Nursing Elites

1. When teaching a patient about the use of finasteride (Proscar) for benign prostatic hyperplasia (BPH), what should the nurse emphasize about the expected outcomes of this therapy?

• A. Expect improvement in symptoms within a few days.
• B. Improvement in symptoms may take several weeks or months.
• C. Expect immediate improvement in urinary flow.
• D. The medication will cure BPH after treatment is complete.

Correct answer: B

Rationale: The correct answer is B. The effects of finasteride in treating BPH may take several weeks or months to become noticeable as it works by shrinking the prostate gland over time. Therefore, patients should be informed that improvement in symptoms may not be immediate. Choice A is incorrect because improvement in symptoms is not expected within a few days. Choice C is incorrect as immediate improvement in urinary flow is not typical with finasteride. Choice D is incorrect because finasteride manages BPH symptoms but does not cure the condition.

2. A patient is hospitalized due to nonadherence to an antitubercular drug treatment. Which of the following is most important for the nurse to do?

• A. Observe the patient taking the medications.
• B. Administer the medications parenterally.
• C. Instruct the family on the medication regimen.
• D. Count the number of tablets in the bottle daily.

Correct answer: A

Rationale: In this scenario, the most crucial action for the nurse to take is to observe the patient taking the medications. This ensures that the patient is actually consuming the prescribed antitubercular drugs, addressing the issue of nonadherence directly. Administering the medications parenterally (intravenously or intramuscularly) is not necessary unless there are specific medical reasons requiring this route of administration. Instructing the family on the medication regimen is important for support but may not directly address the patient's nonadherence. Counting the number of tablets in the bottle daily is not as effective as directly observing the patient taking the medications to ensure compliance.

3. A patient with breast cancer is prescribed tamoxifen (Nolvadex). What should the nurse emphasize during patient education?

• A. Tamoxifen may increase the risk of venous thromboembolism, so patients should be aware of the signs and symptoms of blood clots.
• B. Tamoxifen may cause weight gain, so patients should monitor their diet.
• C. Tamoxifen may cause hot flashes and other menopausal symptoms.
• D. Tamoxifen may decrease the risk of osteoporosis, so patients should ensure adequate calcium intake.

Correct answer: A

Rationale: The correct answer is A. Tamoxifen increases the risk of venous thromboembolism, a serious side effect. Therefore, patients should be educated about the signs and symptoms of blood clots, such as swelling, pain, and redness in the legs, and advised to seek immediate medical attention if they occur. Choice B is incorrect because weight gain is not a significant side effect of tamoxifen. Choice C is incorrect because hot flashes and menopausal symptoms are common side effects of tamoxifen but are not as critical to address as venous thromboembolism. Choice D is incorrect because tamoxifen does not decrease the risk of osteoporosis; in fact, it may increase the risk of bone loss in premenopausal women.

4. A staff member asks what leukocytosis means. How should the nurse respond? Leukocytosis can be defined as:

• A. A normal leukocyte count
• B. A high leukocyte count
• C. A low leukocyte count
• D. Another term for leukopenia

Correct answer: B

Rationale: Leukocytosis refers to an abnormally high leukocyte count. This condition is characterized by an elevated number of white blood cells in the bloodstream. Choice A is incorrect because leukocytosis does not refer to a normal leukocyte count. Choice C is incorrect as leukocytosis is not related to a low leukocyte count. Choice D is incorrect as leukopenia is the opposite of leukocytosis, indicating a low white blood cell count.

5. A patient has been prescribed an estrogen-progestin oral contraceptive. The nurse should emphasize that the risk of thrombophlebitis is most likely in patients who:

• A. Are diabetic.
• B. Smoke cigarettes.
• C. Have a history of hypertension.
• D. Are older than 40.

Correct answer: B

Rationale: The correct answer is B: Smoke cigarettes. Smoking is a significant risk factor for thrombophlebitis, especially when combined with estrogen-progestin contraceptives. Choice A, being diabetic, does not directly increase the risk of thrombophlebitis in this context. Choice C, having a history of hypertension, is not a primary risk factor for thrombophlebitis. Choice D, being older than 40, is not the most likely factor associated with an increased risk of thrombophlebitis in patients taking estrogen-progestin oral contraceptives.

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