Nursing Elites

1. A 57-year-old male presents to his primary care provider with a red face, hands, feet, ears, headache, and drowsiness. A blood smear reveals an increased number of erythrocytes, indicating:

• A. Leukemia
• B. Sideroblastic anemia
• C. Hemosiderosis
• D. Polycythemia vera

Correct answer: D

Rationale: In this case, the symptoms of a red face, hands, feet, ears, headache, and drowsiness along with an increased number of erythrocytes in the blood smear are indicative of polycythemia vera. This condition is characterized by the overproduction of red blood cells, leading to symptoms related to increased blood volume and viscosity. Leukemia (Choice A) is a cancer of the blood and bone marrow, but the presentation described here is more suggestive of polycythemia vera. Sideroblastic anemia (Choice B) is characterized by abnormal iron deposits in erythroblasts, not an increased number of erythrocytes. Hemosiderosis (Choice C) refers to abnormal accumulation of iron in the body, not an increase in red blood cells as seen in polycythemia vera.

2. A male patient with benign prostatic hyperplasia (BPH) is prescribed finasteride (Proscar). What therapeutic effect is expected from this medication?

• A. Reduction in prostate size and improvement in urinary symptoms
• B. Increase in urine flow and relief of urinary obstruction
• C. Improvement in erectile function
• D. Relief of pain associated with BPH

Correct answer: A

Rationale: The correct answer is A: Reduction in prostate size and improvement in urinary symptoms. Finasteride works by reducing the size of the prostate gland, which in turn helps alleviate urinary symptoms such as frequency, urgency, weak stream, and incomplete emptying of the bladder. Choice B is incorrect as while finasteride can improve urine flow indirectly by reducing prostate size, it does not directly increase urine flow. Choice C is incorrect because finasteride is not intended to improve erectile function. Choice D is incorrect as finasteride does not primarily provide relief from pain associated with BPH.

3. In a postmenopausal woman, what condition can be prevented by administering estradiol (Estraderm)?

• A. Endometriosis
• B. Amenorrhea
• C. Osteoporosis
• D. Uterine cancer

Correct answer: C

Rationale: The correct answer is C: Osteoporosis. Estradiol, a form of estrogen, is used to prevent osteoporosis in postmenopausal women by maintaining bone density. Choice A, Endometriosis, is incorrect as estradiol is not used to prevent or treat this condition. Choice B, Amenorrhea, is not prevented by estradiol but rather may result from hormonal changes. Choice D, Uterine cancer, is not directly prevented by estradiol; in fact, long-term unopposed estrogen use can increase the risk of uterine cancer.

4. An older adult patient comes to the clinic complaining of not being able to do what he used to be able to. You know that normal changes associated with aging include:

• A. Improved blood flow
• B. Slowed metabolic rate
• C. Increased brain weight
• D. Improved nerve fiber conduction

Correct answer: B

Rationale: Normal changes associated with aging include a slowed metabolic rate and decreased brain weight. Option A, 'Improved blood flow,' is incorrect as aging is generally associated with reduced vascular health rather than improved blood flow. Option D, 'Improved nerve fiber conduction,' is incorrect as aging typically leads to a decline in nerve function rather than improvement.

5. A nurse is teaching a class about immune deficiencies, and a person from the audience asks which cells are affected by severe combined immune deficiency (SCID) syndrome, and the nurse answers:

• A. B cell deficits
• B. T cell deficits
• C. Complement deficits
• D. B and T cell deficits

Correct answer: D

Rationale: The correct answer is D: B and T cell deficits. Severe combined immune deficiency (SCID) syndrome affects both B and T cells, leading to a severe impairment in the immune system's ability to fight infections. Choice A (B cell deficits) is incorrect because SCID affects not only B cells but also T cells. Choice B (T cell deficits) is incorrect as SCID is characterized by deficits in both B and T cells. Choice C (Complement deficits) is incorrect as SCID primarily involves B and T cell deficiencies rather than complement deficiencies.

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