Nursing Elites

1. Which of the following mediates humoral immunity?

• A. Natural killer cells
• B. T cells
• C. B cells
• D. Neutrophils

Correct answer: C

Rationale: Humoral immunity is mediated by B cells, not natural killer cells, T cells, or neutrophils. B cells are responsible for producing antibodies, which are essential components of humoral immunity.

2. A patient with a complex medical history is considering the use of oral contraceptives. The nurse should be aware that many antibiotics and antiseizure medications cause what effect when combined with oral contraceptives?

• A. Increased risk of pregnancy
• B. Increased blood pressure
• C. Increased risk of thromboembolism
• D. Increased gastric acid

Correct answer: A

Rationale: The correct answer is A: Increased risk of pregnancy. Certain antibiotics and anticonvulsants can decrease the effectiveness of oral contraceptives by inducing liver enzymes that metabolize the hormones more quickly. This interaction can lead to a decreased contraceptive effect, thereby increasing the risk of pregnancy. Choices B, C, and D are incorrect as they do not directly relate to the effect of antibiotics and antiseizure medications on oral contraceptives.

3. A patient has been prescribed mifepristone (RU-486) to terminate a pregnancy. How does this drug achieve its therapeutic effect?

• A. By inhibiting the action of progesterone, which is necessary to maintain pregnancy.
• B. By increasing estrogen levels, which induce uterine contractions.
• C. By altering the uterine lining, preventing implantation.
• D. By stimulating uterine contractions, which expel the embryo.

Correct answer: A

Rationale: Mifepristone (RU-486) functions by inhibiting the action of progesterone, a hormone crucial for maintaining pregnancy. By blocking progesterone, mifepristone disrupts the uterine environment necessary for pregnancy continuation, ultimately leading to termination. Choice B is incorrect because mifepristone does not increase estrogen levels; instead, it acts on progesterone. Choice C is incorrect as mifepristone's mechanism does not involve altering the uterine lining to prevent implantation. Choice D is incorrect because mifepristone does not directly stimulate uterine contractions; its primary action is through progesterone inhibition.

4. A client with a history of hypertension presents with a severe headache and blurred vision. What is the nurse's priority action?

• A. Administer pain relief medication.
• B. Obtain a stat head CT scan.
• C. Administer antihypertensive medications as prescribed.
• D. Call the healthcare provider immediately.

Correct answer: C

Rationale: The correct answer is to administer antihypertensive medications as prescribed. In a client with a history of hypertension presenting with severe headache and blurred vision, these symptoms could indicate a hypertensive crisis. The priority action is to lower the blood pressure promptly to prevent complications such as stroke, heart attack, or organ damage. Administering antihypertensive medications is crucial in this situation. Administering pain relief medication (Choice A) may temporarily alleviate symptoms but does not address the underlying issue of elevated blood pressure. Obtaining a stat head CT scan (Choice B) may be necessary to rule out other causes but should not delay the administration of antihypertensive medications. Calling the healthcare provider immediately (Choice D) is important but may not address the immediate need to lower blood pressure in a hypertensive crisis.

5. A male patient with erectile dysfunction is prescribed sildenafil (Viagra). What specific instruction should the nurse provide to ensure the safe use of this medication?

• A. Take the medication with food to prevent nausea.
• B. Avoid taking nitrates while on this medication.
• C. Take the medication at bedtime to ensure absorption during sleep.
• D. Take the medication with milk to enhance absorption.

Correct answer: B

Rationale: The correct instruction the nurse should provide is to avoid taking nitrates while on sildenafil (Viagra). Combining sildenafil with nitrates can result in severe hypotension due to additive vasodilatory effects. Choice A is incorrect because sildenafil can be taken with or without food. Choice C is incorrect as there is no specific requirement to take sildenafil at bedtime. Choice D is incorrect as taking sildenafil with milk has not been shown to enhance its absorption.

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