Nursing Elites

1. A patient has been prescribed raloxifene (Evista) for the prevention of osteoporosis. What effect should the nurse include in the teaching plan regarding the action of this medication?

• A. Decreases calcium excretion by the kidneys.
• B. Increases intestinal absorption of calcium.
• C. Stimulates bone formation by increasing osteoblast activity.
• D. Selectively binds to estrogen receptors, decreasing bone resorption.

Correct answer: D

Rationale: The correct answer is D: Selectively binds to estrogen receptors, decreasing bone resorption. Raloxifene is a selective estrogen receptor modulator (SERM) that works by binding to estrogen receptors, thereby decreasing bone resorption. This action helps in the prevention and treatment of osteoporosis by preserving bone density. Choices A, B, and C are incorrect because raloxifene does not directly affect calcium excretion by the kidneys, intestinal absorption of calcium, or stimulate bone formation by increasing osteoblast activity.

2. Which of the following are characteristic, localized cardinal signs of acute inflammation? (Select ONE that does not apply.)

• A. Redness
• B. Fatigue
• C. Swelling
• D. Warmth

Correct answer: B

Rationale: The correct answers are A, C, and D. Redness, swelling, and warmth are classic signs of acute inflammation. Redness occurs due to increased blood flow, swelling is caused by leakage of fluid into tissues, and warmth is due to the vasodilation and increased blood flow in the affected area. Fatigue is not a cardinal sign of acute inflammation and is not directly associated with the inflammatory response.

3. Medroxyprogesterone acetate (Provera) is indicated for the treatment of women with

• A. uterine bleeding.
• B. cervical cancer.
• C. ovarian cancer.
• D. fibromyalgia.

Correct answer: A

Rationale: Medroxyprogesterone acetate (Provera) is commonly used to treat conditions like abnormal uterine bleeding, amenorrhea, and endometriosis. It helps regulate the menstrual cycle and reduce excessive bleeding. Therefore, the correct answer is A. Choice B, cervical cancer, is incorrect because Provera is not indicated for the treatment of cancer. Choice C, ovarian cancer, is also incorrect as Provera is not a primary treatment for ovarian cancer. Choice D, fibromyalgia, is unrelated to the use of medroxyprogesterone acetate.

4. A patient was sneezing frequently after a few days of allergic rhinitis, and she noticed her eye became red. She denies any trauma, eye pain, or visual disturbance. Physical examination reveals a subconjunctival hemorrhage. Which statement is accurate pertaining to this case?

• A. The hemorrhage will resolve without treatment within 2 weeks.
• B. The patient should be referred for immediate ophthalmologic examination.
• C. Corticosteroid eye drops will be prescribed to reduce the bleeding.
• D. Antibiotic eye drops will be prescribed to prevent infection.

Correct answer: A

Rationale: The correct answer is A: 'The hemorrhage will resolve without treatment within 2 weeks.' Subconjunctival hemorrhage typically resolves on its own without treatment. It is a self-limiting condition that does not require specific intervention. Choice B is incorrect as immediate ophthalmologic examination is not necessary for subconjunctival hemorrhage unless there are other concerning symptoms or risk factors present. Choice C is incorrect because corticosteroid eye drops are not typically used for subconjunctival hemorrhage. Choice D is also incorrect as antibiotic eye drops are not indicated since subconjunctival hemorrhage is not due to an infection.

5. A 25-year-old just had a colonoscopy and was diagnosed with Crohn disease. Which of the following is consistent with this diagnosis?

• A. Right lower quadrant cramping
• B. Severe bloody diarrhea
• C. Nausea and vomiting
• D. Mostly affects the rectum

Correct answer: A

Rationale: Crohn's disease is a type of inflammatory bowel disease that can affect any part of the digestive tract. Right lower quadrant cramping is consistent with Crohn's disease as it commonly involves the terminal ileum, which is located in the right lower quadrant of the abdomen. Severe bloody diarrhea is more characteristic of ulcerative colitis, another type of inflammatory bowel disease. Nausea and vomiting are not specific symptoms of Crohn's disease. Crohn's disease can affect any part of the digestive tract, not just the rectum, so it is not accurate to say it mostly affects the rectum.

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