Nursing Elites

1. A nursing student having trouble moving her head from side to side is likely experiencing a problem with which type of neurons?

• A. General visceral efferent neurons
• B. Preganglionic neurons
• C. Parasympathetic postganglionic neurons
• D. Pharyngeal efferent neurons

Correct answer: D

Rationale: The correct answer is D: Pharyngeal efferent neurons. Pharyngeal efferent neurons are responsible for controlling head movements, including side-to-side motions. General visceral efferent neurons (Choice A) are involved in innervating smooth muscles and glands in the body's internal organs. Preganglionic neurons (Choice B) are part of the autonomic nervous system and connect the central nervous system to the ganglia. Parasympathetic postganglionic neurons (Choice C) are the second neurons in the parasympathetic nervous system pathway, responsible for innervating target organs. In this case, the issue with moving the head from side to side indicates a problem with the pharyngeal efferent neurons.

2. When educating a patient starting on oral contraceptives, what should the nurse include regarding the medication's effectiveness?

• A. Oral contraceptives are 100% effective when taken correctly.
• B. Oral contraceptives are effective immediately after starting.
• C. Oral contraceptives are less effective if taken with antibiotics.
• D. Oral contraceptives are less effective if taken with food.

Correct answer: C

Rationale: The correct answer is C. Oral contraceptives can be less effective when taken with certain antibiotics as they may interfere with the contraceptive's efficacy, potentially leading to decreased effectiveness. Therefore, patients should be advised to use additional contraception methods if they are also taking antibiotics. Choice A is incorrect because while oral contraceptives are highly effective, they are not 100% foolproof. Choice B is incorrect as oral contraceptives may take some time to reach their full effectiveness after starting. Choice D is incorrect since taking oral contraceptives with food does not necessarily impact their effectiveness.

3. What serious adverse effect should the nurse monitor for during testosterone therapy?

• A. Testosterone therapy increases the risk of cardiovascular events, so regular monitoring is essential.
• B. Testosterone therapy can cause liver dysfunction, so liver function tests should be monitored regularly.
• C. Testosterone therapy can lead to prostate cancer, so regular screenings are recommended.
• D. Testosterone therapy can lead to bone fractures, so bone density should be monitored.

Correct answer: A

Rationale: The correct answer is A. Testosterone therapy is associated with an increased risk of cardiovascular events. Therefore, the nurse should monitor the patient for cardiovascular complications. While monitoring liver function tests (choice B) and bone density (choice D) may be important in some cases, the primary concern during testosterone therapy is the risk of cardiovascular events. Prostate cancer screenings (choice C) are not directly related to testosterone therapy's adverse effects.

4. A patient taking oral contraceptives reports breakthrough bleeding. What should the nurse assess in this patient?

• A. Adherence to the medication schedule
• B. The possibility of pregnancy
• C. The need for an increased dosage
• D. The effectiveness of the current oral contraceptive

Correct answer: A

Rationale: When a patient on oral contraceptives experiences breakthrough bleeding, the nurse should assess the patient's adherence to the medication schedule. Breakthrough bleeding can be a sign of missed doses or inconsistent timing, which can decrease the effectiveness of oral contraceptives. Assessing the patient's adherence helps in ensuring proper use of the medication. Choices B, C, and D are incorrect because breakthrough bleeding is more likely related to adherence issues rather than pregnancy, the need for increased dosage, or the effectiveness of the current oral contraceptive.

5. A patient is starting on a statin medication for hyperlipidemia. What critical instruction should the nurse provide?

• A. Take the medication at night to reduce the risk of muscle pain and other side effects.
• B. Take the medication in the morning with breakfast to improve absorption.
• C. Avoid alcohol consumption while taking this medication to reduce the risk of liver damage.
• D. Take the medication with a high-fat meal to increase its effectiveness.

Correct answer: A

Rationale: The correct answer is A. Statins like atorvastatin should be taken at night to reduce the risk of muscle pain and other side effects. Taking the medication with a high-fat meal (choice D) is not recommended as it can decrease the effectiveness of the medication. Alcohol consumption (choice C) should be moderated but does not need to be completely avoided unless contraindicated. Taking the medication with breakfast (choice B) may not be as effective as taking it at night due to the circadian rhythm of cholesterol synthesis.

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