Nursing Elites

1. The early stages of atheroma development are characterized by:

• A. macrophages full of oxidized low-density lipoprotein (LDL; i.e., foam cells) in the intima
• B. accumulation of lipids in the intima (i.e., fatty streak)
• C. accumulation of proteins such as collagen and elastin (i.e., fibrous cap)
• D. development of calcium and a necrotic lipid core

Correct answer: A

Rationale: The correct answer is A. In the early stages of atheroma development, macrophages accumulate oxidized low-density lipoprotein (LDL) and transform into foam cells, leading to the formation of fatty streaks in the intima of blood vessels. This process is a hallmark of the initial stages of atherosclerosis. Choice B is incorrect as it describes the accumulation of lipids in the intima, which is a later event following foam cell formation. Choice C is also incorrect as it refers to the accumulation of proteins forming the fibrous cap, which occurs at a later stage to stabilize the atheroma. Choice D is incorrect as it describes the development of calcium and a necrotic lipid core, typically seen in advanced atherosclerosis rather than the early stages.

2. A patient is prescribed medroxyprogesterone acetate (Provera) for the treatment of endometriosis. What key instruction should the nurse provide regarding the administration of this medication?

• A. Take the medication at the same time each day to maintain consistent hormone levels.
• B. Discontinue the medication if side effects occur.
• C. Take the medication with food to prevent gastrointestinal upset.
• D. Apply the medication once a week.

Correct answer: A

Rationale: The correct instruction for medroxyprogesterone acetate (Provera) is to take the medication at the same time each day to maintain consistent hormone levels and ensure its effectiveness. Choice B is incorrect because discontinuing the medication abruptly without consulting healthcare providers can be harmful. Choice C is incorrect as taking the medication with food is not necessary for this specific drug. Choice D is incorrect as medroxyprogesterone is typically taken orally, not applied topically.

3. Which of the following tests is recommended for lung cancer screening?

• A. Chest X-ray
• B. Pulmonary function test
• C. Computed tomography (CT) scan
• D. Magnetic resonance imaging

Correct answer: C

Rationale: The correct answer is Computed tomography (CT) scan. When screening for lung cancer, CT scans are recommended over chest X-rays due to their higher sensitivity in detecting lung nodules and early-stage cancers. Pulmonary function tests are not used for screening lung cancer but rather to assess lung function. Magnetic resonance imaging is not the preferred imaging modality for routine lung cancer screening, as CT scans are more commonly used.

4. Which of the following eye disorders manifests with red eye, pain, and visual acuity changes?

• A. Bacterial conjunctivitis
• B. Acute closed-angle glaucoma
• C. Chronic open-angle glaucoma
• D. Blepharitis

Correct answer: B

Rationale: Acute closed-angle glaucoma presents with symptoms such as a red eye, severe pain, and rapid visual acuity changes due to increased intraocular pressure. This condition is considered an ophthalmologic emergency. Bacterial conjunctivitis typically presents with redness, discharge, and irritation but is not associated with severe pain or visual changes. Chronic open-angle glaucoma is usually asymptomatic until advanced stages and does not typically present with acute pain. Blepharitis involves inflammation of the eyelid margins and is characterized by redness and irritation, but it does not cause severe pain or acute visual changes.

5. A patient is prescribed sildenafil (Viagra) for erectile dysfunction. What key contraindication should the nurse review with the patient?

• A. Use of nitrates
• B. History of hypertension
• C. Use of antihypertensive medications
• D. Use of antihypertensive medications

Correct answer: A

Rationale: The correct answer is A: Use of nitrates. Sildenafil (Viagra) is contraindicated in patients taking nitrates due to the risk of severe hypotension. Nitrates and sildenafil both cause vasodilation, so their combined use can lead to a dangerous drop in blood pressure. Choices B, C, and D are incorrect because while a history of hypertension or use of antihypertensive medications may influence treatment decisions, they are not the key contraindication specifically related to sildenafil use.

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