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 patient is starting on atorvastatin (Lipitor) for hyperlipidemia. What important instruction should the nurse provide?

• A. Take the medication at night to reduce the risk of muscle pain.
• B. Avoid consuming grapefruit juice while taking this medication.
• C. Take the medication in the morning with breakfast.
• D. Avoid taking the medication with alcohol to reduce the risk of liver damage.

Correct answer: A

Rationale: The correct answer is A. Atorvastatin should be taken at night to reduce the risk of muscle pain and other side effects. Taking it at night aligns with the body's natural rhythm of cholesterol production, optimizing its effectiveness. Choice B is incorrect because grapefruit juice can increase the risk of side effects by affecting the metabolism of atorvastatin. Choice C is incorrect as taking atorvastatin in the morning does not maximize its effectiveness. Choice D is incorrect because alcohol consumption can increase the risk of liver damage when combined with atorvastatin.

3. A patient is prescribed estradiol (Estrace) for hormone replacement therapy. What should the nurse monitor during this therapy?

• A. Blood pressure
• B. Blood glucose levels
• C. Liver function tests
• D. Kidney function tests

Correct answer: C

Rationale: During estradiol therapy, the nurse should monitor liver function tests. Estradiol can potentially impact liver function, making it essential to assess for any signs of liver dysfunction. Monitoring blood pressure (Choice A) is not directly related to estradiol therapy. While blood glucose levels (Choice B) should be monitored in patients taking certain medications like corticosteroids or antipsychotics, it is not typically necessary for patients on estradiol therapy. Kidney function tests (Choice D) are not the priority for monitoring during estradiol therapy, as the liver is more commonly affected.

4. A client is brought to the emergency department after a motor vehicle accident in which she suffered a spinal cord injury at the level of C5. Which of the following assessments should be the priority?

• A. Monitoring urinary output
• B. Monitoring heart rate and rhythm
• C. Monitoring respiratory rate
• D. Monitoring the client's pain levels

Correct answer: B

Rationale: The correct answer is monitoring heart rate and rhythm. With a C5 spinal cord injury, monitoring heart rate and rhythm is crucial as it can impact autonomic regulation. This level of injury can affect cardiac function due to the disruption of sympathetic nerve fibers. Monitoring urinary output may be important to assess for urinary retention, but it is not the priority in this scenario. While monitoring respiratory rate is essential in all patients, in this case, cardiovascular stability takes precedence. Pain management is important but is not the priority when assessing a client with a C5 spinal cord injury.

5. Multiple sclerosis manifests as asymmetrical and in different parts of the body because:

• A. Autoreactive lymphocytes are causing diffuse patchy damage to the myelin sheath in the central nervous system.
• B. Acetylcholine receptors are destroyed by immunoglobulin G.
• C. Autoreactive T lymphocytes cause progressive loss of neurons in the substantia nigra.
• D. Cortical motor cells degenerate.

Correct answer: A

Rationale: The correct answer is A. Multiple sclerosis is characterized by the immune system attacking the myelin sheath in the central nervous system. This attack leads to patchy damage on the myelin sheath, resulting in asymmetrical neurological symptoms. Choices B, C, and D are incorrect because they do not accurately describe the pathophysiology of multiple sclerosis. In multiple sclerosis, it is the autoreactive lymphocytes that target and damage the myelin sheath, not acetylcholine receptors, T lymphocytes, or cortical motor cells.

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