Nursing Elites

1. A woman of childbearing age is diagnosed with breast cancer. She is currently taking hormonal contraceptives. What information should the woman be given regarding the hormonal contraceptives?

• A. The hormonal contraceptives do not affect the course of the disease.
• B. The hormonal contraceptives will stimulate uterine bleeding.
• C. The hormonal contraceptives will impair uterine bleeding.
• D. The hormonal contraceptives will stimulate tumor growth.

Correct answer: A

Rationale: The correct answer is A. Hormonal contraceptives should be discontinued in women diagnosed with breast cancer because they can potentially stimulate cancer growth. Choice B is incorrect as hormonal contraceptives do not stimulate uterine bleeding. Choice C is also incorrect as hormonal contraceptives typically do not impair uterine bleeding. Choice D is incorrect because hormonal contraceptives are not meant to stimulate tumor growth.

2. The signs of thyroid crisis resulting from Graves' disease include:

• A. constipation with gastric distension.
• B. bradycardia and bradypnea.
• C. hyperthermia and tachycardia.
• D. constipation and lethargy.

Correct answer: C

Rationale: Thyroid crisis in Graves' disease typically presents with hyperthermia (high body temperature) and tachycardia (rapid heart rate). These symptoms are a result of excessive thyroid hormone production and can lead to life-threatening complications if not promptly addressed. Choices A, B, and D are incorrect because constipation with gastric distension, bradycardia and bradypnea, and constipation and lethargy are not typical signs of a thyroid crisis in Graves' disease.

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. A nursing student having trouble moving her head from side to side is likely experiencing a problem with which type of neurons?

• A. General visceral efferent neurons
• B. Preganglionic neurons
• C. Parasympathetic postganglionic neurons
• D. Pharyngeal efferent neurons

Correct answer: D

Rationale: The correct answer is D: Pharyngeal efferent neurons. Pharyngeal efferent neurons are responsible for controlling head movements, including side-to-side motions. General visceral efferent neurons (Choice A) are involved in innervating smooth muscles and glands in the body's internal organs. Preganglionic neurons (Choice B) are part of the autonomic nervous system and connect the central nervous system to the ganglia. Parasympathetic postganglionic neurons (Choice C) are the second neurons in the parasympathetic nervous system pathway, responsible for innervating target organs. In this case, the issue with moving the head from side to side indicates a problem with the pharyngeal efferent neurons.

5. A patient is taking a statin for hyperlipidemia. What important instruction should the nurse provide to the patient?

• A. Take the medication at night to avoid muscle pain.
• B. Take the medication in the morning to ensure it works throughout the day.
• C. Avoid consuming alcohol while taking this medication.
• D. Take the medication with a high-fat meal to increase absorption.

Correct answer: A

Rationale: The correct answer is to instruct the patient to take the medication at night to avoid muscle pain. Statins are known to potentially cause muscle pain or weakness; taking the medication at night can help reduce the incidence of these side effects. Option B is incorrect because the timing of statin administration is not related to its effectiveness throughout the day. Option C is a general precaution when taking medications but not the most important instruction specific to statins. Option D is incorrect as taking the medication with a high-fat meal can actually decrease its absorption.

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