Nursing Elites

1. A patient taking oral contraceptives reports breakthrough bleeding. What should the nurse assess in this patient?

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

Correct answer: A

Rationale: When a patient on oral contraceptives experiences breakthrough bleeding, the nurse should assess the patient's adherence to the medication schedule. Breakthrough bleeding can be a sign of missed doses or inconsistent timing, which can decrease the effectiveness of oral contraceptives. Assessing the patient's adherence helps in ensuring proper use of the medication. Choices B, C, and D are incorrect because breakthrough bleeding is more likely related to adherence issues rather than pregnancy, the need for increased dosage, or the effectiveness of the current oral contraceptive.

2. In addition to matching ABO antigens, a blood transfusion must also be matched for:

• A. HLA type
• B. Rh antigen
• C. Immunoglobulins
• D. Platelet compatibility

Correct answer: B

Rationale: The correct answer is B: Rh antigen. In addition to ABO antigens, Rh antigen must also be matched for a blood transfusion. Rh antigen compatibility is crucial to prevent adverse reactions. Choice A, HLA type, is not directly related to blood transfusions but plays a role in organ transplantation. Choice C, Immunoglobulins, are not typically matched for blood transfusions. Choice D, Platelet compatibility, while important in specific cases, is not a standard requirement for all blood transfusions.

3. Which of the following hormones helps to raise the blood sugar level to help maintain homeostasis?

• A. Antidiuretic hormone (ADH)
• B. Insulin
• C. Glucagon
• D. Thyroxine

Correct answer: C

Rationale: The correct answer is C, Glucagon. Glucagon helps raise blood sugar levels by stimulating the liver to release stored glucose into the bloodstream, thus aiding in maintaining homeostasis. Antidiuretic hormone (ADH), choice A, functions in regulating water balance in the body, not blood sugar levels. Insulin, choice B, lowers blood sugar levels by facilitating glucose uptake by cells. Thyroxine, choice D, is a hormone produced by the thyroid gland that regulates metabolism and has no direct effect on blood sugar levels.

4. A 20-year-old college student has presented to the campus medical clinic seeking to begin oral contraceptive therapy. The nurse has recognized the need for adequate health education related to the patient's request. The nurse should emphasize the fact that successful prevention of pregnancy depends primarily on the patient's

• A. current health status.
• B. vigilant adherence to the drug regimen.
• C. knowledge of sexual health.
• D. risk factors for adverse effects.

Correct answer: B

Rationale: The correct answer is B: 'vigilant adherence to the drug regimen.' When initiating oral contraceptive therapy, the success of preventing pregnancy relies heavily on the patient's commitment to following the prescribed regimen consistently. Compliance with taking the oral contraceptives as directed is crucial for their effectiveness. Choice A, 'current health status,' is not the primary factor for successful prevention of pregnancy with oral contraceptives. Choice C, 'knowledge of sexual health,' while important, is not the primary determinant of contraceptive efficacy. Choice D, 'risk factors for adverse effects,' though relevant for monitoring and managing side effects, is not the primary focus for ensuring contraceptive success.

5. A patient is prescribed medroxyprogesterone acetate (Provera) for the treatment of endometriosis. What should the nurse include in the patient teaching?

• A. Take the medication with food to prevent nausea.
• B. Take the medication at the same time each day to maintain consistent hormone levels.
• C. Avoid prolonged sun exposure while taking this medication.
• D. Discontinue the medication if side effects occur.

Correct answer: B

Rationale: The correct answer is to take the medication at the same time each day to maintain consistent hormone levels and effectiveness. This is crucial for the drug to work optimally. Choice A is incorrect because medroxyprogesterone acetate does not necessarily need to be taken with food to prevent nausea. Choice C is not directly related to the medication's administration and is not a common teaching point for this drug. Choice D is incorrect as discontinuing the medication abruptly can lead to adverse effects and is not recommended without consulting a healthcare provider.

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