Nursing Elites

1. What action is specific to hormonal contraceptives and should be taught to this woman?

• A. The cervical mucus is altered to prevent sperm penetration.
• B. The release of follicle-stimulating hormone is increased to block fertility.
• C. The maturation of the endometrial lining is activated by the contraceptive.
• D. The pituitary gland increases the synthesis and release of luteinizing hormone.

Correct answer: A

Rationale: The correct action specific to hormonal contraceptives that should be taught to the woman is that they alter cervical mucus to prevent sperm penetration. This mechanism helps in preventing pregnancy by reducing the chances of sperm reaching the egg. Choices B, C, and D are incorrect. Choice B is inaccurate as hormonal contraceptives work by inhibiting ovulation rather than increasing follicle-stimulating hormone release. Choice C is incorrect as hormonal contraceptives do not activate the maturation of the endometrial lining; instead, they modify it to prevent implantation. Choice D is also incorrect as hormonal contraceptives do not stimulate the pituitary gland to increase luteinizing hormone synthesis and release.

2. A client on an acute medicine unit of a hospital with a diagnosis of small bowel obstruction is reporting intense, diffuse pain in her abdomen. Which physiologic phenomenon is most likely contributing to her complaint?

• A. Somatic pain resulting from pressure on the parietal peritoneum
• B. Referred pain from her small bowel
• C. Visceral pain resulting from distension and ischemia
• D. Neuropathic pain resulting from autonomic dysfunction

Correct answer: C

Rationale: Visceral pain is associated with distension, ischemia, and inflammation of internal organs. In the case of a small bowel obstruction, the intense, diffuse pain reported by the client is likely due to the distension and ischemia of the small bowel. Somatic pain (Choice A) would be more localized and sharp, typically arising from the parietal peritoneum. Referred pain (Choice B) is pain perceived at a site distant from the actual pathology. Neuropathic pain (Choice D) involves dysfunction or damage to the nervous system and is not typically associated with the described physiologic phenomenon of distension and ischemia in the context of a small bowel obstruction.

3. In a patient with chronic kidney disease and a hemoglobin level of 9 g/dL, which of the following treatments is most appropriate?

• A. Iron supplementation
• B. Erythropoiesis-stimulating agents
• C. Blood transfusion
• D. Vitamin B12 supplementation

Correct answer: B

Rationale: In chronic kidney disease, anemia commonly occurs due to decreased erythropoietin production. Erythropoiesis-stimulating agents, such as erythropoietin or darbepoetin, are the mainstay of treatment to stimulate red blood cell production. Iron supplementation is more appropriate for iron-deficiency anemia, not the anemia of chronic kidney disease. Blood transfusion is reserved for severe cases or acute blood loss. Vitamin B12 supplementation is indicated for megaloblastic anemia caused by vitamin B12 deficiency, not specifically in chronic kidney disease-related anemia.

4. Which type of lymphocyte recognizes and eliminates virus-infected cells and cancerous cells?

• A. Neutrophils
• B. Macrophages
• C. Natural killer cells
• D. Langerhans cells

Correct answer: C

Rationale: Natural killer cells are a type of lymphocyte that plays a crucial role in recognizing and eliminating virus-infected cells and cancerous cells. Neutrophils (Choice A) are a type of white blood cell involved in fighting infections, mainly through phagocytosis. Macrophages (Choice B) are another type of white blood cell that engulfs and digests cellular debris and pathogens. Langerhans cells (Choice D) are a type of dendritic cell found in the skin and mucosa, primarily involved in antigen presentation.

5. A patient with osteoporosis is prescribed raloxifene (Evista). What is the primary therapeutic action of this medication?

• A. It decreases bone resorption and increases bone density.
• B. It stimulates the formation of new bone.
• C. It increases calcium absorption in the intestines.
• D. It increases the excretion of calcium through the kidneys.

Correct answer: A

Rationale: The correct answer is A. Raloxifene works by decreasing bone resorption and increasing bone density. This helps in preventing further bone loss and reducing the risk of fractures in patients with osteoporosis. Choice B is incorrect because raloxifene does not stimulate the formation of new bone, but rather helps to maintain existing bone mass. Choice C is incorrect as raloxifene does not directly increase calcium absorption in the intestines. Choice D is also incorrect as raloxifene does not increase the excretion of calcium through the kidneys.

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