Nursing Elites

1. A patient is prescribed medroxyprogesterone acetate (Provera) for the treatment of endometriosis. What key instruction should the nurse provide regarding the administration of this medication?

• A. Take the medication at the same time each day to maintain consistent hormone levels.
• B. Discontinue the medication if side effects occur.
• C. Take the medication with food to prevent gastrointestinal upset.
• D. Apply the medication once a week.

Correct answer: A

Rationale: The correct instruction for medroxyprogesterone acetate (Provera) is to take the medication at the same time each day to maintain consistent hormone levels and ensure its effectiveness. Choice B is incorrect because discontinuing the medication abruptly without consulting healthcare providers can be harmful. Choice C is incorrect as taking the medication with food is not necessary for this specific drug. Choice D is incorrect as medroxyprogesterone is typically taken orally, not applied topically.

2. A family member expresses concern to a nurse about behavioral changes in an elderly aunt. Which would cause the nurse to suspect a cognitive impairment disorder?

• A. Decreased interest in activities that she once enjoyed
• B. Fear of being alone at night
• C. Increased complaints of physical ailments
• D. Problems with preparing a meal or balancing her checkbook

Correct answer: D

Rationale: The correct answer is D. Problems with tasks like meal preparation and balancing a checkbook can indicate cognitive impairment, as these activities involve cognitive functions such as memory, attention, and executive function. Choices A, B, and C are less indicative of cognitive impairment. Decreased interest in activities and increased complaints of physical ailments may be related to other factors like depression, while fear of being alone at night could be due to anxiety or other psychological issues.

3. A 30-year-old male was diagnosed with HIV. Which of the following treatments would be most effective?

• A. Reverse transcriptase inhibitors
• B. Protease inhibitors
• C. Entrance inhibitors
• D. Highly active antiretroviral therapy

Correct answer: D

Rationale: The correct answer is D: Highly active antiretroviral therapy (HAART). HAART involves a combination of different classes of antiretroviral drugs, which can effectively suppress the HIV virus, reduce the viral load, and improve the immune function. While choices A, B, and C are also used in HIV treatment, the most effective approach is a combination therapy like HAART due to its ability to target the virus at different stages of its life cycle, reducing the risk of drug resistance and improving treatment outcomes.

4. A 17-year-old woman has come to the clinic requesting emergency contraception after having unprotected sex 24 hours ago. What medication is the clinician most likely to prescribe?

• A. Levonorgestrel (Plan B)
• B. Mifepristone (RU-486)
• C. Ulipristal acetate (ella)
• D. Estradiol (Estrace)

Correct answer: A

Rationale: The correct answer is A: Levonorgestrel (Plan B). Levonorgestrel is the most commonly prescribed medication for emergency contraception within 72 hours of unprotected intercourse. It is effective when taken within 72 hours after intercourse, with better efficacy the sooner it is taken. Choice B, Mifepristone (RU-486), is not indicated for emergency contraception but is used for medical abortion. Choice C, Ulipristal acetate (ella), is another option for emergency contraception that is effective up to 120 hours after unprotected intercourse. Choice D, Estradiol (Estrace), is not used for emergency contraception.

5. On the advice of his brother, a 53-year-old man has made an appointment to request a prescription for Viagra. The nurse who works at the clinic is reviewing the man's medical history and would recognize what health problem as being prohibitive to this treatment?

• A. Type 2 diabetes, treated with metformin
• B. Hypercholesterolemia, treated with simvastatin
• C. Angina, treated with nitroglycerin
• D. Hypertension, treated with metoprolol

Correct answer: C

Rationale: Nitroglycerin is contraindicated with Viagra due to their combined effects on lowering blood pressure, which can result in a severe drop and potentially life-threatening complications. Using both medications together can lead to hypotension, putting the patient at risk. Therefore, the presence of angina treated with nitroglycerin would make prescribing Viagra unsafe. Choices A, B, and D are not directly contraindicated with Viagra and can be managed concurrently with this treatment.

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