Nursing Elites

1. A male patient is receiving testosterone therapy for hypogonadism. What adverse effect should the nurse monitor for during this therapy?

• A. Increased risk of cardiovascular events
• B. Increased risk of liver dysfunction
• C. Increased risk of prostate cancer
• D. Increased risk of bone fractures

Correct answer: A

Rationale: The correct answer is A: Increased risk of cardiovascular events. Testosterone therapy for hypogonadism is associated with an increased risk of cardiovascular events, such as myocardial infarction and stroke. Monitoring for signs and symptoms of cardiovascular issues is crucial during testosterone therapy. Choices B, C, and D are incorrect because testosterone therapy is not typically associated with an increased risk of liver dysfunction, prostate cancer, or bone fractures.

2. Right-sided heart failure is characterized by:

• A. Immunosuppression
• B. Pulmonary edema
• C. Peripheral edema
• D. Coughing

Correct answer: C

Rationale: Right-sided heart failure is characterized by peripheral edema, which results from the buildup of fluid in the body. This fluid accumulates in the extremities due to the heart's inability to effectively pump blood forward. Choices A, B, and D are incorrect. Immunosuppression is not a typical feature of right-sided heart failure. Pulmonary edema is more commonly associated with left-sided heart failure, where fluid accumulates in the lungs. Coughing is a symptom that can be present in various conditions but is not a defining characteristic of right-sided heart failure.

3. A patient with a history of venous thromboembolism is prescribed hormone replacement therapy (HRT). What should the nurse discuss with the patient regarding the risks of HRT?

• A. HRT is associated with an increased risk of venous thromboembolism, so the patient should be aware of the signs and symptoms of blood clots.
• B. HRT can decrease the risk of osteoporosis, but the patient should also be aware of the increased risk of venous thromboembolism.
• C. HRT may increase the risk of breast cancer, so the patient should undergo regular breast exams.
• D. HRT can improve mood and energy levels, but it also carries a risk of cardiovascular events.

Correct answer: A

Rationale: The correct answer is A. Hormone replacement therapy (HRT) is indeed associated with an increased risk of venous thromboembolism. Therefore, patients should be educated about the signs and symptoms of blood clots and advised to seek immediate medical attention if they occur. Choice B is incorrect because although HRT may decrease the risk of osteoporosis, the focus of concern in this case is the increased risk of venous thromboembolism. Choice C is incorrect as it mentions the risk of breast cancer, which is not the primary concern when discussing HRT with a patient with a history of venous thromboembolism. Choice D is also incorrect as it mentions cardiovascular events, which are not the main focus of risk associated with HRT in this scenario.

4. What is a cause of the crystallization within the synovial fluid of the joint affected by gouty arthritis?

• A. Destruction of proteoglycans
• B. Underexcretion of uric acid
• C. Overexcretion of uric acid
• D. Increased absorption of uric acid

Correct answer: B

Rationale: The correct answer is B: Underexcretion of uric acid. In gouty arthritis, the crystallization within the synovial fluid of the affected joint is caused by the underexcretion of uric acid, leading to the accumulation and subsequent crystallization of urate crystals. Choice A, destruction of proteoglycans, is incorrect as it is not directly related to the crystallization process in gouty arthritis. Choice C, overexcretion of uric acid, is incorrect because gout is primarily associated with underexcretion or decreased excretion of uric acid rather than overexcretion. Choice D, increased absorption of uric acid, is also incorrect as the primary issue in gouty arthritis is the body's inability to properly eliminate uric acid.

5. A teacher in a preschool is diagnosed with giardiasis. Which of the following medications will be administered to treat the diarrhea and abdominal distention?

• A. Sulfasalazine (Azulfidine)
• B. Metronidazole (Flagyl)
• C. Trimethoprim–sulfamethoxazole (Bactrim)
• D. Doxycycline (Vibramycin)

Correct answer: B

Rationale: The correct answer is B. Metronidazole (Flagyl) is the drug of choice for treating giardiasis, which is a common cause of diarrhea and abdominal distention. Sulfasalazine (Choice A) is used to treat inflammatory bowel disease. Trimethoprim–sulfamethoxazole (Choice C) is commonly used for urinary tract infections and Pneumocystis jirovecii pneumonia. Doxycycline (Choice D) is commonly used to treat various bacterial infections but is not the first-line treatment for giardiasis.

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