Nursing Elites

1. A patient taking hormonal contraceptives will soon turn 35 years of age. She is moderately obese and has smoked for 15 years. Which of the following is most important?

• A. Begin an exercise regimen.
• B. Begin smoking cessation.
• C. Begin daily aspirin therapy.
• D. Begin taking a loop diuretic to aid weight loss.

Correct answer: B

Rationale: The most important action for a patient taking hormonal contraceptives, who is nearing 35 years of age, moderately obese, and has a history of smoking for 15 years, is to begin smoking cessation. Women over 35, especially smokers, are at an increased risk of blood clots and cardiovascular issues when using hormonal contraceptives. Smoking cessation is crucial to reduce this risk. Beginning an exercise regimen may be beneficial for overall health but is not as critical as stopping smoking in this scenario. Daily aspirin therapy or taking a loop diuretic are not indicated in this situation and may not address the primary risk associated with hormonal contraceptives and smoking.

2. What causes secondary brain injury after head trauma?

• A. Brain injury resulting from the body’s response to tissue damage
• B. Brain injury resulting from initial trauma
• C. Injury as a result of medical therapy
• D. Focal areas of bleeding

Correct answer: A

Rationale: The correct answer is A. Secondary brain injury occurs due to the body's response to the initial trauma, which can worsen the effects of the primary injury. This response includes processes like inflammation, increased intracranial pressure, and reduced oxygen delivery to tissues. Choice B is incorrect because it refers to the primary trauma itself, not the secondary injury. Choice C is incorrect as it relates to injury caused by medical interventions rather than the body's response. Choice D is incorrect as it specifically mentions focal areas of bleeding, which is a consequence of trauma rather than the cause of secondary brain injury.

3. A 30-year-old woman is taking an oral contraceptive and is concerned about the potential side effects. What should the nurse include in the patient education?

• A. Oral contraceptives can cause weight loss and increased energy levels.
• B. Oral contraceptives can cause increased appetite and weight gain.
• C. Oral contraceptives can cause headaches and breast tenderness.
• D. Oral contraceptives have no side effects.

Correct answer: C

Rationale: The correct answer is C: 'Oral contraceptives can cause headaches and breast tenderness.' It is essential for the nurse to educate the patient about common side effects of oral contraceptives, such as headaches and breast tenderness. Choices A, B, and D are incorrect. Weight loss and increased energy levels (Choice A) are not common side effects of oral contraceptives. Similarly, increased appetite and weight gain (Choice B) are not typical side effects. Finally, stating that oral contraceptives have no side effects (Choice D) is inaccurate as they can have various side effects, albeit usually mild and manageable.

4. A client presents to the emergency department with lower right quadrant abdominal pain, fever, nausea, and occasional diarrhea. After palpating the abdomen, the client displays tenderness. What would the nurse anticipate the client to be experiencing?

• A. Pseudomembranous colitis
• B. Peptic ulcer disease
• C. Appendicitis
• D. Esophageal cancer

Correct answer: C

Rationale: The correct answer is C: Appendicitis. The symptoms described - lower right quadrant abdominal pain, fever, nausea, diarrhea, and tenderness upon palpation - are classic signs of appendicitis. Appendicitis is an inflammatory condition of the appendix that often presents with these symptoms and requires immediate medical attention. Choice A, Pseudomembranous colitis, typically presents with watery diarrhea and is associated with antibiotic use. Choice B, Peptic ulcer disease, commonly presents with epigastric pain related to meals and can be accompanied by nausea or vomiting, but it does not typically cause right lower quadrant pain. Choice D, Esophageal cancer, usually presents with symptoms related to swallowing difficulties, weight loss, and sometimes chest pain, but it is not associated with the symptoms described in the scenario.

5. During a follow-up visit, a patient being treated for latent tuberculosis mentions inconsistent drug intake. What should subsequent health education focus on?

• A. The importance of adhering to the treatment regimen to reduce adverse effects
• B. The necessity of consistently taking the prescribed drugs for TB cure
• C. Matching drug dosages carefully to signs and symptoms
• D. The consequence of nonadherence leading to antiretroviral use

Correct answer: B

Rationale: The correct answer is B because consistent intake of prescribed drugs is crucial for curing tuberculosis. By emphasizing the necessity of following the treatment plan, the patient is more likely to achieve a successful outcome. Choice A is incorrect because it focuses on the risk of adverse effects rather than the primary goal of TB cure. Choice C is incorrect as it does not address the issue of inconsistent drug intake. Choice D is also incorrect as it introduces a different treatment (antiretrovirals) not relevant to latent tuberculosis.

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