Nursing Elites

1. What is the primary action of bisphosphonates when prescribed to a patient with osteoporosis?

• A. It inhibits bone resorption, which helps maintain bone density.
• B. It stimulates new bone formation by increasing osteoblast activity.
• C. It increases calcium absorption in the intestines, which helps build stronger bones.
• D. It decreases calcium excretion by the kidneys, helping to maintain bone density.

Correct answer: A

Rationale: The correct answer is A: "It inhibits bone resorption, which helps maintain bone density." Bisphosphonates work by inhibiting bone resorption carried out by osteoclasts, thereby preventing the breakdown of bones and helping to maintain or increase bone density in patients with osteoporosis. Choices B, C, and D are incorrect because bisphosphonates do not directly stimulate new bone formation, increase calcium absorption in the intestines, or decrease calcium excretion by the kidneys.

2. A 60-year-old male client with a long history of back pain has had little success with a variety of analgesic regimens that his family physician has prescribed. He has recently been diagnosed with a chronic pain disorder. Which teaching points about chronic pain would his physician most likely emphasize to the client?

• A. Chronic pain is often difficult to treat and requires a multimodal approach.
• B. Chronic pain indicates that an underlying injury has not healed properly.
• C. Chronic pain can be managed with a single long-term medication.
• D. Chronic pain is typically less severe than acute pain but lasts longer.

Correct answer: A

Rationale: The correct answer is A. Chronic pain is often complex and challenging to treat, necessitating a multimodal approach that may include medication, physical therapy, and behavioral therapy. Choice B is incorrect because chronic pain does not always indicate that an underlying injury has not healed properly; it can persist even after the initial injury has healed. Choice C is incorrect as chronic pain management usually involves a combination of treatments rather than relying solely on a single long-term medication. Choice D is incorrect because chronic pain is not necessarily less severe than acute pain; it can vary in intensity and duration depending on the individual and underlying condition.

3. Which of the following disturbances would cause a client to experience gout?

• A. Serotonin receptors
• B. Uric acid metabolism
• C. Liver function
• D. Cardiac function

Correct answer: B

Rationale: Gout is caused by a disturbance in uric acid metabolism, leading to the accumulation of uric acid crystals in joints. Serotonin receptors (Choice A) are not related to gout. Liver function (Choice C) is important for metabolism but is not directly linked to gout development. Cardiac function (Choice D) is primarily related to the heart's functioning and not associated with gout.

4. What is a common trigger for acute bronchospasm in asthma?

• A. Infection
• B. Allergic reaction
• C. Excessive exercise
• D. High altitude

Correct answer: B

Rationale: An allergic reaction is a common trigger for acute bronchospasm in asthma patients. When individuals with asthma come in contact with allergens like pollen, dust mites, or pet dander, it can lead to an allergic reaction that triggers bronchospasm. Infections, excessive exercise, and high altitudes can exacerbate asthma symptoms, but they are not the most common trigger for acute bronchospasm in asthma patients.

5. A 60-year-old man presents with painless hematuria. Which of the following should be the next step in the evaluation?

• A. Urinalysis
• B. Renal ultrasound
• C. Cystoscopy
• D. Intravenous pyelogram

Correct answer: C

Rationale: In a 60-year-old man presenting with painless hematuria, the next step in the evaluation should be cystoscopy. Cystoscopy is recommended to assess the cause of hematuria, particularly to rule out bladder cancer, which is more common in older individuals. Urinalysis (Choice A) can provide initial information but may not definitively diagnose the underlying cause. Renal ultrasound (Choice B) and intravenous pyelogram (Choice D) are imaging studies that may be considered later in the evaluation process but are not the initial step for painless hematuria.

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