Nursing Elites

1. In menopausal women, what is the primary goal of estrogen therapy?

• A. To relieve menopausal symptoms
• B. To prevent osteoporosis
• C. To increase calcium absorption
• D. To maintain bone strength

Correct answer: B

Rationale: The primary goal of estrogen therapy in menopausal women is to prevent osteoporosis by maintaining bone density. Estrogen helps in preserving bone mass and reducing the risk of fractures. While estrogen therapy may alleviate some menopausal symptoms, such as hot flashes, its primary focus is on bone health rather than symptom management. Increasing calcium absorption and maintaining bone strength are outcomes of preventing osteoporosis rather than the primary goal of estrogen therapy.

2. The early stages of atheroma development are characterized by:

• A. macrophages full of oxidized low-density lipoprotein (LDL; i.e., foam cells) in the intima
• B. accumulation of lipids in the intima (i.e., fatty streak)
• C. accumulation of proteins such as collagen and elastin (i.e., fibrous cap)
• D. development of calcium and a necrotic lipid core

Correct answer: A

Rationale: The correct answer is A. In the early stages of atheroma development, macrophages accumulate oxidized low-density lipoprotein (LDL) and transform into foam cells, leading to the formation of fatty streaks in the intima of blood vessels. This process is a hallmark of the initial stages of atherosclerosis. Choice B is incorrect as it describes the accumulation of lipids in the intima, which is a later event following foam cell formation. Choice C is also incorrect as it refers to the accumulation of proteins forming the fibrous cap, which occurs at a later stage to stabilize the atheroma. Choice D is incorrect as it describes the development of calcium and a necrotic lipid core, typically seen in advanced atherosclerosis rather than the early stages.

3. A patient is receiving oral nystatin suspension for a fungal infection of the mouth. Which of the following adverse effects is most likely to be experienced with this form of nystatin?

• A. Local irritation
• B. Burning
• C. Nausea
• D. Urinary urgency

Correct answer: A

Rationale: The correct answer is A: Local irritation. When using oral nystatin suspension for a fungal infection of the mouth, local irritation is the most likely adverse effect that a patient may experience. Nystatin is generally well-tolerated, but some patients may develop local irritation, such as mouth or throat irritation. Choices B, C, and D are less likely adverse effects of oral nystatin suspension. Burning, nausea, and urinary urgency are not commonly associated with nystatin use for a fungal infection of the mouth.

4. 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.

5. A child is experiencing difficulty with chewing and swallowing. The nurse knows that which cells may be innervating specialized gut-related receptors that provide taste and smell?

• A. Special somatic afferent fibers
• B. General somatic afferents
• C. Special visceral afferent cells
• D. General visceral afferent neurons

Correct answer: C

Rationale: The correct answer is C: Special visceral afferent cells. These cells are responsible for innervating taste and smell receptors related to the gut. Special somatic afferent fibers (choice A) are involved in sensations like touch and proprioception, not taste and smell. General somatic afferents (choice B) carry sensory information from the skin and musculoskeletal system, not taste and smell. General visceral afferent neurons (choice D) transmit sensory information from internal organs, but not specifically related to taste and smell sensations.

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