Nursing Elites

1. During patient teaching, a young woman asks the nurse the following question: 'If I get pregnant on the 'pill,' should I continue to take it?' What is the nurse's best response?

• A. The pill has no effect on pregnancy.
• B. The pill will cause miscarriage.
• C. This is a personal choice for each woman.
• D. The pill can be harmful to the fetus and should be discontinued.

Correct answer: C

Rationale: The correct answer is 'C: This is a personal choice for each woman.' If a woman becomes pregnant while taking birth control pills, it is generally recommended to discontinue them as they can potentially harm the fetus. However, the decision to continue or discontinue the pill in case of pregnancy is ultimately a personal choice for each woman. Choice A is incorrect because birth control pills are meant to prevent pregnancy, but if a woman becomes pregnant while taking them, the situation changes. Choice B is incorrect because birth control pills do not cause miscarriage; they are intended to prevent pregnancy. Choice D is incorrect because while it is generally advised to discontinue the pill if pregnancy occurs, the decision ultimately depends on the individual circumstances and preferences of the woman.

2. Which of the following are risk factors for hypertension (HTN)?

• A. High sugar, low-fat diet
• B. Increased physical activity
• C. Tobacco use
• D. Low-fat diet

Correct answer: C

Rationale: Tobacco use is a well-established risk factor for hypertension (HTN) as it can lead to increased blood pressure. High sugar intake and low-fat diets, as well as increased physical activity, are not directly associated with hypertension. While low-fat diets are generally recommended for overall health, they are not specifically linked to hypertension risk.

3. What symptoms would the nurse expect to see in a client with chronic obstructive pulmonary disease (COPD)?

• A. Dyspnea on exertion
• B. Normal lung sounds
• C. Normal arterial blood gases
• D. Onset of the disease during young adulthood

Correct answer: A

Rationale: The correct answer is A: Dyspnea on exertion. COPD typically manifests with symptoms like dyspnea on exertion due to impaired lung function. This symptom is a result of the airways being obstructed and the lungs not being able to expel air effectively. Choices B and C are incorrect because in COPD, abnormal lung sounds such as wheezing, crackles, or diminished breath sounds are often heard upon auscultation, and arterial blood gases are usually abnormal, showing low oxygen levels and high carbon dioxide levels. Choice D is incorrect as COPD is more commonly diagnosed in individuals over 40 who have a history of smoking or exposure to lung irritants.

4. A public health nurse is responsible for the administration of numerous immunizations. Which of the following guidelines regarding anaphylaxis should the nurse adhere to?

• A. The patient should be observed for anaphylaxis for 1 minute after administration.
• B. The patient should be observed for anaphylaxis for 5 minutes after administration.
• C. The patient should be observed for anaphylaxis for 30 minutes after administration.
• D. The patient should be observed for anaphylaxis for 90 minutes after administration.

Correct answer: C

Rationale: The correct answer is C: 'The patient should be observed for anaphylaxis for 30 minutes after administration.' This is because anaphylaxis can occur within minutes of administration of an immunization. By observing the patient for 30 minutes, the nurse can promptly identify and manage any signs of anaphylaxis. Choices A, B, and D are incorrect as they suggest shorter or longer observation periods, which may not be sufficient to detect and respond to anaphylaxis in a timely manner.

5. When discussing the risks associated with hormone replacement therapy (HRT) with a patient who has a history of coronary artery disease, what should the nurse emphasize?

• A. HRT may increase the risk of cardiovascular events such as heart attack and stroke.
• B. HRT may increase the risk of osteoporosis.
• C. HRT may decrease the risk of venous thromboembolism.
• D. HRT may increase the risk of breast cancer.

Correct answer: A

Rationale: The correct answer is A. Hormone replacement therapy (HRT) is associated with an increased risk of cardiovascular events, such as heart attack and stroke, especially in patients with a history of coronary artery disease. Choice B is incorrect because HRT is actually known to decrease the risk of osteoporosis. Choice C is incorrect as HRT is associated with an increased risk of venous thromboembolism. Choice D is also incorrect as HRT may slightly increase the risk of breast cancer.

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