Nursing Elites

1. A patient is prescribed medroxyprogesterone acetate (Provera) for the treatment of endometriosis. What should the nurse teach the patient about the use of this medication?

• A. Medroxyprogesterone should be taken with food to prevent nausea.
• B. Medroxyprogesterone can be taken intermittently when symptoms worsen.
• C. Medroxyprogesterone should be taken at the same time each day to maintain consistent hormone levels.
• D. Medroxyprogesterone should be discontinued if side effects occur.

Correct answer: C

Rationale: The correct answer is C. Medroxyprogesterone should be taken at the same time each day to maintain consistent hormone levels and effectiveness. Taking it at different times can lead to hormonal fluctuations and reduced medication efficacy. Choice A is incorrect because medroxyprogesterone does not need to be taken with food to prevent nausea. Choice B is incorrect as medroxyprogesterone is typically taken continuously rather than intermittently. Choice D is incorrect because side effects should be reported to the healthcare provider for further evaluation and management, not automatically leading to discontinuation of the medication.

2. What occurs in a client with polycythemia?

• A. Deficient plasma in the blood
• B. Increased lymphatic fluid being produced
• C. Increased red blood cells being produced
• D. Deficient number of red blood cells

Correct answer: C

Rationale: The correct answer is C: Increased red blood cells being produced. Polycythemia is a condition characterized by an elevated number of red blood cells in the blood. This increased concentration of red blood cells can lead to blood thickening and potentially result in complications such as blood clots. Choices A, B, and D are incorrect because polycythemia does not involve deficient plasma, increased lymphatic fluid production, or a deficient number of red blood cells.

3. The college health nurse is providing health education for freshmen. Which of the following pieces of information about immunizations is applicable to individuals of this age group?

• A. The oral polio vaccine should be updated.
• B. The yearly administration of flu vaccine is recommended.
• C. The tetanus toxoid should be within 2 years.
• D. The administration of hepatitis A vaccine is mandatory.

Correct answer: B

Rationale: For freshmen in college, the yearly administration of the flu vaccine is recommended. This is important to protect against seasonal influenza outbreaks that can spread rapidly in close living quarters such as dormitories. Choice A is incorrect as oral polio vaccine is not typically given to individuals of this age group. Choice C is incorrect as tetanus toxoid boosters are usually recommended every 10 years, not within 2 years. Choice D is incorrect as the administration of the hepatitis A vaccine is not mandatory for all individuals in this age group.

4. Prior to leaving on a backpacking trip to Southeast Asia, a college student has received a tetanus booster shot. This immunization confers protection by way of what immune process?

• A. Passive natural immunity
• B. Active natural immunity
• C. Passive artificial immunity
• D. Active artificial immunity

Correct answer: D

Rationale: The correct answer is D: Active artificial immunity. A tetanus booster shot confers protection through active artificial immunity. Active immunity involves the body producing its antibodies in response to an antigen, providing long-lasting protection. In this case, the tetanus booster shot triggers the student's immune system to produce specific antibodies against tetanus toxins. Choices A, B, and C are incorrect because passive immunity does not involve the individual's immune system producing antibodies; instead, it involves the direct transfer of antibodies from another source (natural or artificial) for immediate, but temporary, protection.

5. A patient with severe peripheral vascular disease has developed signs of dry gangrene on the great toe of one foot. Which of the following pathophysiologic processes most likely contributed to this diagnosis?

• A. Inappropriate activation of apoptosis
• B. Bacterial invasion
• C. Impaired arterial blood supply
• D. Metaplastic cellular changes

Correct answer: C

Rationale: The correct answer is C: Impaired arterial blood supply. Dry gangrene is typically caused by impaired arterial blood supply, leading to tissue death without bacterial infection. Choices A, B, and D are incorrect. Inappropriate activation of apoptosis is not a common cause of dry gangrene. Bacterial invasion usually leads to wet gangrene, not dry gangrene. Metaplastic cellular changes are not directly associated with the development of dry gangrene.

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