Nursing Elites

1. 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.

2. In a postmenopausal woman, what condition can be prevented by administering estradiol (Estraderm)?

• A. Endometriosis
• B. Amenorrhea
• C. Osteoporosis
• D. Uterine cancer

Correct answer: C

Rationale: The correct answer is C: Osteoporosis. Estradiol, a form of estrogen, is used to prevent osteoporosis in postmenopausal women by maintaining bone density. Choice A, Endometriosis, is incorrect as estradiol is not used to prevent or treat this condition. Choice B, Amenorrhea, is not prevented by estradiol but rather may result from hormonal changes. Choice D, Uterine cancer, is not directly prevented by estradiol; in fact, long-term unopposed estrogen use can increase the risk of uterine cancer.

3. A secondary immune response differs from the primary immune response in that:

• A. It is more rapid than the primary response and results in higher antibody levels
• B. It is slower than the primary response and doesn't change the antibody levels
• C. It occurs at the same time as the primary response but results in a decrease in antibodies
• D. It only occurs in hyperallergic reactions and results in a decrease in antibodies

Correct answer: A

Rationale: The correct answer is A. A secondary immune response is characterized by being more rapid than the primary response and results in higher antibody levels. This is because memory B cells are already present and can quickly differentiate into plasma cells upon re-exposure to the antigen. Choice B is incorrect because a secondary immune response is faster, not slower, than the primary response, and it does lead to higher antibody levels. Choice C is incorrect because a secondary response does not result in a decrease in antibodies; instead, it leads to an increase. Choice D is incorrect because a secondary immune response is not limited to hyperallergic reactions, and it results in an increase, not a decrease, in antibodies.

4. A 54-year-old man presents with a temperature of 38.8°C (101.8°F), a racing heart, fatigue, and an upset stomach after spending an afternoon building a deck on a very hot, humid day. The physician assessing the man is performing a differential diagnosis as part of her assessment. Which finding would suggest fever rather than hyperthermia as a cause of the elevation in the man's temperature?

• A. Absence of sweating
• B. Shivering
• C. Lack of thirst
• D. Increased heart rate

Correct answer: B

Rationale: Shivering is a physiological response to fever, as the body attempts to generate heat to increase the internal temperature. Hyperthermia, on the other hand, does not involve shivering. Absence of sweating (choice A) is more indicative of hyperthermia, as the body struggles to cool down without sweating. Lack of thirst (choice C) can be seen in both fever and hyperthermia. Increased heart rate (choice D) can occur in both fever and hyperthermia due to the body's attempt to regulate temperature.

5. A client arrives with symptoms of stroke. What should the nurse assess first?

• A. Level of consciousness
• B. Blood pressure
• C. Pupil reaction
• D. Heart rate

Correct answer: A

Rationale: Assessing the level of consciousness is a critical first step in evaluating a potential stroke. Changes in the level of consciousness can indicate the severity and location of brain damage, helping to guide immediate interventions. Assessing blood pressure, pupil reaction, and heart rate are also important aspects of the assessment in a suspected stroke patient. However, the priority is to quickly determine the client's level of consciousness to assess their neurological status.

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