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 is a complication of compartment syndrome?

• A. Hemorrhage
• B. Pain and tissue damage
• C. Increased limb function
• D. Chronic kidney disease

Correct answer: B

Rationale: The correct answer is B: Pain and tissue damage. Compartment syndrome occurs due to increased pressure within the muscle compartments, leading to pain and tissue damage. Hemorrhage (choice A) is not a typical complication of compartment syndrome. Increased limb function (choice C) is not a complication but rather a potential improvement if the condition is managed appropriately. Chronic kidney disease (choice D) is unrelated to compartment syndrome.

3. Prior to administering iodoquinol (Yodoxin), what assessment should the nurse make?

• A. Assess for allergy to iodine.
• B. Note the time the patient last ate.
• C. Assess for skin eruptions.
• D. Assess for ophthalmic symptoms.

Correct answer: A

Rationale: Before administering iodoquinol (Yodoxin), the nurse should assess for allergy to iodine since iodoquinol is a medication containing iodine. Assessing for skin eruptions (choice C) and ophthalmic symptoms (choice D) are not specifically related to iodoquinol administration. Noting the time the patient last ate (choice B) may be relevant for certain medications but is not directly related to assessing for an allergy to iodine in this case.

4. The early stages of atheroma development are characterized by:

• A. macrophages full of oxidized low-density lipoprotein (LDL; i.e., foam cells) in the intima
• B. accumulation of lipids in the intima (i.e., fatty streak)
• C. accumulation of proteins such as collagen and elastin (i.e., fibrous cap)
• D. development of calcium and a necrotic lipid core

Correct answer: A

Rationale: The correct answer is A. In the early stages of atheroma development, macrophages accumulate oxidized low-density lipoprotein (LDL) and transform into foam cells, leading to the formation of fatty streaks in the intima of blood vessels. This process is a hallmark of the initial stages of atherosclerosis. Choice B is incorrect as it describes the accumulation of lipids in the intima, which is a later event following foam cell formation. Choice C is also incorrect as it refers to the accumulation of proteins forming the fibrous cap, which occurs at a later stage to stabilize the atheroma. Choice D is incorrect as it describes the development of calcium and a necrotic lipid core, typically seen in advanced atherosclerosis rather than the early stages.

5. A man with gout has developed large, hard nodules around his toes and elbows. The phase of gout he is in is:

• A. asymptomatic
• B. acute flare
• C. the intercritical period
• D. chronic gout

Correct answer: D

Rationale: The correct answer is 'chronic gout.' Chronic gout is characterized by the presence of tophi, which are large, hard nodules that can develop around joints like toes and elbows. These tophi are a sign of longstanding, untreated gout. Choice A, 'asymptomatic,' is incorrect as the presence of tophi indicates a symptomatic phase. Choice B, 'acute flare,' is incorrect as acute flares are characterized by sudden and severe pain, inflammation, and redness in the joints, not the development of tophi. Choice C, 'the intercritical period,' is also incorrect as this phase occurs between acute attacks and is typically asymptomatic, without the presence of tophi.

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