Nursing Elites

1. A patient who was frequently homeless over the past several years has begun a drug regimen consisting solely of isoniazid (INH). What is this patient's most likely diagnosis?

• A. Active tuberculosis
• B. Latent tuberculosis
• C. Mycobacterium avium complex
• D. Human immunodeficiency virus

Correct answer: A

Rationale: The correct answer is A: Active tuberculosis. Given the patient's history of homelessness and initiation of isoniazid (INH) treatment, the most likely diagnosis is active tuberculosis. Isoniazid is a first-line medication used in the treatment of active tuberculosis. Latent tuberculosis (choice B) would not typically necessitate treatment with isoniazid alone. Mycobacterium avium complex (choice C) is not typically treated with isoniazid alone. Human immunodeficiency virus (choice D) is a risk factor for developing tuberculosis but is not the primary diagnosis in this patient scenario.

2. How should the nurse respond to a 72-year-old patient diagnosed with benign prostatic hypertrophy (BPH) who is skeptical about tamsulosin (Flomax) for symptom relief?

• A. “Flomax can increase the amount of urine your kidneys produce, resulting in better urine flow.”
• B. “Flomax can relax your prostate and your bladder neck, making it easier to pass urine.”
• C. “Flomax makes your urine less alkaline, reducing the irritation that makes your prostate swell.”
• D. “Flomax increases the strength of your bladder muscle and results in a stronger flow of urine.”

Correct answer: B

Rationale: The correct response is choice B because it explains the mechanism of action of Flomax, which helps the patient understand how the medication works. By stating that Flomax relaxes the prostate and bladder neck, making it easier to pass urine, the nurse is addressing the patient's concerns about symptom relief. Choices A, C, and D provide inaccurate information about Flomax's mechanism of action and do not directly address the patient's skepticism or concerns.

3. A patient with a history of breast cancer is being prescribed tamoxifen (Nolvadex). What is a critical point the nurse should include in the patient education?

• A. Tamoxifen may increase the risk of venous thromboembolism.
• B. Tamoxifen may decrease the risk of osteoporosis.
• C. Tamoxifen may cause hot flashes and other menopausal symptoms.
• D. Tamoxifen may cause weight gain and fluid retention.

Correct answer: A

Rationale: The correct answer is A. Tamoxifen increases the risk of venous thromboembolism, so patients should be educated about the signs and symptoms of blood clots. Choice B is incorrect because tamoxifen does not decrease the risk of osteoporosis. Choice C is incorrect as tamoxifen may cause hot flashes and other menopausal symptoms but this is not the critical point for patient education. Choice D is incorrect as tamoxifen may cause weight gain and fluid retention, but it is not the critical point that the nurse should focus on in patient education.

4. A patient is prescribed estradiol (Estrace) for hormone replacement therapy (HRT). What should the nurse monitor during this therapy?

• A. Blood glucose levels
• B. Liver function tests
• C. Kidney function tests
• D. Blood pressure

Correct answer: B

Rationale: During estradiol therapy, monitoring liver function tests is essential due to the potential for liver dysfunction. Estradiol can affect liver function, making it crucial to monitor enzyme levels. Choice A, blood glucose levels, is not directly impacted by estradiol therapy, making it an incorrect choice. Choice C, kidney function tests, is not typically affected by estradiol therapy, so it is not the priority for monitoring. Choice D, blood pressure, is also not the primary parameter to monitor during estradiol therapy unless there are pre-existing conditions that warrant such monitoring.

5. What occurs in a client with polycythemia?

• A. Deficient plasma in the blood
• B. Increased lymphatic fluid being produced
• C. Increased red blood cells being produced
• D. Deficient number of red blood cells

Correct answer: C

Rationale: The correct answer is C: Increased red blood cells being produced. Polycythemia is a condition characterized by an elevated number of red blood cells in the blood. This increased concentration of red blood cells can lead to blood thickening and potentially result in complications such as blood clots. Choices A, B, and D are incorrect because polycythemia does not involve deficient plasma, increased lymphatic fluid production, or a deficient number of red blood cells.

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