Nursing Elites

1. When assessing a patient experiencing breakthrough bleeding while taking oral contraceptives, what should the nurse consider?

• A. The possibility of pregnancy
• B. The patient's adherence to the medication schedule
• C. The need for an increased dosage
• D. The effectiveness of the current oral contraceptive

Correct answer: B

Rationale: When a patient on oral contraceptives experiences breakthrough bleeding, it is crucial for the nurse to consider the patient's adherence to the medication schedule. Breakthrough bleeding is often a sign of missed doses or inconsistent use, which can decrease the effectiveness of the oral contraceptive. Considering the possibility of pregnancy (Choice A) is important but secondary to assessing adherence. The need for an increased dosage (Choice C) is not typically the first consideration for breakthrough bleeding. Evaluating the effectiveness of the current oral contraceptive (Choice D) is relevant but should come after assessing adherence to the medication schedule.

2. Which of the following disorders is more likely to be associated with blood in the stool?

• A. Gastroesophageal reflux
• B. Crohn's disease
• C. Irritable bowel syndrome
• D. Colon cancer

Correct answer: D

Rationale: The correct answer is D, Colon cancer. Colon cancer commonly presents with blood in the stool due to bleeding from the tumor. Gastroesophageal reflux (Choice A) is associated with heartburn and regurgitation of stomach contents into the esophagus. Crohn's disease (Choice B) is a type of inflammatory bowel disease that can cause symptoms like abdominal pain, diarrhea, and weight loss, but it does not typically present with blood in the stool as a primary symptom. Irritable bowel syndrome (Choice C) is a functional gastrointestinal disorder characterized by symptoms such as abdominal pain, bloating, and changes in bowel habits, but it does not usually involve blood in the stool as a prominent feature.

3. Which of the following is a characteristic of osteosarcoma?

• A. Slow-growing tumor that begins in the bone marrow
• B. Solitary tumor that most often affects the metaphyseal region of the femur or tibia
• C. An aggressive tumor most often found in the bone marrow of long bones
• D. A tumor that infiltrates the trabeculae in spongy bone and implants in surrounding tissue

Correct answer: C

Rationale: Osteosarcoma is an aggressive bone tumor that most commonly arises in the bone marrow of long bones, such as the femur or tibia. Choice A is incorrect as osteosarcoma is not a slow-growing tumor but rather a fast-growing one. Choice B is incorrect as osteosarcoma is not typically solitary but can involve multiple lesions. Choice D is incorrect as osteosarcoma primarily affects the medullary (marrow) cavity of bones, rather than infiltrating the trabeculae in spongy bone and surrounding tissue.

4. A patient has acute respiratory failure (ARF). Which of the following would the nurse expect to find?

• A. Alkalosis and hyperventilation
• B. Hypoxemia and hypercapnia
• C. Alkalosis and high potassium
• D. Elevated sodium and acidosis

Correct answer: B

Rationale: In acute respiratory failure, hypoxemia (low blood oxygen) and hypercapnia (high blood carbon dioxide) are commonly observed. Choice A is incorrect because alkalosis (high pH) and hyperventilation are not typically seen in acute respiratory failure. Choice C is incorrect as it mentions alkalosis and high potassium, which are not characteristic of acute respiratory failure. Choice D is also incorrect because elevated sodium and acidosis are not typically associated with acute respiratory failure.

5. Which of the following is the most appropriate diagnostic method for identifying lung cancer in its early stages?

• A. CT scan
• B. MRI
• C. X-ray
• D. Biopsy

Correct answer: D

Rationale: A biopsy is the most appropriate method for diagnosing lung cancer in its early stages. A biopsy involves taking a small tissue sample from the lung for examination under a microscope. This method provides a definitive diagnosis by identifying cancerous cells. CT scans, MRIs, and X-rays can help detect abnormalities in the lungs, but a biopsy is necessary to confirm the presence of lung cancer. CT scans offer detailed images of the lung's structure, MRIs use magnetic fields for imaging soft tissues, and X-rays provide a basic view of the lungs, but none of these imaging techniques can definitively confirm the presence of cancer without a biopsy.

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