Nursing Elites

1. A patient is being treated with raloxifene (Evista) for osteoporosis. What should the nurse teach the patient about this medication?

• A. It is used as a selective estrogen receptor modulator to prevent bone loss.
• B. It works by decreasing bone formation and increasing bone resorption.
• C. It should be taken with food to reduce gastrointestinal side effects.
• D. It may cause weight gain and fluid retention.

Correct answer: C

Rationale: The correct answer is C. Raloxifene is a selective estrogen receptor modulator (SERM) used to prevent bone loss. It should be taken with food to reduce gastrointestinal side effects, not on an empty stomach. Choices A and B are incorrect because raloxifene is indeed a SERM that prevents bone loss, but it does not directly work by increasing bone formation or decreasing bone resorption. Choice D is incorrect as weight gain and fluid retention are not common side effects of raloxifene.

2. A patient has been prescribed conjugated estrogens for the treatment of menopausal symptoms. What should the nurse include in the patient teaching?

• A. Increase the intake of calcium-rich foods.
• B. Decrease the intake of high-fat foods.
• C. Avoid the use of tobacco.
• D. Avoid exposure to sunlight.

Correct answer: A

Rationale: The correct answer is A: Increase the intake of calcium-rich foods. Patients taking conjugated estrogens should increase their intake of calcium-rich foods to help prevent osteoporosis. Estrogen therapy can lead to an increased risk of osteoporosis, so ensuring an adequate intake of calcium is crucial. Choices B, decreasing high-fat foods, and C, avoiding tobacco, are general health recommendations but not directly related to the prescription of conjugated estrogens. Choice D, avoiding exposure to sunlight, is not a direct concern when taking conjugated estrogens.

3. A patient has been diagnosed with a fungal infection and is to be treated with itraconazole (Sporanox). Prior to administration, the nurse notes that the patient is taking carbamazepine (Tegretol) for a seizure disorder. Based on this medication regime, which of the following will be true regarding the medications?

• A. The serum level of carbamazepine will be increased.
• B. The patient's carbamazepine should be discontinued.
• C. The patient's antiseizure medication should be changed.
• D. The patient will require a higher dosage of itraconazole (Sporanox).

Correct answer: A

Rationale: When itraconazole is administered with carbamazepine, itraconazole may increase the serum levels of carbamazepine, potentially leading to toxicity. Therefore, choice A is correct. Discontinuing carbamazepine (choice B) or changing the antiseizure medication (choice C) is not necessary unless advised by a healthcare provider. Choice D, requiring a higher dosage of itraconazole, is not accurate in this scenario.

4. What is the cause of swelling during acute inflammation?

• A. Collagenase
• B. Fluid exudate
• C. Lymphocytic margination
• D. Anaerobic glycolysis

Correct answer: B

Rationale: Swelling during acute inflammation is primarily caused by the accumulation of fluid exudate in the affected tissues. This fluid exudate contains proteins and cells that leak from blood vessels due to increased vascular permeability. Collagenase (Choice A) is an enzyme that breaks down collagen and is not directly responsible for swelling. Lymphocytic margination (Choice C) is the process where white blood cells line up along the blood vessel walls, which does not directly cause swelling. Anaerobic glycolysis (Choice D) is a metabolic process that occurs in the absence of oxygen and is not related to the mechanism of swelling in acute inflammation.

5. When teaching a young woman about the use of hormonal contraceptives, a nurse should emphasize that these drugs are most effective when taken:

• A. Immediately after sexual intercourse.
• B. At the same time each day.
• C. Before going to bed at night.
• D. On an empty stomach.

Correct answer: B

Rationale: The correct answer is B: 'At the same time each day.' Hormonal contraceptives should be taken consistently at the same time each day to maintain stable hormone levels, which is crucial for their effectiveness. Taking them at random times can increase the risk of contraceptive failure. Choices A, C, and D are incorrect because taking hormonal contraceptives immediately after sexual intercourse, before going to bed at night, or on an empty stomach does not align with the recommended usage instructions for these drugs.

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