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. Which of the following disturbances would cause a client to experience gout?

• A. Serotonin receptors
• B. Uric acid metabolism
• C. Liver function
• D. Cardiac function

Correct answer: B

Rationale: Gout is caused by a disturbance in uric acid metabolism, leading to the accumulation of uric acid crystals in joints. Serotonin receptors (Choice A) are not related to gout. Liver function (Choice C) is important for metabolism but is not directly linked to gout development. Cardiac function (Choice D) is primarily related to the heart's functioning and not associated with gout.

3. During admission, 82-year-old Mr. Robeson is brought to the medical-surgical unit for diagnostic confirmation and management of probable delirium. Which statement by the client’s daughter best supports the diagnosis?

• A. “Maybe it’s just caused by aging. This usually happens by age 82.”
• B. “The changes in his behavior came on so quickly! I wasn’t sure what was happening.”
• C. “Dad just didn’t seem to know what he was doing. He would forget what he had for breakfast.”
• D. “Dad has always been so independent. He’s lived alone for years since mom died.”

Correct answer: B

Rationale: The correct answer is B because sudden onset of behavioral changes is a typical symptom of delirium. Delirium is characterized by an acute and fluctuating disturbance in attention, awareness, and cognition. Choice A is incorrect because delirium is not a normal part of aging. Choice C describes memory issues, which can be seen in delirium but are less specific than sudden behavioral changes. Choice D, while it mentions the patient's independence, does not directly support the diagnosis of delirium.

4. What is the common denominator of all forms of heart failure?

• A. Pulmonary edema
• B. Jugular venous distention
• C. Peripheral edema
• D. Reduced cardiac output

Correct answer: D

Rationale: The correct answer is D: Reduced cardiac output. All forms of heart failure share the common denominator of reduced cardiac output, which leads to inadequate tissue perfusion. Pulmonary edema (choice A) is a consequence of heart failure but not the common denominator. Jugular venous distention (choice B) and peripheral edema (choice C) are signs of heart failure but do not represent the common denominator shared by all forms.

5. A nurse is teaching a patient about the use of raloxifene (Evista) for the prevention of osteoporosis. What is the primary therapeutic action of this medication?

• A. It decreases the absorption of calcium from the intestines.
• B. It decreases bone resorption and increases bone density.
• C. It increases the excretion of calcium through the kidneys.
• D. It stimulates the formation of new bone.

Correct answer: B

Rationale: The correct answer is B. Raloxifene, a selective estrogen receptor modulator (SERM), works by decreasing bone resorption and increasing bone density. This action helps in preventing osteoporosis by maintaining bone strength. Choice A is incorrect as raloxifene does not affect the absorption of calcium from the intestines. Choice C is incorrect as raloxifene does not increase the excretion of calcium through the kidneys. Choice D is incorrect as raloxifene does not directly stimulate the formation of new bone; instead, it primarily works by reducing bone loss.

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