Nursing Elites

1. What long-term risks should the nurse discuss with a patient starting on hormone replacement therapy (HRT)?

• A. HRT is associated with increased risks of cardiovascular events and breast cancer, so these risks should be discussed with the patient.
• B. HRT can improve mood and energy levels, but it also increases the risk of osteoporosis.
• C. HRT can increase the risk of venous thromboembolism, so patients should undergo regular screening.
• D. HRT decreases the risk of fractures, but it also increases the risk of developing diabetes.

Correct answer: A

Rationale: The correct answer is A. When starting on hormone replacement therapy (HRT), the nurse should discuss the increased risks of cardiovascular events and breast cancer with the patient. These risks are important to consider to make an informed decision. Choice B is incorrect as HRT does not increase the risk of osteoporosis; in fact, it may help prevent it. Choice C is incorrect as while HRT can increase the risk of venous thromboembolism, regular screening is not the primary focus for discussion. Choice D is incorrect as HRT does not decrease the risk of fractures and is not primarily associated with an increased risk of developing diabetes.

2. A group of nursing students and their professor are engaged in a service learning project and will be caring for patients in Haiti. What medication should be administered to prevent the development of malaria?

• A. Metronidazole (Flagyl)
• B. Oprelvekin (Neumega)
• C. Chloroquine phosphate (Aralen)
• D. Chloroprocaine hydrochloride (Nesacaine)

Correct answer: C

Rationale: The correct answer is Chloroquine phosphate (Aralen). Chloroquine is a medication used to prevent and treat malaria. It works by killing the malaria parasite in the red blood cells. Metronidazole (Flagyl) is an antibiotic used to treat various bacterial and parasitic infections, not malaria. Oprelvekin (Neumega) is a medication used to stimulate platelet production. Chloroprocaine hydrochloride (Nesacaine) is a local anesthetic used for epidural anesthesia. Therefore, Chloroquine phosphate is the appropriate medication for preventing malaria in this scenario.

3. Thrombocytopenia is which disorder below?

• A. Increased blood coagulation
• B. Increased platelet production
• C. Increased number of infections
• D. Decreased platelet production

Correct answer: D

Rationale: Thrombocytopenia is a disorder characterized by a decreased platelet count or decreased platelet production, which affects blood clotting. Choice A, 'Increased blood coagulation,' is incorrect as thrombocytopenia is associated with decreased platelets, leading to impaired clotting. Choice B, 'Increased platelet production,' is incorrect as thrombocytopenia is characterized by a decrease in platelet production. Choice C, 'Increased number of infections,' is unrelated to thrombocytopenia, which primarily involves low platelet levels.

4. Pain in the lower extremities due to peripheral artery disease usually worsens:

• A. with rest because blood flow increases.
• B. with elevation of the extremity because blood is diverted away.
• C. when the leg is in a dependent position because blood pools.
• D. when the leg is touched or massaged because cytokines are released.

Correct answer: B

Rationale: In peripheral artery disease, pain in the lower extremities worsens with the elevation of the extremity because it diverts blood flow away from the affected area, exacerbating the pain. Choices A, C, and D are incorrect. Resting doesn't increase blood flow, a dependent position doesn't lead to blood pooling in this context, and pain worsening due to touch or massage is not a typical feature of peripheral artery disease.

5. A child's thymus gland is fully formed and proportionately larger than an adult's. Which of the following processes that contribute to immunity takes place in the thymus gland?

• A. Differentiation of B cells
• B. Production of natural killer (NK) cells
• C. Proliferation of T cells
• D. Filtration of antigens from the blood

Correct answer: C

Rationale: The correct answer is C: Proliferation of T cells. The thymus gland is responsible for the maturation and proliferation of T cells, which play a crucial role in adaptive immunity. Option A, differentiation of B cells, is incorrect because B cell maturation primarily occurs in the bone marrow. Option B, production of natural killer (NK) cells, is incorrect as NK cells are mainly produced in the bone marrow and lymph nodes. Option D, filtration of antigens from the blood, is incorrect as antigen filtration is not a primary function of the thymus gland.

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