Nursing Elites

1. A male patient is receiving androgen therapy for hypogonadism. What laboratory tests should the nurse monitor during this therapy?

• A. Liver function tests
• B. Kidney function tests
• C. Prostate-specific antigen (PSA)
• D. Complete blood count (CBC)

Correct answer: A

Rationale: During androgen therapy for hypogonadism, it is important to monitor liver function tests. Androgens can affect the liver, potentially leading to liver dysfunction. Monitoring liver function tests helps in early detection of any liver abnormalities. Kidney function tests (Choice B) are not typically affected by androgen therapy. Prostate-specific antigen (PSA) levels (Choice C) may be monitored for conditions like prostate cancer, but it is not directly related to androgen therapy for hypogonadism. A complete blood count (CBC) (Choice D) may not show specific changes related to androgen therapy for hypogonadism.

2. A client with Guillain-Barré syndrome is experiencing ascending paralysis. Which of the following interventions should the nurse prioritize?

• A. Monitor for signs of respiratory distress.
• B. Prepare the client for plasmapheresis.
• C. Administer analgesics for pain management.
• D. Initiate passive range-of-motion exercises.

Correct answer: A

Rationale: The correct answer is A: Monitor for signs of respiratory distress. In Guillain-Barré syndrome, ascending paralysis can lead to respiratory muscle involvement, putting the client at risk for respiratory distress and failure. Prioritizing respiratory monitoring is crucial to ensure timely intervention if respiratory compromise occurs. Plasmapheresis (Choice B) may be indicated in some cases to remove harmful antibodies, but the priority in this situation is respiratory support. Administering analgesics (Choice C) for pain management and initiating passive range-of-motion exercises (Choice D) are important aspects of care but are not the priority when the client's respiratory status is at risk.

3. What is the common denominator of all forms of heart failure?

• A. Pulmonary edema
• B. Jugular venous distention
• C. Peripheral edema
• D. Reduced cardiac output

Correct answer: D

Rationale: The correct answer is D: Reduced cardiac output. All forms of heart failure share the common denominator of reduced cardiac output, which leads to inadequate tissue perfusion. Pulmonary edema (choice A) is a consequence of heart failure but not the common denominator. Jugular venous distention (choice B) and peripheral edema (choice C) are signs of heart failure but do not represent the common denominator shared by all forms.

4. A 65-year-old man is admitted to the intensive care unit from the operating room after a triple coronary artery bypass graft. He is intubated and on a ventilator. Lactic acid levels were normal postoperatively, but now they are rising. The increased level could be an indication of:

• A. excessive sedation
• B. bowel ischemia
• C. excessive volume infusion in the operating room
• D. mild hypothermia postoperatively

Correct answer: B

Rationale: In this scenario, the rising lactic acid levels in a 65-year-old man after a coronary artery bypass graft could indicate bowel ischemia. Bowel ischemia can lead to anaerobic metabolism, causing an increase in lactic acid levels. Excessive sedation may cause respiratory depression but would not directly lead to rising lactic acid levels. Excessive volume infusion in the operating room might cause fluid overload but would not typically result in rising lactic acid levels. Mild hypothermia postoperatively could lead to shivering and increased oxygen consumption, but it is less likely to be the primary cause of rising lactic acid levels in this context.

5. What is a characteristic of coronary artery disease (CAD)?

• A. The build-up of infectious by-products in the lymph nodes
• B. Insufficient delivery of oxygenated blood to the myocardium
• C. Insufficient delivery of carbon dioxide to the lungs
• D. The build-up of bile in the stomach and gallbladder

Correct answer: B

Rationale: The correct characteristic of coronary artery disease (CAD) is the insufficient delivery of oxygenated blood to the myocardium. CAD is a condition where the coronary arteries become narrowed or blocked, leading to reduced blood flow to the heart muscle. This lack of oxygenated blood can result in chest pain, known as angina, and if a coronary artery becomes completely blocked, it can cause a heart attack. Choices A, C, and D are incorrect. Choice A refers to an issue related to the lymphatic system, choice C is about gas exchange in the lungs, and choice D describes a problem with bile accumulation in the digestive system, none of which are characteristics of CAD.

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