Nursing Elites

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

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

Correct answer: C

Rationale: During estradiol therapy, the nurse should monitor liver function tests. Estradiol can potentially impact liver function, making it essential to assess for any signs of liver dysfunction. Monitoring blood pressure (Choice A) is not directly related to estradiol therapy. While blood glucose levels (Choice B) should be monitored in patients taking certain medications like corticosteroids or antipsychotics, it is not typically necessary for patients on estradiol therapy. Kidney function tests (Choice D) are not the priority for monitoring during estradiol therapy, as the liver is more commonly affected.

2. While planning care for an elderly patient, the nurse remembers that increased age is associated with:

• A. Increased T cell function
• B. Increased immune function
• C. Increased production of antibodies
• D. Increased levels of circulating autoantibodies

Correct answer: D

Rationale: As individuals age, their immune function tends to decrease, making them more susceptible to infections and diseases. Additionally, increased age is associated with higher levels of circulating autoantibodies, which can lead to autoimmune conditions. Choice A is incorrect as aging is not typically associated with increased T cell function. Choice C is also incorrect as aging does not necessarily result in increased production of antibodies. Therefore, the correct answers are B (Decreased immune function) and D (Increased levels of circulating autoantibodies).

3. In a male patient with benign prostatic hyperplasia (BPH) prescribed tamsulosin (Flomax), what is the expected therapeutic effect of this medication?

• A. Decreased urinary frequency and urgency
• B. Increased urinary output
• C. Decreased blood pressure
• D. Increased hair growth

Correct answer: A

Rationale: The correct answer is A: Decreased urinary frequency and urgency. Tamsulosin is prescribed for patients with BPH to relax the muscles in the prostate and bladder neck. This relaxation helps in relieving the symptoms of BPH, such as decreased urinary flow, frequent urination, and urgency. Choice B is incorrect because tamsulosin does not increase urinary output but rather improves the flow of urine by relaxing the muscles. Choice C is incorrect as tamsulosin is not primarily used for reducing blood pressure. Choice D is also incorrect as tamsulosin does not promote increased hair growth.

4. A patient who is taking metronidazole for the past 4 days for the treatment of a parasitic infection reports to the nurse that his most recent dose made him 'flushed, sweaty, and sick in the stomach.' What assessment is most likely to address the cause of this phenomenon?

• A. “Have you experienced any allergic reactions to metronidazole before?”
• B. “Did you drink any alcoholic beverages around the time of taking the drug?”
• C. “Did you take this dose on an empty stomach?”
• D. “Are you currently using any over-the-counter antihistamines?”

Correct answer: B

Rationale: The correct answer is B. Metronidazole can cause a disulfiram-like reaction when taken with alcohol, leading to symptoms such as flushing, sweating, and gastrointestinal upset. Asking the patient about alcohol consumption can help identify if this reaction is due to alcohol interaction. Choice A is incorrect as it focuses on penicillin allergy, which is not relevant to metronidazole. Choice C is less likely to cause the reported symptoms and is not a common concern with metronidazole. Choice D is not directly related to the symptoms described by the patient.

5. What is the most sensitive indicator of altered brain function?

• A. The ability to perform complex mathematics
• B. Altered level of consciousness
• C. The lack of cerebrospinal fluid production
• D. Intact cranial nerve functions

Correct answer: B

Rationale: The correct answer is B: Altered level of consciousness. Changes in consciousness are the most sensitive indicator of altered brain function as they can signal underlying neurological issues. Option A, the ability to perform complex mathematics, though it involves brain function, is not as sensitive or direct an indicator as altered consciousness. Option C, the lack of cerebrospinal fluid production, is more related to conditions like hydrocephalus rather than a direct indicator of altered brain function. Option D, intact cranial nerve functions, indicate the normal functioning of peripheral nerves and are not as sensitive to changes in brain function as alterations in consciousness.

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