Nursing Elites

1. A patient with a history of breast cancer is being prescribed tamoxifen (Nolvadex). What should the nurse include in the patient education about the use of this medication?

• A. Tamoxifen may increase the risk of venous thromboembolism, so the patient should be aware of the signs and symptoms of blood clots.
• B. Tamoxifen may cause hot flashes, so the patient should be prepared for this side effect.
• C. Tamoxifen may decrease the risk of osteoporosis, so the patient should ensure adequate calcium intake.
• D. Tamoxifen may cause weight gain, so the patient should monitor their diet and exercise regularly.

Correct answer: A

Rationale: The correct answer is A. Tamoxifen is known to increase the risk of venous thromboembolism, a serious side effect. Patients should be educated about the signs and symptoms of blood clots, such as swelling, pain, or redness in the affected limb, and the importance of seeking immediate medical attention if they occur. Choice B is incorrect because hot flashes are a common side effect of tamoxifen but not a critical concern like venous thromboembolism. Choice C is incorrect as tamoxifen is not associated with a decreased risk of osteoporosis. Choice D is incorrect because while weight gain can occur with tamoxifen, it is not as crucial to educate the patient about as the risk of venous thromboembolism.

2. A child with a serious fungal infection is receiving amphotericin B parenterally. Which of the following minerals will the patient most likely be required to receive?

• A. Chloride
• B. Magnesium
• C. Glucose
• D. Sodium

Correct answer: B

Rationale: When a patient is receiving amphotericin B, which is known to cause renal toxicity, they are most likely to require magnesium supplementation. Amphotericin B can lead to renal loss of magnesium, potassium, and calcium. Magnesium is an essential mineral that plays a vital role in various physiological functions, and its levels need to be monitored and supplemented when necessary. Chloride, glucose, and sodium are not typically supplemented in the context of amphotericin B therapy for a serious fungal infection.

3. A patient with a complex medical history is considering the use of oral contraceptives. The nurse should be aware that many antibiotics and antiseizure medications cause what effect when combined with oral contraceptives?

• A. Increased risk of pregnancy
• B. Increased blood pressure
• C. Increased risk of thromboembolism
• D. Increased gastric acid

Correct answer: A

Rationale: The correct answer is A: Increased risk of pregnancy. Certain antibiotics and anticonvulsants can decrease the effectiveness of oral contraceptives by inducing liver enzymes that metabolize the hormones more quickly. This interaction can lead to a decreased contraceptive effect, thereby increasing the risk of pregnancy. Choices B, C, and D are incorrect as they do not directly relate to the effect of antibiotics and antiseizure medications on oral contraceptives.

4. When the maternal immune system becomes sensitized against antigens expressed by the fetus, what type of immune reaction occurs?

• A. Autoimmune
• B. Anaphylaxis
• C. Alloimmune
• D. Allergic

Correct answer: C

Rationale: When the maternal immune system becomes sensitized against antigens expressed by the fetus, an alloimmune reaction occurs. In this situation, the mother's immune system recognizes the fetus as foreign due to differences in antigens, leading to an immune response against the fetus. Choice A, 'Autoimmune,' is incorrect because it refers to the immune system mistakenly attacking the body's own cells and tissues. Choice B, 'Anaphylaxis,' is not the correct answer as it is a severe allergic reaction that can be life-threatening. Choice D, 'Allergic,' is also incorrect as it refers to an immune response triggered by allergens, not antigens expressed by the fetus.

5. What is the primary cause of angina?

• A. Increased oxygen demand by the heart
• B. Obstruction of the coronary arteries
• C. Lack of oxygen in the lungs
• D. Decreased blood supply to the liver

Correct answer: B

Rationale: The correct answer is B: Obstruction of the coronary arteries. Angina is primarily caused by a reduced blood flow to the heart due to blockages or narrowing in the coronary arteries. Choice A is incorrect because while increased oxygen demand can contribute to angina symptoms, it is not the primary cause. Choice C is incorrect as angina is not caused by a lack of oxygen in the lungs. Choice D is also incorrect as angina is not related to decreased blood supply to the liver.

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