Nursing Elites

1. A patient is prescribed estradiol (Estrace) for hormone replacement therapy (HRT). What should the nurse monitor during this therapy?

• A. Blood glucose levels
• B. Liver function tests
• C. Kidney function tests
• D. Blood pressure

Correct answer: B

Rationale: During estradiol therapy, monitoring liver function tests is essential due to the potential for liver dysfunction. Estradiol can affect liver function, making it crucial to monitor enzyme levels. Choice A, blood glucose levels, is not directly impacted by estradiol therapy, making it an incorrect choice. Choice C, kidney function tests, is not typically affected by estradiol therapy, so it is not the priority for monitoring. Choice D, blood pressure, is also not the primary parameter to monitor during estradiol therapy unless there are pre-existing conditions that warrant such monitoring.

2. A group of nursing students and their professor are engaged in a service learning project and will be caring for patients in Haiti. What medication should be administered to prevent the development of malaria?

• A. Metronidazole (Flagyl)
• B. Oprelvekin (Neumega)
• C. Chloroquine phosphate (Aralen)
• D. Chloroprocaine hydrochloride (Nesacaine)

Correct answer: C

Rationale: The correct answer is Chloroquine phosphate (Aralen). Chloroquine is a medication used to prevent and treat malaria. It works by killing the malaria parasite in the red blood cells. Metronidazole (Flagyl) is an antibiotic used to treat various bacterial and parasitic infections, not malaria. Oprelvekin (Neumega) is a medication used to stimulate platelet production. Chloroprocaine hydrochloride (Nesacaine) is a local anesthetic used for epidural anesthesia. Therefore, Chloroquine phosphate is the appropriate medication for preventing malaria in this scenario.

3. A patient is administered a nucleotide reverse transcriptase inhibitor in combination with a nonnucleotide reverse transcriptase inhibitor. What is the main rationale for administering these medications together?

• A. They improve treatment adherence.
• B. They reduce the duration of illness.
• C. They exhibit synergistic antiviral effects.
• D. They prevent opportunistic infections.

Correct answer: C

Rationale: The main rationale for administering a nucleotide reverse transcriptase inhibitor in combination with a nonnucleotide reverse transcriptase inhibitor is that they exhibit synergistic antiviral effects when used together. This combination enhances their antiviral activity against HIV by targeting different steps in the viral replication cycle. Choice A is incorrect because the rationale for combining these medications is based on their antiviral effects, not treatment adherence. Choice B is incorrect because the primary purpose of combination therapy is not to reduce the duration of illness but to improve treatment efficacy. Choice D is incorrect as the main focus of this combination is not on preventing opportunistic infections but on directly targeting the HIV virus.

4. Which of the following nursing diagnoses would provide the most plausible indication for the use of epoetin alfa (Epogen) in a patient with renal failure?

• A. Risk for infection related to decreased erythropoiesis
• B. Activity intolerance related to decreased oxygen-carrying capacity
• C. Powerlessness related to sequelae of renal failure
• D. Ineffective breathing pattern related to inadequate erythropoietin synthesis

Correct answer: B

Rationale: The correct answer is B. In a patient with renal failure, the use of epoetin alfa (Epogen) is primarily aimed at addressing the decreased oxygen-carrying capacity due to impaired erythropoiesis. Epoetin alfa is a medication that stimulates red blood cell production, thereby improving the oxygen-carrying capacity of the blood. This would directly address the activity intolerance commonly seen in patients with renal failure. Choices A, C, and D are incorrect because they do not directly relate to the primary purpose of using epoetin alfa in this context. Risk for infection, powerlessness, and ineffective breathing pattern are important considerations in the care of a patient with renal failure, but they are not the primary indications for using epoetin alfa.

5. A patient taking an oral contraceptive missed one pill. What should the nurse teach the patient to do?

• A. Take two pills as soon as you remember, then continue the regular schedule.
• B. Take one pill as soon as you remember, then continue the regular schedule.
• C. Skip the missed pill and continue the regular schedule.
• D. Take two pills immediately, then continue the regular schedule.

Correct answer: A

Rationale: When a patient taking an oral contraceptive misses one pill, the correct action is to take two pills as soon as they remember and then continue the regular schedule. Option A is the correct answer because doubling up the dose helps maintain the effectiveness of the contraceptive. Option B is incorrect because taking only one pill after missing one may decrease contraceptive effectiveness. Option C is wrong as skipping the missed pill can also reduce effectiveness. Option D is inaccurate because taking two pills immediately is not necessary; the patient should take the missed pill as soon as remembered and then resume the regular dosing schedule.

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