Nursing Elites

1. A 67-year-old man is receiving androgen therapy for osteoporosis. What laboratory test should the nurse monitor during this therapy?

• A. Liver function tests
• B. Blood glucose levels
• C. Prostate-specific antigen (PSA)
• D. Cholesterol levels

Correct answer: A

Rationale: During androgen therapy, monitoring liver function tests is crucial to detect any signs of liver dysfunction. Androgens can potentially impact liver function, making it essential to monitor enzymes such as ALT and AST. While blood glucose levels and cholesterol levels are important parameters to monitor in certain situations, they are not the primary focus during androgen therapy for osteoporosis. Prostate-specific antigen (PSA) monitoring is more relevant in the context of prostate health and cancer screening, not specifically during androgen therapy for osteoporosis.

2. An MRI scan of a 33-year-old female client with new-onset seizures has revealed a lesion on her frontal lobe. Which of the following signs and symptoms would most likely be a direct result of this lesion?

• A. Changes in sensation or movement in the client's limbs
• B. Fluctuations in blood pressure
• C. Changes in speech and reasoning
• D. Increased intracranial pressure

Correct answer: C

Rationale: The correct answer is C: Changes in speech and reasoning. The frontal lobe is responsible for higher cognitive functions, including speech and reasoning. A lesion in this area can lead to difficulties in speech production, language comprehension, and reasoning abilities. Choices A, B, and D are incorrect. Changes in sensation or movement in the client's limbs are more associated with lesions in the motor or sensory cortices of the brain, not the frontal lobe. Fluctuations in blood pressure are often related to autonomic nervous system dysfunction, which is controlled by other brain regions. Increased intracranial pressure is typically seen in conditions like brain tumors or head trauma, not directly related to a frontal lobe lesion.

3. A client with a history of rheumatic fever presents with signs of heart failure. What is the likely underlying cause?

• A. Infective endocarditis
• B. Coronary artery disease
• C. Mitral valve stenosis
• D. Aortic regurgitation

Correct answer: C

Rationale: The correct answer is C: Mitral valve stenosis. Rheumatic fever can lead to scarring and thickening of the heart valves, often affecting the mitral valve. This stenosis can impede blood flow from the left atrium to the left ventricle, eventually causing heart failure. Choice A, infective endocarditis, is an infection of the endocardium, the inner lining of the heart chambers and valves, and is not directly related to rheumatic fever. Choice B, coronary artery disease, involves the obstruction of coronary arteries supplying the heart muscle with blood, leading to ischemia and not typically associated with rheumatic fever. Choice D, aortic regurgitation, is the backflow of blood from the aorta to the left ventricle and is not a common consequence of rheumatic fever.

4. A patient with breast cancer is prescribed tamoxifen (Nolvadex). What important information should the nurse provide during patient education?

• A. Tamoxifen may increase the risk of venous thromboembolism, so patients should be educated about the signs and symptoms of blood clots.
• B. Tamoxifen may cause weight gain, so patients should monitor their diet.
• C. Tamoxifen may decrease the risk of osteoporosis, so patients should ensure adequate calcium intake.
• D. Tamoxifen may increase the risk of breast cancer, so regular mammograms are essential.

Correct answer: A

Rationale: The correct answer is A. Tamoxifen increases the risk of venous thromboembolism, a serious side effect, so patients should be educated about the signs and symptoms of blood clots. This information is crucial as early recognition and prompt treatment of blood clots can prevent complications. Choices B, C, and D are incorrect because tamoxifen is not associated with causing weight gain, decreasing the risk of osteoporosis, or increasing the risk of breast cancer. Providing accurate information is essential for patient safety and understanding.

5. A 35-year-old male has enlarged lymph nodes in the neck and a mediastinal mass. He was diagnosed with Hodgkin lymphoma. Which of the following abnormal cells would the nurse expect to find with this disease?

• A. Merkel cell
• B. Schwann cell
• C. Reed-Sternberg cell
• D. Kupffer cell

Correct answer: C

Rationale: Reed-Sternberg cells are characteristic of Hodgkin lymphoma. These large abnormal cells have a bi-lobed or multi-lobed nucleus and are essential for diagnosing Hodgkin lymphoma through histological examination. Merkel cells are associated with Merkel cell carcinoma, Schwann cells are related to nerve sheaths, and Kupffer cells are liver macrophages. Therefore, choices A, B, and D are incorrect for Hodgkin lymphoma.

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