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. Which of the following factors are known to contribute to an individual's ability to adapt to stress? (Select ONE that does not apply.)

• A. Ethnicity
• B. Age
• C. Socioeconomic status
• D. Gender

Correct answer: A

Rationale: The correct factors that contribute to an individual's ability to adapt to stress are age, socioeconomic status, and gender. Age can influence coping mechanisms and resilience. Socioeconomic status can impact access to resources and support systems. Gender differences can also play a role in how individuals experience and manage stress. Ethnicity, while important in other contexts, is not directly mentioned in the provided rationale and is not one of the factors listed as contributing to an individual's ability to adapt to stress.

3. Mrs. Jordan is an elderly client diagnosed with Alzheimer’s disease. She becomes agitated and combative when a nurse approaches to help with morning care. The most appropriate nursing intervention in this situation would be to:

• A. tell the client firmly that it is time to get dressed.
• B. obtain assistance to restrain the client for safety.
• C. remain calm and talk quietly to the client.
• D. call the doctor and request an order for sedation.

Correct answer: C

Rationale: When dealing with an elderly client with Alzheimer’s disease who is agitated and combative, the most appropriate nursing intervention is to remain calm and talk quietly to the client. This approach can help soothe the client and prevent escalating the situation. Choice A is incorrect as being firm may further agitate the client. Choice B is inappropriate as restraining should only be used as a last resort for safety reasons and after other de-escalation techniques have been attempted. Choice D is not the best initial intervention and should only be considered after other non-pharmacological interventions have failed.

4. Which of the following describes passive immunity?

• A. Vaccination against the disease
• B. Transfer of antibodies from mother to baby
• C. Cuts or wounds that are infected and heal
• D. Having the disease in question

Correct answer: B

Rationale: Passive immunity is the transfer of pre-formed antibodies from one individual to another, providing immediate but temporary protection. In this case, the correct answer is the transfer of antibodies from the mother to the baby, as it describes the concept of passive immunity. Choice A, vaccination against the disease, refers to active immunity where the individual's immune system is stimulated to produce antibodies. Choice C, cuts or wounds that are infected and heal, is unrelated to immunity. Choice D, having the disease in question, does not describe passive immunity but rather acquiring active immunity through exposure to the pathogen.

5. Which of the following women is at highest risk for the development of endometrial cancer?

• A. A 50-year-old postmenopausal woman with a history of high-risk human papillomavirus
• B. A 45-year-old woman who is obese and has a menstrual pattern consisting of periods of amenorrhea and infrequent periods
• C. A 40-year-old woman who is overweight and has hypertension
• D. A 55-year-old woman who smokes

Correct answer: B

Rationale: The correct answer is a 45-year-old woman who is obese and has a menstrual pattern consisting of periods of amenorrhea and infrequent periods. Obesity and prolonged exposure to estrogen unopposed by progesterone due to infrequent ovulation are significant risk factors for endometrial cancer. Choices A, C, and D do not directly correlate with the increased risk of endometrial cancer. Postmenopausal status alone (Choice A), overweight with hypertension (Choice C), and smoking (Choice D) are not the primary risk factors for endometrial cancer.

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