Nursing Elites

1. A patient is taking raloxifene (Evista) for osteoporosis. What is the primary therapeutic effect of this medication?

• A. It stimulates the formation of new bone.
• B. It decreases bone resorption and increases bone density.
• C. It increases the excretion of calcium through the kidneys.
• D. It increases calcium absorption in the intestines.

Correct answer: B

Rationale: The correct answer is B. Raloxifene, a selective estrogen receptor modulator (SERM), primarily works by decreasing bone resorption and increasing bone density. This mechanism of action helps in the prevention and treatment of osteoporosis by maintaining or improving bone strength. Choice A is incorrect because raloxifene does not directly stimulate the formation of new bone but rather helps in preserving existing bone. Choice C is incorrect because raloxifene does not increase the excretion of calcium through the kidneys; instead, it acts on bone tissue. Choice D is incorrect as raloxifene does not directly increase calcium absorption in the intestines but rather focuses on bone health.

2. 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.

3. A report comes back indicating that muscular atrophy has occurred. A nurse recalls that muscular atrophy involves a decrease in muscle cell size:

• A. Number
• B. Size
• C. Vacuoles
• D. Lipofuscin

Correct answer: B

Rationale: The correct answer is B: Size. Muscular atrophy is characterized by a reduction in the size of muscle cells. This decrease in size can be due to various factors such as disuse, aging, or disease. Choice A, Number, is incorrect because muscular atrophy does not involve a decrease in the number of muscle cells but rather their size. Choice C, Vacuoles, is incorrect as vacuoles are not directly related to the definition of muscular atrophy. Choice D, Lipofuscin, is incorrect as lipofuscin is a pigment associated with aging and has no direct connection to the decrease in muscle cell size seen in muscular atrophy.

4. A 51-year-old woman has the following clinical findings: thin hair, exophthalmos, hyperreflexia, and pretibial edema. These findings are consistent with:

• A. Subacute thyroiditis.
• B. Autoimmune thyroiditis.
• C. Graves disease.
• D. Hashimoto’s disease.

Correct answer: C

Rationale: The clinical findings of thin hair, exophthalmos, hyperreflexia, and pretibial edema are classic features of Graves disease, an autoimmune disorder that results in hyperthyroidism. Exophthalmos (bulging eyes) and pretibial edema (swelling in the lower legs) are particularly associated with Graves disease due to the autoimmune stimulation of the thyroid gland, leading to increased thyroid hormone production. Subacute thyroiditis (Choice A) typically presents with neck pain and tenderness, while autoimmune thyroiditis (Choice B) is commonly known as Hashimoto's thyroiditis, which presents with hypothyroidism symptoms. Hashimoto's disease (Choice D) is characterized by goiter and hypothyroidism, which contrasts with the hyperthyroidism seen in this patient.

5. A 30-year-old female has suffered a third-degree burn to her hand after spilling hot oil in a kitchen accident. Which teaching point by a member of her care team is most appropriate?

• A. Your hand will likely heal without the need for a skin graft.
• B. You might experience a loss of sensation in your hand after it heals.
• C. Be sure to keep your hand elevated to reduce swelling.
• D. We will need to monitor you for infection as your hand heals.

Correct answer: D

Rationale: In third-degree burns, infection is a major concern due to the extensive damage to the skin. Monitoring for infection is crucial. Choice A is incorrect because third-degree burns often require skin grafts due to the severity of the injury. Choice B is incorrect as loss of sensation is more common in nerve damage and not necessarily in burns. Choice C is incorrect because while elevation can help with swelling in minor burns, it is not the most critical concern in third-degree burns.

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