Nursing Elites

1. A patient with breast cancer is prescribed tamoxifen (Nolvadex). What key point should the nurse include in the patient education?

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

Correct answer: A

Rationale: The correct answer is A: "Tamoxifen may increase the risk of venous thromboembolism." It is crucial for patients to be aware of the signs and symptoms of blood clots while taking tamoxifen. Choice B is incorrect because hot flashes and menopausal symptoms are common side effects of tamoxifen, but they are not the key point to emphasize. Choice C is incorrect as weight gain and fluid retention are potential side effects of tamoxifen but not the key point for patient education. Choice D is incorrect as tamoxifen does not decrease the risk of osteoporosis; in fact, it may increase the risk of bone loss.

2. An imbalance of which of the following hormones could lead to increased calcium levels in the blood?

• A. Parathyroid hormone
• B. Antidiuretic hormone
• C. Calcitonin
• D. Melatonin

Correct answer: A

Rationale: The correct answer is Parathyroid hormone (Choice A). Parathyroid hormone plays a key role in regulating calcium levels in the blood. When there is an imbalance in parathyroid hormone secretion, it can lead to increased calcium levels in the blood. Antidiuretic hormone (Choice B) is involved in regulating water balance, not calcium levels. Calcitonin (Choice C) helps lower blood calcium levels and is unlikely to cause an increase. Melatonin (Choice D) regulates sleep-wake cycles and does not have a direct effect on calcium levels in the blood.

3. A 30-year-old female has suffered a third-degree burn to her hand after spilling hot oil in a kitchen accident. Which teaching point by a member of her care team is most appropriate?

• A. Your hand will likely heal without the need for a skin graft.
• B. You might experience a loss of sensation in your hand after it heals.
• C. Be sure to keep your hand elevated to reduce swelling.
• D. We will need to monitor you for infection as your hand heals.

Correct answer: D

Rationale: In third-degree burns, infection is a major concern due to the extensive damage to the skin. Monitoring for infection is crucial. Choice A is incorrect because third-degree burns often require skin grafts due to the severity of the injury. Choice B is incorrect as loss of sensation is more common in nerve damage and not necessarily in burns. Choice C is incorrect because while elevation can help with swelling in minor burns, it is not the most critical concern in third-degree burns.

4. In chronic obstructive pulmonary disease, the inflammatory response predominantly involves:

• A. eosinophils
• B. neutrophils
• C. monocytes
• D. cells

Correct answer: B

Rationale: In chronic obstructive pulmonary disease, the inflammatory response predominantly involves neutrophils. Neutrophils play a key role in COPD due to their involvement in initiating and sustaining the inflammatory process. Eosinophils are more commonly associated with asthma rather than COPD. Monocytes are less involved in the inflammatory response in COPD compared to neutrophils. The choice 'cells' is too broad and vague to be a specific answer in this context.

5. What is a critical point the nurse should include in patient education for a patient prescribed tamoxifen (Nolvadex)?

• 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 critical point the nurse should include in patient education for a patient prescribed tamoxifen is that it may increase the risk of venous thromboembolism. This is crucial information because tamoxifen is known to promote blood clot formation, and patients need to be aware of the signs and symptoms of blood clots to seek prompt medical attention. Choices B, C, and D are incorrect as tamoxifen is not associated with decreasing the risk of osteoporosis, causing hot flashes and other menopausal symptoms, or directly causing weight gain and fluid retention.

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