Nursing Elites

1. A patient is taking testosterone for hypogonadism. What adverse effect should the nurse monitor for during this therapy?

• A. Increased risk of liver dysfunction
• B. Increased risk of cardiovascular events
• C. Increased risk of prostate cancer
• D. Increased risk of bone fractures

Correct answer: B

Rationale: The correct adverse effect to monitor for when a patient is taking testosterone for hypogonadism is an increased risk of cardiovascular events. Testosterone therapy has been associated with an elevated risk of cardiovascular events such as heart attack and stroke, especially in older patients. Monitoring cardiovascular health is crucial during testosterone therapy. The other choices are incorrect because testosterone therapy is not primarily linked to liver dysfunction (choice A), prostate cancer (choice C), or bone fractures (choice D).

2. Which of the following describes the type of incontinence due to an increase in intraabdominal pressure such as coughing, sneezing, and laughing?

• A. Overflow
• B. Stress
• C. Mixed
• D. Functional

Correct answer: B

Rationale: The correct answer is B: Stress. Stress incontinence occurs when there is an increase in intraabdominal pressure, for example, during activities like coughing, sneezing, or laughing, leading to urine leakage. This type of incontinence is specifically triggered by physical movements or activities that put pressure on the bladder. Choices A, C, and D are incorrect because overflow incontinence is characterized by the bladder not emptying properly, mixed incontinence is a combination of stress and urge incontinence, and functional incontinence is typically due to physical or cognitive impairments.

3. DiGeorge syndrome is a primary immune deficiency caused by:

• A. Failure of B cells to mature
• B. Congenital lack of thymic tissue
• C. Failure of formed elements of blood to develop
• D. Selective IgG deficiency

Correct answer: B

Rationale: DiGeorge syndrome is caused by a congenital lack of thymic tissue, which plays a crucial role in T cell development and maturation, leading to immune deficiency. Choice A is incorrect because DiGeorge syndrome primarily affects T cells, not B cells. Choice C is incorrect as it is too broad and not specific to the thymus. Choice D is incorrect as selective IgG deficiency is a different condition unrelated to DiGeorge syndrome.

4. A patient began antiretroviral therapy several weeks ago for the treatment of HIV, and he has now presented to the clinic for a scheduled follow-up appointment. He states to the nurse, “I've been pretty good about taking all my pills on time, though it was a bit hit and miss over the holiday weekend.” How should the nurse best respond to this patient's statement?

• A. “Remember that if you miss a dose, you need to take a double dose at the next scheduled time.”
• B. “It's acceptable to miss an occasional dose as long as your symptoms don't worsen, but it's important to strive for consistent adherence.”
• C. “Remember that your antiretroviral drugs will only be effective if you take them consistently and as prescribed.”
• D. “If you're not consistent with taking your medications, you're likely to develop more side effects.”

Correct answer: C

Rationale: The correct response is to remind the patient that antiretroviral drugs are most effective when taken consistently and as prescribed. Choice A is incorrect because taking a double dose after missing a dose is not recommended, as it can lead to medication toxicity. Choice B is incorrect as it may give the impression that missing doses is acceptable, which can reduce the effectiveness of the treatment. Choice D is incorrect because while consistency is important, the focus should be on treatment effectiveness rather than side effects.

5. A patient is prescribed raloxifene (Evista) for osteoporosis. What is the primary therapeutic action of this medication?

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

Correct answer: B

Rationale: The correct answer is B. Raloxifene works by decreasing bone resorption and increasing bone density, which helps in the prevention and treatment of osteoporosis. Choice A is incorrect as raloxifene does not directly stimulate the formation of new bone. Choice C is incorrect because raloxifene does not primarily affect calcium absorption in the intestines. Choice D is incorrect as raloxifene does not increase the excretion of calcium through the kidneys.

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