Nursing Elites

1. A patient is prescribed raloxifene (Evista) for osteoporosis. What is the primary mechanism of action for this medication?

• A. Raloxifene decreases bone resorption, which helps to maintain or increase bone density.
• B. Raloxifene increases calcium absorption in the intestines, which helps build stronger bones.
• C. Raloxifene stimulates new bone formation by increasing osteoblast activity.
• D. Raloxifene decreases calcium excretion by the kidneys, helping to maintain bone density.

Correct answer: A

Rationale: Raloxifene decreases bone resorption, which helps to maintain or increase bone density, making it effective in the prevention and treatment of osteoporosis.

2. A patient has been using Viagra on an intermittent basis for several years. However, he has cited delays in the onset and peak of action as the occasional source of frustration. What PDE5 inhibitor may be of particular benefit to this patient's needs?

• A. Avanafil (Stendra)
• B. Tadalafil (Cialis)
• C. Vardenafil (Levitra)
• D. Alprostadil (Caverject)

Correct answer: A

Rationale: The correct answer is Avanafil (Stendra). Avanafil has a rapid onset of action compared to other PDE5 inhibitors, making it suitable for patients experiencing delays in onset and peak of action with other medications like Viagra. Tadalafil (Cialis), Vardenafil (Levitra), and Alprostadil (Caverject) do not offer the same rapid onset of action as Avanafil, making them less suitable for addressing the specific needs of this patient.

3. What can multiple dark bands on the nails indicate?

• A. They are considered a normal variant.
• B. They can be associated with malignant melanoma.
• C. They are indicative of a nail fungus.
• D. They are associated with aging.

Correct answer: B

Rationale: Multiple dark bands on the nails can be associated with malignant melanoma, a serious type of skin cancer. While dark bands on the nails can sometimes be a normal variant, they should not be ignored as they could also be a sign of a serious condition like melanoma. Nail fungus typically presents with different symptoms such as thickened, discolored, or brittle nails. Dark bands on the nails are not directly associated with aging.

4. A 67-year-old man is receiving androgen therapy for osteoporosis. What laboratory test should the nurse monitor during this therapy?

• A. Liver function tests
• B. Blood glucose levels
• C. Prostate-specific antigen (PSA)
• D. Cholesterol levels

Correct answer: A

Rationale: During androgen therapy, monitoring liver function tests is crucial to detect any signs of liver dysfunction. Androgens can potentially impact liver function, making it essential to monitor enzymes such as ALT and AST. While blood glucose levels and cholesterol levels are important parameters to monitor in certain situations, they are not the primary focus during androgen therapy for osteoporosis. Prostate-specific antigen (PSA) monitoring is more relevant in the context of prostate health and cancer screening, not specifically during androgen therapy for osteoporosis.

5. Two people experience the same stressor yet only one is able to cope and adapt adequately. An example of the person with an increased capacity to adapt is the one with:

• A. A sense of purpose in life
• B. Circadian rhythm disruption
• C. Age-related renal dysfunction
• D. Excessive weight gain or loss

Correct answer: A

Rationale: A strong sense of purpose in life is associated with better stress coping mechanisms, which can enhance a person's capacity to adapt. Having a clear sense of purpose provides individuals with motivation, direction, and resilience to face challenges. Choices B, C, and D are not directly related to an increased capacity to adapt to stress. Circadian rhythm disruption, age-related renal dysfunction, and excessive weight gain or loss may have negative impacts on overall well-being and stress management.

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