Nursing Elites

1. A man with gout has developed large, hard nodules around his toes and elbows. The phase of gout he is in is:

• A. asymptomatic
• B. acute flare
• C. the intercritical period
• D. chronic gout

Correct answer: D

Rationale: The correct answer is 'chronic gout.' Chronic gout is characterized by the presence of tophi, which are large, hard nodules that can develop around joints like toes and elbows. These tophi are a sign of longstanding, untreated gout. Choice A, 'asymptomatic,' is incorrect as the presence of tophi indicates a symptomatic phase. Choice B, 'acute flare,' is incorrect as acute flares are characterized by sudden and severe pain, inflammation, and redness in the joints, not the development of tophi. Choice C, 'the intercritical period,' is also incorrect as this phase occurs between acute attacks and is typically asymptomatic, without the presence of tophi.

2. A 45-year-old client is admitted with new-onset status epilepticus. What is the priority nursing intervention?

• A. Administer IV fluids and monitor electrolytes.
• B. Administer antiepileptic medications as prescribed.
• C. Ensure a patent airway and prepare for possible intubation.
• D. Monitor the client for signs of hypotension.

Correct answer: C

Rationale: The correct answer is C. In a client with new-onset status epilepticus, the priority nursing intervention is to ensure a patent airway and prepare for possible intubation. This is crucial to prevent hypoxia and further complications. Administering IV fluids and monitoring electrolytes (choice A) can be important but ensuring airway patency takes precedence. Administering antiepileptic medications (choice B) is essential but only after securing the airway. Monitoring for hypotension (choice D) is also important but not the priority when managing status epilepticus.

3. A male patient with hypogonadism is receiving testosterone therapy. What is the most serious adverse effect the nurse should monitor for?

• A. Increased risk of breast cancer
• B. Increased risk of cardiovascular events
• C. Increased risk of liver dysfunction
• D. Increased risk of prostate cancer

Correct answer: B

Rationale: The correct answer is B: Increased risk of cardiovascular events. Testosterone therapy can lead to an increased risk of cardiovascular events such as heart attacks and strokes, especially in older patients. Monitoring for signs and symptoms of cardiovascular issues is crucial when administering testosterone therapy. Choices A, C, and D are incorrect because testosterone therapy does not typically lead to an increased risk of breast cancer, liver dysfunction, or prostate cancer.

4. A patient with a history of hypertension presents with a severe headache, confusion, and visual disturbances. His blood pressure is 220/120 mm Hg. Which of the following is the most likely diagnosis?

• A. Migraine
• B. Cluster headache
• C. Hypertensive emergency
• D. Tension headache

Correct answer: C

Rationale: A patient with a history of hypertension presenting with a severe headache, confusion, and visual disturbances, along with a blood pressure of 220/120 mm Hg, likely has a hypertensive emergency. In this situation, the severely elevated blood pressure can lead to end-organ damage, causing symptoms such as headache and confusion. Migraine and tension headaches are not associated with such high blood pressure levels. Cluster headaches typically do not present with visual disturbances and confusion in the setting of severe hypertension.

5. The nurse knows which phenomenon listed below is an accurate statement about axonal transport?

• A. Anterograde and retrograde axonal transport allow for the communication of nerve impulses between a neuron and the central nervous system (CNS).
• B. Materials can be transported to the nerve terminal by either fast or slow components.
• C. The unidirectional nature of the axonal transport system protects the CNS against potential pathogens.
• D. Axonal transport facilitates the movement of electrical impulses but precludes the transport of molecular materials.

Correct answer: B

Rationale: The correct answer is B. Axonal transport involves the movement of materials to the nerve terminal by either fast or slow components, which is essential for cell survival. Choice A is incorrect because while anterograde and retrograde axonal transport are involved in the movement of materials, they do not specifically relate to the communication of nerve impulses between a neuron and the CNS. Choice C is incorrect because the unidirectional nature of axonal transport does not primarily function to protect the CNS against pathogens. Choice D is incorrect as axonal transport is responsible for the movement of various materials, not just electrical impulses.

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