Nursing Elites

1. Why is it important for a patient to take a new oral contraceptive at the same time each day?

• A. Taking the medication at the same time each day helps maintain stable hormone levels, which is critical for preventing pregnancy.
• B. Taking the medication at the same time each day reduces the risk of breakthrough bleeding.
• C. Taking the medication at the same time each day ensures consistent absorption and effectiveness.
• D. Taking the medication at the same time each day is important, but missing a dose occasionally is not a concern.

Correct answer: A

Rationale: The correct answer is A. Taking oral contraceptives at the same time each day is crucial for maintaining stable hormone levels, which is essential for the contraceptive's effectiveness in preventing pregnancy. Choice B is incorrect because the primary reason for taking the medication consistently is hormone level stability, not specifically to reduce breakthrough bleeding. Choice C is incorrect as it focuses on absorption and effectiveness, which are important but do not address the main reason for consistent timing. Choice D is incorrect because missing doses can impact contraceptive efficacy, making consistent timing essential for optimal protection.

2. In clients with a cognitive impairment disorder, the phenomenon of increased confusion in the early evening hours is called:

• A. Aphasia.
• B. Agnosia.
• C. Sundowning.
• D. Confabulation.

Correct answer: C

Rationale: The correct answer is C: Sundowning. Sundowning is a phenomenon where individuals with cognitive impairment experience increased confusion and agitation in the late afternoon or early evening. This often occurs in conditions like dementia. Choice A, Aphasia, refers to a language disorder affecting a person's ability to communicate. Choice B, Agnosia, is the inability to recognize objects. Choice D, Confabulation, is the production of false memories without the intention to deceive, often seen in conditions like Korsakoff's syndrome.

3. An older adult patient comes to the clinic complaining of not being able to do what he used to be able to. You know that normal changes associated with aging include:

• A. Improved blood flow
• B. Slowed metabolic rate
• C. Increased brain weight
• D. Improved nerve fiber conduction

Correct answer: B

Rationale: Normal changes associated with aging include a slowed metabolic rate and decreased brain weight. Option A, 'Improved blood flow,' is incorrect as aging is generally associated with reduced vascular health rather than improved blood flow. Option D, 'Improved nerve fiber conduction,' is incorrect as aging typically leads to a decline in nerve function rather than improvement.

4. A patient has been prescribed sildenafil (Viagra) for erectile dysfunction. What important information should the healthcare provider provide?

• A. This medication can cause sudden hearing loss.
• B. This medication should not be taken more than once a day.
• C. You should avoid taking this medication with high-fat meals.
• D. Avoid taking nitrates while on this medication.

Correct answer: D

Rationale: The correct answer is D. Sildenafil (Viagra) should not be taken with nitrates due to the risk of severe hypotension. Nitrates can potentiate the hypotensive effects of sildenafil, leading to a dangerous drop in blood pressure. Choice A is incorrect because sudden hearing loss is a rare but serious side effect associated with sildenafil, not a common side effect. Choice B is not the most important information related to sildenafil use. While it is generally recommended not to exceed one dose per day, the interaction with nitrates is more critical. Choice C is also important to consider as high-fat meals can delay the onset of action of sildenafil, but it is not as crucial as avoiding nitrates.

5. A male patient with benign prostatic hyperplasia (BPH) is being treated with tamsulosin (Flomax). What should the nurse include in the teaching plan for this patient?

• A. Avoid lying down after taking the medication.
• B. Take the medication with meals.
• C. Report any side effects such as dizziness or fainting.
• D. Take the medication at bedtime.

Correct answer: C

Rationale: The correct answer is C: 'Report any side effects such as dizziness or fainting.' Patients taking tamsulosin should be advised to report any side effects, such as dizziness or fainting, which can occur due to orthostatic hypotension. Choices A, B, and D are incorrect because avoiding lying down after taking the medication, taking it with meals, or at bedtime are not specific teaching points related to the potential side effects of tamsulosin.

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