Nursing Elites

1. What potential risk should the nurse identify as being associated with infliximab (Remicade) in the treatment of rheumatoid arthritis?

• A. Risk for infection
• B. Risk for decreased level of consciousness
• C. Risk for nephrotoxicity
• D. Risk for hepatotoxicity

Correct answer: A

Rationale: The correct answer is A: Risk for infection. Infliximab (Remicade) is a medication used to treat autoimmune conditions like rheumatoid arthritis. One of the main risks associated with infliximab is an increased susceptibility to infections due to its immunosuppressive effects. This drug works by targeting specific proteins in the body's immune system, which can weaken the body's ability to fight off infections. Choices B, C, and D are incorrect because infliximab is not typically associated with decreased level of consciousness, nephrotoxicity, or hepatotoxicity. It is important for healthcare providers to monitor patients on infliximab for signs of infection and educate them on the importance of infection prevention strategies.

2. Which of the following patients are at higher risk for developing oral cancer?

• A. A female who has taken oral contraceptives for the last 4 years
• B. Both an adult male with a history of alcoholism and a middle-aged male who smokes a pipe
• C. An adult female who eats spicy foods regularly
• D. An older adult female who chews gum frequently

Correct answer: B

Rationale: The correct answer is 'Both an adult male with a history of alcoholism and a middle-aged male who smokes a pipe.' Alcohol consumption and tobacco use, such as smoking a pipe, are well-known risk factors for developing oral cancer. These two factors significantly increase the likelihood of developing oral cancer compared to the other choices. Taking oral contraceptives, eating spicy foods regularly, and chewing gum frequently are not established risk factors for oral cancer, making them less likely to lead to the development of this type of cancer.

3. What is the purpose of the inflammatory response?

• A. Prevents blood from entering the injured tissue
• B. Elevates body temperature to prevent spread of infection
• C. Prevents formation of abscess
• D. Minimizes injury and promotes healing

Correct answer: D

Rationale: The inflammatory response is a protective mechanism triggered by tissue damage or infection. It aims to minimize injury by removing harmful stimuli and initiating the healing process. Choice A is incorrect because blood flow to the injured tissue is actually increased to deliver immune cells and nutrients. Choice B is incorrect because while fever is a response to infection, it is not the primary purpose of the inflammatory response. Choice C is incorrect because abscess formation can occur as part of the inflammatory response in an attempt to contain an infection.

4. What should a nurse include in patient teaching for a patient prescribed medroxyprogesterone acetate (Provera) for endometriosis?

• A. Medroxyprogesterone should be taken at the same time each day to maintain consistent hormone levels and effectiveness in treating endometriosis.
• B. Medroxyprogesterone can be taken with food to reduce gastrointestinal upset.
• C. Medroxyprogesterone should be discontinued if side effects occur.
• D. Medroxyprogesterone should be taken once a week to maintain effectiveness.

Correct answer: A

Rationale: When teaching a patient prescribed medroxyprogesterone acetate (Provera) for endometriosis, the nurse should emphasize the importance of taking the medication at the same time each day. This helps maintain consistent hormone levels and ensures the effectiveness of the treatment. Option A is correct because it addresses this key point. Option B is incorrect because medroxyprogesterone should be taken consistently but not necessarily with food. Option C is incorrect because discontinuing the medication without consulting a healthcare provider is not advisable. Option D is incorrect as medroxyprogesterone is usually taken daily, not weekly, for the treatment of endometriosis.

5. Pain in the lower extremities due to peripheral artery disease usually worsens:

• A. with rest because blood flow increases.
• B. with elevation of the extremity because blood is diverted away.
• C. when the leg is in a dependent position because blood pools.
• D. when the leg is touched or massaged because cytokines are released.

Correct answer: B

Rationale: In peripheral artery disease, pain in the lower extremities worsens with the elevation of the extremity because it diverts blood flow away from the affected area, exacerbating the pain. Choices A, C, and D are incorrect. Resting doesn't increase blood flow, a dependent position doesn't lead to blood pooling in this context, and pain worsening due to touch or massage is not a typical feature of peripheral artery disease.

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