Nursing Elites

1. A woman is being treated with clomiphene citrate for the treatment of infertility. She states to the nurse that she has seen an increase in vaginal discharge. The nurse knows that this effect is related to:

• A. Increased blood flow to the vaginal area.
• B. Increased cervical mucus production.
• C. Increased production of vaginal secretions.
• D. Increased lubrication in the vaginal canal.

Correct answer: C

Rationale: The correct answer is C: 'Increased production of vaginal secretions.' Clomiphene citrate affects cervical mucus production, leading to an increase in vaginal secretions. This effect is beneficial for fertility as it helps create a more hospitable environment for sperm transport. Choice A, 'Increased blood flow to the vaginal area,' is incorrect as the increase in vaginal discharge is primarily due to changes in cervical mucus. Choice B, 'Increased cervical mucus production,' is partially correct but does not fully explain the increase in vaginal secretions. Choice D, 'Increased lubrication in the vaginal canal,' is not directly related to the effect seen with clomiphene citrate treatment for infertility.

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. A patient is to be administered an immunization. The serum contains aluminum phosphate. What route is most appropriate to administer this immunization?

• A. Intramuscularly
• B. Subcutaneously
• C. Intravenously
• D. Orally

Correct answer: A

Rationale: The most appropriate route to administer an immunization containing aluminum phosphate is intramuscularly. Aluminum phosphate is commonly used as an adjuvant in vaccines to enhance the immune response. Intramuscular administration allows for the vaccine to be delivered into the muscle tissue, where it can be effectively absorbed by the body's immune cells. Subcutaneous administration is not ideal for vaccines containing aluminum phosphate, as it may not elicit the desired immune response. Intravenous administration is typically reserved for specific medications or situations that require rapid absorption into the bloodstream. Oral administration is not suitable for vaccines containing aluminum phosphate as they would be degraded in the gastrointestinal tract.

4. 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.

5. Which of the following would the nurse see in a client with thrombocytopenia?

• A. A decreased platelet cell count
• B. Decreased white blood cell count
• C. Increased red blood cell count
• D. An increased platelet cell count

Correct answer: A

Rationale: Thrombocytopenia is characterized by a decreased platelet cell count, leading to an increased risk of bleeding. Therefore, the correct answer is A. Choice B, a decreased white blood cell count, is not typically associated with thrombocytopenia. Choice C, an increased red blood cell count, is not a characteristic finding in thrombocytopenia. Choice D, an increased platelet cell count, is the opposite of what is observed in thrombocytopenia.

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