Nursing Elites

1. In emphysema, what features result in impaired oxygenation?

• A. The bronchioles are inflamed and filled with mucus
• B. The alveoli have lost surfactant and collapse
• C. Enlarged, permanently inflated alveoli
• D. The accumulation of purulent fluid in the bronchioles

Correct answer: C

Rationale: The correct answer is C. In emphysema, impaired oxygenation results from enlarged and permanently inflated alveoli, leading to reduced surface area for gas exchange. Choices A, B, and D are incorrect. In emphysema, bronchioles are not typically filled with mucus, alveoli losing surfactant and collapsing is more characteristic of conditions like atelectasis, and purulent fluid accumulation in the bronchioles is commonly seen in conditions like pneumonia, not emphysema.

2. What condition is a result of Polycythemia Vera, which involves excess red blood cells?

• A. Tissue ischemia & necrosis
• B. Chronic pancreatitis
• C. Low blood pressure & heart rate
• D. Increased numbers of infections

Correct answer: A

Rationale: Polycythemia Vera, characterized by excess red blood cells, can cause tissue ischemia and necrosis due to the increased blood viscosity. This condition restricts blood flow, leading to inadequate oxygen delivery to tissues and subsequent tissue damage. Choices B, C, and D are incorrect because they are not directly associated with the pathophysiology of Polycythemia Vera.

3. A patient with a history of osteoporosis is prescribed alendronate (Fosamax). What instructions should the nurse provide to ensure the effectiveness of the medication?

• A. Take the medication with a full glass of water and remain upright for at least 30 minutes to prevent esophageal irritation and ensure proper absorption.
• B. Take the medication with milk to enhance calcium absorption.
• C. Take the medication at bedtime to ensure absorption during sleep.
• D. Take the medication with food to prevent nausea.

Correct answer: A

Rationale: The correct answer is A. Alendronate should be taken with a full glass of water and patients should remain upright for at least 30 minutes to prevent esophageal irritation and ensure proper absorption. Taking the medication with milk (choice B) is not recommended as it may interfere with the absorption of alendronate. Taking the medication at bedtime (choice C) is not necessary for optimal absorption. Taking the medication with food (choice D) is also not recommended as food can reduce the absorption of alendronate.

4. A patient is starting on a statin medication for hyperlipidemia. What critical instruction should the nurse provide?

• A. Take the medication at night to reduce the risk of muscle pain and other side effects.
• B. Take the medication in the morning with breakfast to improve absorption.
• C. Avoid alcohol consumption while taking this medication to reduce the risk of liver damage.
• D. Take the medication with a high-fat meal to increase its effectiveness.

Correct answer: A

Rationale: The correct answer is A. Statins like atorvastatin should be taken at night to reduce the risk of muscle pain and other side effects. Taking the medication with a high-fat meal (choice D) is not recommended as it can decrease the effectiveness of the medication. Alcohol consumption (choice C) should be moderated but does not need to be completely avoided unless contraindicated. Taking the medication with breakfast (choice B) may not be as effective as taking it at night due to the circadian rhythm of cholesterol synthesis.

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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