Nursing Elites

1. A 25-year-old just had a colonoscopy and was diagnosed with Crohn disease. Which of the following symptoms is consistent with this diagnosis?

• A. Right lower quadrant cramping
• B. Severe bloody diarrhea
• C. Nausea and vomiting
• D. Mostly affects the rectum

Correct answer: A

Rationale: The correct answer is A: Right lower quadrant cramping. Crohn's disease commonly presents with abdominal pain, particularly in the right lower quadrant. Choice B, severe bloody diarrhea, is more characteristic of ulcerative colitis, another type of inflammatory bowel disease. Choice C, nausea and vomiting, are not typical symptoms of Crohn's disease. Choice D is incorrect as Crohn's disease can affect any part of the gastrointestinal tract, not just the rectum.

2. Which ability should Nurse Rebecca expect from a client in the mild stage of dementia of the Alzheimer’s type?

• A. Remembering the daily schedule
• B. Recalling past events
• C. Coping with anxiety
• D. Solving problems of daily living

Correct answer: B

Rationale: In the mild stage of dementia of the Alzheimer’s type, clients can often recall past events but may have difficulty with new information. Therefore, Nurse Rebecca should expect the client to have the ability to recall past events. Choice A is incorrect because remembering the daily schedule may become challenging as the disease progresses. Choice C is incorrect as clients in the mild stage may experience anxiety, but coping with anxiety is not a specific ability associated with this stage of dementia. Choice D is incorrect as solving problems of daily living becomes more challenging as the disease advances, not in the mild stage.

3. A patient is taking alendronate (Fosamax) for the treatment of osteoporosis. What instructions should the nurse provide to ensure the effectiveness of the medication?

• A. Take the medication with food to avoid gastrointestinal upset.
• B. Take the medication in the morning with a full glass of water and remain upright for at least 30 minutes.
• C. Take the medication before bed to ensure absorption during sleep.
• D. Take the medication with milk to enhance calcium absorption.

Correct answer: B

Rationale: The correct answer is B. Alendronate should be taken in the morning with a full glass of water and the patient should remain upright for at least 30 minutes. This is important to prevent esophageal irritation and ensure proper absorption of the medication. Choice A is incorrect because alendronate should not be taken with food as it can decrease its absorption. Choice C is incorrect as taking the medication before bed increases the risk of esophageal irritation and reduces absorption due to lying down. Choice D is also incorrect because taking alendronate with milk or other calcium-rich foods can decrease its absorption.

4. A male patient receiving androgen therapy is concerned about the risk of prostate cancer. What should the nurse explain regarding this risk?

• A. Finasteride has been shown to lower the risk of developing prostate cancer.
• B. Finasteride does not affect the risk of prostate cancer.
• C. Finasteride may increase the risk of developing prostate cancer, so regular screenings are recommended.
• D. Finasteride has no effect on the risk of prostate cancer, so regular screenings are unnecessary.

Correct answer: A

Rationale: The correct answer is A. Finasteride has been shown to lower the risk of developing prostate cancer. However, regular screenings are still recommended to monitor for any potential issues. Choice B is incorrect because finasteride has been associated with a reduced risk of developing prostate cancer. Choice C is incorrect as finasteride is not known to increase the risk of prostate cancer; in fact, it has shown a protective effect. Choice D is incorrect because while finasteride may lower the risk of prostate cancer, regular screenings are still necessary to ensure early detection and treatment if needed.

5. Mrs. Mendoza is a 75-year-old client who has dementia of the Alzheimer’s type and confabulates. The nurse understands that this client:

• A. Denies confusion by being jovial.
• B. Pretends to be someone else.
• C. Rationalizes various behaviors.
• D. Fills in memory gaps with fantasy.

Correct answer: D

Rationale: Confabulation, a common symptom in dementia, involves filling in memory gaps with fabricated stories rather than intentionally pretending to be someone else (Choice B), denying confusion by being jovial (Choice A), or rationalizing various behaviors (Choice C). Confabulation is not a deliberate act but a memory error that results in the creation of false memories.

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