Nursing Elites

1. A 9-year-old girl has a diffuse collection of symptoms that are indicative of deficits in endocrine and autonomic nervous system control. She also suffers from persistent fluid and electrolyte imbalances. On which aspect of the nervous system listed below would her health care providers focus their diagnostic efforts?

• A. The thalamus
• B. The pituitary
• C. The hypothalamus
• D. The midbrain

Correct answer: C

Rationale: The correct answer is C: The hypothalamus. The hypothalamus plays a central role in regulating endocrine and autonomic functions, including fluid and electrolyte balance. In this case, the girl's symptoms of deficits in endocrine and autonomic nervous system control, along with fluid and electrolyte imbalances, point towards dysfunction in the hypothalamus. Choices A, B, and D are incorrect because the thalamus is mainly involved in sensory relay, the pituitary gland regulates various hormones but is controlled by the hypothalamus, and the midbrain is responsible for motor control and arousal, not endocrine or autonomic functions.

2. Which of the following women is at highest risk for the development of endometrial cancer?

• A. A 50-year-old postmenopausal woman with a history of high-risk human papillomavirus
• B. A 45-year-old woman who is obese and has a menstrual pattern consisting of periods of amenorrhea and infrequent periods
• C. A 40-year-old woman who is overweight and has hypertension
• D. A 55-year-old woman who smokes

Correct answer: B

Rationale: The correct answer is a 45-year-old woman who is obese and has a menstrual pattern consisting of periods of amenorrhea and infrequent periods. Obesity and prolonged exposure to estrogen unopposed by progesterone due to infrequent ovulation are significant risk factors for endometrial cancer. Choices A, C, and D do not directly correlate with the increased risk of endometrial cancer. Postmenopausal status alone (Choice A), overweight with hypertension (Choice C), and smoking (Choice D) are not the primary risk factors for endometrial cancer.

3. What is a common trigger for acute bronchospasm in asthma?

• A. Infection
• B. Allergic reaction
• C. Excessive exercise
• D. High altitude

Correct answer: B

Rationale: An allergic reaction is a common trigger for acute bronchospasm in asthma patients. When individuals with asthma come in contact with allergens like pollen, dust mites, or pet dander, it can lead to an allergic reaction that triggers bronchospasm. Infections, excessive exercise, and high altitudes can exacerbate asthma symptoms, but they are not the most common trigger for acute bronchospasm in asthma patients.

4. A patient is starting on atorvastatin (Lipitor) for hyperlipidemia. What critical instruction should the nurse provide?

• A. Take the medication at night to reduce the risk of muscle pain and other side effects.
• B. Avoid consuming grapefruit juice while taking this medication.
• C. Take the medication in the morning with breakfast to improve absorption.
• D. Take the medication with a high-fat meal to increase its effectiveness.

Correct answer: A

Rationale: The correct answer is to take the medication at night to reduce the risk of muscle pain and other side effects. Atorvastatin, like other statins, is more effective when taken in the evening as the body produces more cholesterol at night. Taking it with a high-fat meal (choice D) is not recommended as it may reduce the drug's absorption. Grapefruit juice (choice B) should be avoided with atorvastatin as it can increase the risk of side effects. Taking the medication in the morning with breakfast (choice C) is not as effective as taking it at night.

5. A 45-year-old diabetic male is experiencing erectile dysfunction. If his erectile dysfunction is caused by the nervous system, then the nurse can educate the client that the venous blood supply to the penis is controlled by:

• A. Sympathetic nerves.
• B. Parasympathetic nerves.
• C. Somatic nerves.
• D. Spinal reflexes.

Correct answer: B

Rationale: Erectile function is primarily controlled by the parasympathetic nervous system, which facilitates the dilation of blood vessels in the penis. The parasympathetic nerves are responsible for vasodilation in the penis, allowing blood to enter and creating an erection. Sympathetic nerves, on the other hand, are responsible for ejaculation by causing contraction of the muscles around the vas deferens. Somatic nerves are involved in sensation and movement, not specifically in controlling blood supply to the penis. Spinal reflexes can play a role in the erectile process, but they are not directly responsible for controlling the venous blood supply.

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