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. What property is found in clients with metastatic cancer?

• A. Tumors that are well encapsulated
• B. Tumors with slow, stable growth
• C. Cells that are genetically stable
• D. Cells invading local tissue and overrunning neighboring cells

Correct answer: D

Rationale: Metastatic cancer is characterized by cells that invade local tissue and overrun neighboring cells. Therefore, the correct answer is D. Choices A, B, and C are incorrect because metastatic cancer is associated with aggressive behavior where cells invade and spread to other parts of the body, rather than being well encapsulated, growing slowly, or being genetically stable.

3. A male patient with benign prostatic hyperplasia (BPH) is prescribed finasteride (Proscar). What should the nurse include in the patient education?

• A. The medication is expected to reduce the size of the prostate, which should improve urinary symptoms over time.
• B. The medication will improve symptoms within a few days.
• C. The medication will cure BPH after treatment is complete.
• D. The medication may cause erectile dysfunction as a side effect.

Correct answer: A

Rationale: Finasteride is expected to reduce the size of the prostate, which should improve urinary symptoms over time, although the effects may take several weeks or months to become noticeable.

4. A client with Guillain-Barré syndrome is experiencing ascending paralysis. Which of the following interventions should the nurse prioritize?

• A. Monitor for signs of respiratory distress.
• B. Prepare the client for plasmapheresis.
• C. Administer analgesics for pain management.
• D. Initiate passive range-of-motion exercises.

Correct answer: A

Rationale: The correct answer is A: Monitor for signs of respiratory distress. In Guillain-Barré syndrome, ascending paralysis can lead to respiratory muscle involvement, putting the client at risk for respiratory distress and failure. Prioritizing respiratory monitoring is crucial to ensure timely intervention if respiratory compromise occurs. Plasmapheresis (Choice B) may be indicated in some cases to remove harmful antibodies, but the priority in this situation is respiratory support. Administering analgesics (Choice C) for pain management and initiating passive range-of-motion exercises (Choice D) are important aspects of care but are not the priority when the client's respiratory status is at risk.

5. Which individual is likely to have the best prognosis for recovery from his or her insult to the peripheral nervous system? An adult:

• A. client who developed rhabdomyolysis and ischemic injury after a tourniquet application.
• B. who suffered a bone-depth laceration to the shoulder during a knife attack.
• C. who had his forearm partially crushed by gears during an industrial accident.
• D. client who had nerves transected during surgery to remove a tumor from the mandible.

Correct answer: C

Rationale: The correct answer is C. Crushing-type injuries to the peripheral nervous system generally have a better prognosis compared to nerve transections or lacerations. In the scenario provided, the individual who had his forearm partially crushed by gears during an industrial accident is likely to have a better chance of recovery compared to nerve transection (choice D) or laceration (choice B). Rhabdomyolysis and ischemic injury after tourniquet application (choice A) are not directly related to peripheral nerve injury and do not indicate a better prognosis for recovery.

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