Nursing Elites

1. Which of the following clinical findings in a 51-year-old woman is consistent with Graves disease?

• A. Thin hair, exophthalmos, hyperreflexia, and pretibial edema.
• B. Thin hair, exophthalmos, weight gain, and constipation.
• C. Thick hair, bradycardia, weight loss, and dry skin.
• D. Thick hair, bradycardia, weight gain, and constipation.

Correct answer: A

Rationale: The clinical findings of thin hair, exophthalmos (bulging eyes), hyperreflexia, and pretibial edema are classic manifestations of Graves disease, an autoimmune condition that results in hyperthyroidism. Choice B is incorrect because weight gain and constipation are more indicative of hypothyroidism, not hyperthyroidism seen in Graves disease. Choice C is incorrect as the symptoms described are more characteristic of hypothyroidism, not hyperthyroidism. Choice D is also incorrect as the symptoms listed are not consistent with Graves disease but rather suggest hypothyroidism.

2. During childhood, the thymus decreases in size, and this is referred to as ______ atrophy.

• A. Physiologic
• B. Pathologic
• C. Disuse
• D. Neurogenic

Correct answer: A

Rationale: The correct answer is A, 'Physiologic.' Physiologic atrophy is a normal part of development, like the reduction in thymus size during childhood. Pathologic atrophy (choice B) refers to tissue wasting due to disease, not a normal process like the reduction in thymus size. Disuse atrophy (choice C) results from a lack of physical activity or stimulation, which is not the case with thymus size reduction. Neurogenic atrophy (choice D) is caused by damage to or diseases of the nerves supplying the muscles, not related to the thymus size reduction seen in childhood.

3. Which condition is characterized by a lack of antidiuretic hormone (ADH)?

• A. Diabetes mellitus
• B. Diabetes insipidus
• C. Cushing's disease
• D. Hyperthyroidism

Correct answer: B

Rationale: The correct answer is B, Diabetes insipidus. Diabetes insipidus is characterized by a lack of antidiuretic hormone (ADH), leading to excessive urination and thirst. Choice A, Diabetes mellitus, is a different condition characterized by high blood sugar levels. Choice C, Cushing's disease, is caused by prolonged exposure to high levels of cortisol. Choice D, Hyperthyroidism, involves an overactive thyroid gland producing excess thyroid hormones.

4. A client presents to the emergency department with lower right quadrant abdominal pain, fever, nausea, and occasional diarrhea. After palpating the abdomen, the client displays tenderness. What would the nurse anticipate the client to be experiencing?

• A. Pseudomembranous colitis
• B. Peptic ulcer disease
• C. Appendicitis
• D. Esophageal cancer

Correct answer: C

Rationale: The correct answer is C: Appendicitis. The symptoms described - lower right quadrant abdominal pain, fever, nausea, diarrhea, and tenderness upon palpation - are classic signs of appendicitis. Appendicitis is an inflammatory condition of the appendix that often presents with these symptoms and requires immediate medical attention. Choice A, Pseudomembranous colitis, typically presents with watery diarrhea and is associated with antibiotic use. Choice B, Peptic ulcer disease, commonly presents with epigastric pain related to meals and can be accompanied by nausea or vomiting, but it does not typically cause right lower quadrant pain. Choice D, Esophageal cancer, usually presents with symptoms related to swallowing difficulties, weight loss, and sometimes chest pain, but it is not associated with the symptoms described in the scenario.

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

• A. Take the medication at the same time each day to maintain consistent hormone levels.
• B. Medroxyprogesterone should be taken with food to reduce gastrointestinal upset.
• C. Medroxyprogesterone should be discontinued if side effects occur.
• D. Medroxyprogesterone should be taken once a week to maintain effectiveness.

Correct answer: A

Rationale: The correct instruction the nurse should provide regarding the use of medroxyprogesterone acetate (Provera) for endometriosis is to take the medication at the same time each day. This helps to maintain consistent hormone levels and ensures the effectiveness of the treatment. Choice B is incorrect because medroxyprogesterone should be taken without regard to meals. Choice C is incorrect because side effects should be reported to the healthcare provider for evaluation rather than discontinuing the medication without medical advice. Choice D is incorrect as medroxyprogesterone is usually taken daily, not weekly, for the treatment of endometriosis.

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