Nursing Elites

1. A patient taking an oral contraceptive missed one pill. What should the nurse teach the patient to do?

• A. Take two pills as soon as you remember, then continue the regular schedule.
• B. Take one pill as soon as you remember, then continue the regular schedule.
• C. Skip the missed pill and continue the regular schedule.
• D. Take two pills immediately, then continue the regular schedule.

Correct answer: A

Rationale: When a patient taking an oral contraceptive misses one pill, the correct action is to take two pills as soon as they remember and then continue the regular schedule. Option A is the correct answer because doubling up the dose helps maintain the effectiveness of the contraceptive. Option B is incorrect because taking only one pill after missing one may decrease contraceptive effectiveness. Option C is wrong as skipping the missed pill can also reduce effectiveness. Option D is inaccurate because taking two pills immediately is not necessary; the patient should take the missed pill as soon as remembered and then resume the regular dosing schedule.

2. Which of the following patients are at higher risk for developing oral cancer?

• A. A female who has taken oral contraceptives for the last 4 years
• B. Both an adult male with a history of alcoholism and a middle-aged male who smokes a pipe
• C. An adult female who eats spicy foods regularly
• D. An older adult female who chews gum frequently

Correct answer: B

Rationale: The correct answer is 'Both an adult male with a history of alcoholism and a middle-aged male who smokes a pipe.' Alcohol consumption and tobacco use, such as smoking a pipe, are well-known risk factors for developing oral cancer. These two factors significantly increase the likelihood of developing oral cancer compared to the other choices. Taking oral contraceptives, eating spicy foods regularly, and chewing gum frequently are not established risk factors for oral cancer, making them less likely to lead to the development of this type of cancer.

3. A patient with systemic candidiasis has been prescribed flucytosine. The nurse should be aware of the need to administer this drug with which of the following?

• A. Vitamin D and calcium supplements
• B. Fluconazole (Diflucan)
• C. Amphotericin B
• D. Penicillin G

Correct answer: C

Rationale: The correct answer is C: Amphotericin B. When treating systemic candidiasis, Amphotericin B is the drug of choice, not flucytosine. Amphotericin B is an antifungal medication used to treat severe fungal infections like systemic candidiasis. Choices A, B, and D are incorrect because vitamin D and calcium supplements, fluconazole, and penicillin G are not the drugs of choice for treating systemic candidiasis.

4. A 21-year-old male is brought to the ED following a night of partying in his fraternity. His friends found him 'asleep' and couldn't get him to respond. They cannot recall how many alcoholic beverages he drank the night before. While educating a student nurse and the man's friends, the nurse begins by explaining that alcohol is:

• A. A water-soluble compound that is easily absorbed by the gastric lining of the stomach.
• B. Very lipid-soluble and rapidly crosses the blood–brain barrier.
• C. Able to reverse the transport of some substances to remove them from the brain.
• D. Very likely to cause sedation and therefore the client just needs to sleep it off.

Correct answer: B

Rationale: The correct answer is B. Alcohol is very lipid-soluble and rapidly crosses the blood–brain barrier, leading to its effects on the central nervous system and causing symptoms like sedation and unconsciousness. Choice A is incorrect because alcohol is not water-soluble; it is lipid-soluble. Choice C is incorrect as alcohol does not reverse the transport of substances from the brain. Choice D is incorrect as sedation from alcohol is not a reason to just 'sleep it off' in cases of alcohol poisoning, which can be life-threatening and requires medical attention.

5. Which of the following steps occurs first during hemostasis?

• A. Vascular spasm
• B. Platelet plug
• C. Coagulation
• D. Dissolution of the clot

Correct answer: A

Rationale: Vascular spasm is the initial step in hemostasis, where blood vessels constrict to reduce blood flow to the injured area. This constriction helps limit blood loss until further steps like platelet plug formation and coagulation can take place. Platelet plug formation and coagulation occur after the vascular spasm, making them incorrect choices. Dissolution of the clot happens much later in the healing process, after the injury has sufficiently healed.

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