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 with benign prostatic hyperplasia (BPH) is prescribed finasteride (Proscar). What outcome should the nurse expect if the medication is effective?

• A. Decreased urinary frequency and urgency
• B. Increased prostate size
• C. Increased blood pressure
• D. Decreased blood pressure

Correct answer: A

Rationale: The correct answer is A: Decreased urinary frequency and urgency. Finasteride is used to reduce the size of the prostate gland in patients with BPH. As a result, when the medication is effective, the patient should experience a decrease in urinary frequency and urgency. Choices B, C, and D are incorrect. Choice B is inaccurate because finasteride aims to reduce prostate size, not increase it. Choices C and D are unrelated to the action of finasteride in treating BPH.

3. A patient is prescribed medroxyprogesterone acetate (Provera) for the treatment of endometriosis. What should the nurse teach the patient about the use of this medication?

• A. Medroxyprogesterone should be taken with food to prevent nausea.
• B. Medroxyprogesterone can be taken intermittently when symptoms worsen.
• C. Medroxyprogesterone should be taken at the same time each day to maintain consistent hormone levels.
• D. Medroxyprogesterone should be discontinued if side effects occur.

Correct answer: C

Rationale: The correct answer is C. Medroxyprogesterone should be taken at the same time each day to maintain consistent hormone levels and effectiveness. Taking it at different times can lead to hormonal fluctuations and reduced medication efficacy. Choice A is incorrect because medroxyprogesterone does not need to be taken with food to prevent nausea. Choice B is incorrect as medroxyprogesterone is typically taken continuously rather than intermittently. Choice D is incorrect because side effects should be reported to the healthcare provider for further evaluation and management, not automatically leading to discontinuation of the medication.

4. Following a spinal cord injury suffered in a motor vehicle accident, a 22-year-old male has lost fine motor function of his finger and thumb, but is still able to perform gross motor movements of his hand and arm. Which component of his 'white matter' has most likely been damaged?

• A. The inner layer (archilayer)
• B. The middle layer (paleolayer)
• C. The outer layer (neolayer)
• D. The reticular formation

Correct answer: C

Rationale: The correct answer is C: The outer layer (neolayer). The white matter of the spinal cord consists of three layers: the outer layer (neolayer), the middle layer (paleolayer), and the inner layer (archilayer). Damage to the outer layer (neolayer) is likely to affect fine motor skills, explaining the loss of fine motor function in the finger and thumb while gross motor movements remain intact. Choices A, B, and D are incorrect as they do not correspond to the specific layer of the white matter that is typically associated with fine motor control.

5. A client on an acute medicine unit of a hospital with a diagnosis of small bowel obstruction is reporting intense, diffuse pain in her abdomen. Which physiologic phenomenon is most likely contributing to her complaint?

• A. Somatic pain resulting from pressure on the parietal peritoneum
• B. Referred pain from her small bowel
• C. Visceral pain resulting from distension and ischemia
• D. Neuropathic pain resulting from autonomic dysfunction

Correct answer: C

Rationale: Visceral pain is associated with distension, ischemia, and inflammation of internal organs. In the case of a small bowel obstruction, the intense, diffuse pain reported by the client is likely due to the distension and ischemia of the small bowel. Somatic pain (Choice A) would be more localized and sharp, typically arising from the parietal peritoneum. Referred pain (Choice B) is pain perceived at a site distant from the actual pathology. Neuropathic pain (Choice D) involves dysfunction or damage to the nervous system and is not typically associated with the described physiologic phenomenon of distension and ischemia in the context of a small bowel obstruction.

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