Nursing Elites

1. A patient with a history of hypertension presents with a severe headache, confusion, and visual disturbances. His blood pressure is 220/120 mm Hg. Which of the following is the most likely diagnosis?

• A. Migraine
• B. Cluster headache
• C. Hypertensive emergency
• D. Tension headache

Correct answer: C

Rationale: A patient with a history of hypertension presenting with a severe headache, confusion, and visual disturbances, along with a blood pressure of 220/120 mm Hg, likely has a hypertensive emergency. In this situation, the severely elevated blood pressure can lead to end-organ damage, causing symptoms such as headache and confusion. Migraine and tension headaches are not associated with such high blood pressure levels. Cluster headaches typically do not present with visual disturbances and confusion in the setting of severe hypertension.

2. A 17-year-old woman has come to the clinic requesting emergency contraception after having unprotected sex 24 hours ago. What medication is the clinician most likely to prescribe?

• A. Levonorgestrel (Plan B)
• B. Mifepristone (RU-486)
• C. Ulipristal acetate (ella)
• D. Estradiol (Estrace)

Correct answer: A

Rationale: The correct answer is A: Levonorgestrel (Plan B). Levonorgestrel is the most commonly prescribed medication for emergency contraception within 72 hours of unprotected intercourse. It is effective when taken within 72 hours after intercourse, with better efficacy the sooner it is taken. Choice B, Mifepristone (RU-486), is not indicated for emergency contraception but is used for medical abortion. Choice C, Ulipristal acetate (ella), is another option for emergency contraception that is effective up to 120 hours after unprotected intercourse. Choice D, Estradiol (Estrace), is not used for emergency contraception.

3. What is the best way to prevent transmission of infectious agents?

• A. Take antibiotics daily
• B. Call the practitioner for herbal supplements
• C. Wash hands
• D. Avoid public areas as much as possible

Correct answer: C

Rationale: The correct answer is C: Wash hands. Washing hands is the most effective way to prevent the transmission of infectious agents. Antibiotics are not effective in preventing infections, and their overuse can lead to antibiotic resistance. Calling a practitioner for herbal supplements is not a primary method for preventing the transmission of infectious agents. Avoiding public areas entirely is impractical and not as effective as proper hand hygiene.

4. After sustaining a concussion, a client experiences headache, vomiting, blurred vision, and loss of consciousness. What does this indicate?

• A. Increased intracranial pressure
• B. Lower extremity compartment syndrome
• C. Consuming too much food at once
• D. Improved kidney function

Correct answer: A

Rationale: The symptoms of headache, vomiting, blurred vision, and loss of consciousness following a concussion are indicative of increased intracranial pressure. These symptoms are commonly associated with intracranial pressure elevation, which can be dangerous and requires immediate medical attention. Lower extremity compartment syndrome is characterized by severe pain and swelling in the affected limb, not the symptoms mentioned. Consuming too much food at once may lead to digestive issues but does not correlate with the symptoms described. Improved kidney function would not manifest through the symptoms mentioned after a concussion.

5. What important instruction should the nurse provide about taking medroxyprogesterone acetate (Provera) for a patient with endometriosis?

• A. Take the medication at the same time each day to maintain consistent hormone levels.
• B. Medroxyprogesterone should be taken with food to reduce gastrointestinal upset.
• C. Discontinue medroxyprogesterone if side effects occur.
• D. Medroxyprogesterone should be taken once a week to maintain effectiveness.

Correct answer: A

Rationale: The correct answer is to take the medication at the same time each day to maintain consistent hormone levels and effectiveness. This consistency is crucial for achieving therapeutic outcomes. Choice B is incorrect because medroxyprogesterone should be taken at the same time each day, regardless of food intake. Choice C is incorrect because side effects should be reported to the healthcare provider for further evaluation rather than discontinuing the medication abruptly. Choice D is incorrect as medroxyprogesterone is usually taken daily for the prescribed duration.

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