritized because cryptococcosis commonly affects the central nervous system, leading to symptoms such as headache, confusion, and altered mental status. This assessment is crucial in monitoring for any neurological complications and guiding appropriate interventions. Functional assessment focuses on the patient's ability to perform activities of daily living and is not directly associated with cryptococcosis. Nutritional assessment is important for overall health but is not the priority when assessing for cryptococcosis. Cardiac assessment is not a priority in cryptococcosis as the primary manifestations are related to the central nervous system.

4. Innate resistance or immunity:

• A. Involves 'memory'
• B. Is a development of an individual's later years
• C. Is a relatively slow and specific process
• D. Depends on physical, mechanical, and biochemical barriers

Correct answer: D

Rationale: Innate resistance or immunity relies on the body's natural defenses like physical, mechanical, and biochemical barriers. These barriers act as the first line of defense against pathogens and do not involve memory (choice A). Innate immunity is present from birth and does not develop over an individual's later years (choice B). Additionally, innate immunity is a rapid and nonspecific process, not a slow and specific one (choice C). Therefore, the correct answer is D.

5. 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.

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