Nursing Elites

1. A patient is starting on medroxyprogesterone acetate (Provera) for endometriosis. What should the nurse include in the patient teaching?

• A. Take the medication with food to prevent nausea.
• B. Take the medication at the same time each day to maintain consistent hormone levels.
• C. Avoid prolonged sun exposure while taking this medication.
• D. Discontinue the medication if side effects occur.

Correct answer: B

Rationale: The correct answer is B. Patients starting on medroxyprogesterone acetate (Provera) for endometriosis should be instructed to take the medication at the same time each day to maintain consistent hormone levels and effectiveness. Choice A is incorrect because medroxyprogesterone acetate can be taken with or without food. Choice C is unrelated to the medication and not a specific concern with its use. Choice D is incorrect as patients should not discontinue the medication without consulting their healthcare provider, even if side effects occur.

2. If a patient complains of dizziness, which term below best describes this feeling?

• A. Contraindication
• B. Sign
• C. Objective data
• D. Symptom

Correct answer: D

Rationale: The correct answer is D: 'Symptom.' Dizziness is a symptom because it is a subjective experience reported by the patient. A 'contraindication' refers to a specific situation in which a drug, procedure, or surgery should not be used because it may be harmful. A 'sign' is an objective finding that can be observed or measured. 'Objective data' refers to measurable and observable information about a patient's condition, which is usually obtained through physical examination or diagnostic tests. Therefore, in this case, 'Symptom' is the best term to describe the patient's feeling of dizziness.

3. A patient is prescribed testosterone gel for hypogonadism. What important instruction should the nurse provide regarding the application of this medication?

• A. Apply the gel to the chest or upper arms.
• B. Apply the gel to the face and neck.
• C. Apply the gel to the genitals for maximum absorption.
• D. Apply the gel to the scalp and back.

Correct answer: A

Rationale: The correct answer is to apply the testosterone gel to the chest or upper arms. This is recommended to minimize the risk of unintentional transfer of the medication to others, especially women and children, through skin contact. Applying the gel to the face, neck, or genitals is not advised as it can lead to unintended exposure to others. Additionally, applying the gel to the scalp or back is not appropriate as these areas are not indicated for absorption of testosterone.

4. A female patient is taking combined hormonal contraceptives to prevent pregnancy. She visits the gynecology clinic and is noted to have a blood pressure of 176/102 mm Hg. The patient is started on enalapril mesylate 10 mg. In collaboration with the primary care provider, what other patient teaching should be provided based on her current medication regimen?

• A. Instruct on a low-salt diet.
• B. Instruct to discontinue the contraceptives.
• C. Instruct on the use of relaxation techniques to decrease stress.
• D. Instruct on the rationale for increasing the contraceptive dose.

Correct answer: A

Rationale: Women on hormonal contraceptives and antihypertensives like enalapril should be counseled to adopt a low-salt diet if severe hypertension occurs. This dietary modification can help in managing blood pressure levels. Instructing to discontinue the contraceptives is crucial in cases of severe hypertension as it poses an increased risk of cardiovascular events. Instructing on relaxation techniques may have some benefits in reducing stress levels but addressing the root cause, such as discontinuing contraceptives in this scenario, is more critical. There is no rationale for increasing the contraceptive dose when hypertension is present; in fact, it should be stopped to prevent complications.

5. Which of the following types of vitamin or mineral deficiency can cause megaloblastic anemia and is associated with lower extremity paresthesias?

• A. Vitamin B12
• B. Folate
• C. Iron
• D. Vitamin K

Correct answer: A

Rationale: The correct answer is Vitamin B12. Vitamin B12 deficiency can lead to megaloblastic anemia and neurological symptoms, including lower extremity paresthesias. Folate deficiency can also cause megaloblastic anemia but typically does not present with neurological symptoms. Iron deficiency leads to microcytic anemia, not megaloblastic anemia. Vitamin K deficiency is associated with coagulation abnormalities, not megaloblastic anemia.

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