Nursing Elites

1. Which of the following nonpharmacologic treatments is most likely to be a useful and appropriate supplement to pharmacologic analgesia at this point?

• A. Cognitive-behavioral therapy
• B. Cold and heat application
• C. Therapeutic ultrasound
• D. Biofeedback

Correct answer: B

Rationale: The correct answer is B: Cold and heat application. Cold and heat application are commonly used nonpharmacologic methods for managing pain and can complement pharmacologic treatments. Cold packs can help reduce inflammation and numb localized areas, while heat application can increase blood flow and relax muscles. Cognitive-behavioral therapy (A) focuses on changing negative thought patterns and behaviors to manage pain but may not directly supplement pharmacologic analgesia. Therapeutic ultrasound (C) uses sound waves to generate heat within body tissues, which can be therapeutic, but it may not be as directly complementary to pharmacologic analgesia as cold and heat application. Biofeedback (D) involves using electronic devices to help individuals control physiological processes, but its direct role as a supplement to pharmacologic analgesia may be less pronounced compared to cold and heat application.

2. Which of the following is a characteristic of disseminated intravascular coagulation (DIC)?

• A. Simultaneous stroke and heart attack
• B. Simultaneous clotting and bleeding
• C. Simultaneous clotting and insulin release
• D. Simultaneous bleeding and vomiting

Correct answer: B

Rationale: Disseminated intravascular coagulation (DIC) is characterized by simultaneous clotting and bleeding throughout the body. This imbalance in the body's clotting system leads to the formation of blood clots in small blood vessels, which can consume clotting factors and platelets, ultimately leading to excessive bleeding. Choices A, C, and D are incorrect because they do not describe the characteristic feature of DIC, which involves both clotting and bleeding.

3. A patient is starting on oral contraceptives. What should the nurse emphasize about the importance of taking the medication at the same time each day?

• A. Taking the medication at the same time each day helps maintain stable hormone levels and ensures effectiveness.
• B. Taking the medication at the same time each day reduces the risk of breakthrough bleeding.
• C. Taking the medication at the same time each day ensures consistent absorption and effectiveness.
• D. Taking the medication at the same time each day is important, but missing a dose occasionally is not a concern.

Correct answer: A

Rationale: The correct answer is A. Taking oral contraceptives at the same time each day helps maintain stable hormone levels and ensures their effectiveness in preventing pregnancy. Choice B is incorrect because the primary emphasis of consistent timing is on hormone levels and effectiveness, not on reducing breakthrough bleeding. Choice C is incorrect because while consistent absorption is a factor, the main focus is on maintaining stable hormone levels. Choice D is incorrect as missing doses can significantly impact contraceptive efficacy.

4. What long-term risks should the nurse discuss with a patient starting on hormone replacement therapy (HRT)?

• A. HRT is associated with increased risks of cardiovascular events and breast cancer, so these risks should be discussed with the patient.
• B. HRT can improve mood and energy levels, but it also increases the risk of osteoporosis.
• C. HRT can increase the risk of venous thromboembolism, so patients should undergo regular screening.
• D. HRT decreases the risk of fractures, but it also increases the risk of developing diabetes.

Correct answer: A

Rationale: The correct answer is A. When starting on hormone replacement therapy (HRT), the nurse should discuss the increased risks of cardiovascular events and breast cancer with the patient. These risks are important to consider to make an informed decision. Choice B is incorrect as HRT does not increase the risk of osteoporosis; in fact, it may help prevent it. Choice C is incorrect as while HRT can increase the risk of venous thromboembolism, regular screening is not the primary focus for discussion. Choice D is incorrect as HRT does not decrease the risk of fractures and is not primarily associated with an increased risk of developing diabetes.

5. After a 27-year-old woman with epilepsy had a generalized seizure, she feels tired and falls asleep. This is:

• A. an ominous sign.
• B. normal and termed the postictal period.
• C. a reflection of an underlying brain tumor.
• D. only worrisome if there are focal neurologic deficits after.

Correct answer: B

Rationale: The correct answer is B: normal and termed the postictal period. The postictal period is a common phase following a seizure where the individual may experience fatigue, confusion, or sleepiness. It is a normal part of the seizure event and does not necessarily indicate a serious issue. Choice A is incorrect because feeling tired and falling asleep after a seizure is not an ominous sign but rather a typical postictal symptom. Choice C is incorrect as there is no indication in the scenario provided that links the symptoms to an underlying brain tumor. Choice D is incorrect because the absence of focal neurologic deficits does not make the postictal period worrisome.

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