Nursing Elites

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

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

Correct answer: A

Rationale: The correct answer is A: Increased risk of liver dysfunction. Testosterone therapy can lead to liver dysfunction, including cholestatic jaundice and hepatitis. This adverse effect necessitates monitoring of liver function tests during testosterone therapy. Choice B, increased risk of prostate cancer, is incorrect because testosterone therapy does not cause prostate cancer but is contraindicated in patients with known or suspected prostate cancer. Choice C, increased risk of bone fractures, is incorrect as testosterone therapy is actually associated with an increase in bone mineral density, reducing the risk of fractures. Choice D, increased risk of breast cancer, is incorrect because testosterone therapy in males does not increase the risk of breast cancer.

2. 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. Gouty arthritis is primarily caused by the underexcretion of uric acid, leading to its accumulation in joints and subsequent crystallization. Choices A, C, and D are incorrect as they do not directly relate to the pathophysiology of gout. Destruction of proteoglycans, overexcretion of uric acid, and increased absorption of uric acid are not primary causes of gouty arthritis.

3. Which condition is characterized by a lack of antidiuretic hormone (ADH)?

• A. Diabetes mellitus
• B. Diabetes insipidus
• C. Cushing's disease
• D. Hyperthyroidism

Correct answer: B

Rationale: The correct answer is B, Diabetes insipidus. Diabetes insipidus is characterized by a lack of antidiuretic hormone (ADH), leading to excessive urination and thirst. Choice A, Diabetes mellitus, is a different condition characterized by high blood sugar levels. Choice C, Cushing's disease, is caused by prolonged exposure to high levels of cortisol. Choice D, Hyperthyroidism, involves an overactive thyroid gland producing excess thyroid hormones.

4. A patient is prescribed medroxyprogesterone acetate (Provera) for the treatment of endometriosis. What key instruction should the nurse provide regarding the administration of this medication?

• A. Take the medication at the same time each day to maintain consistent hormone levels.
• B. Discontinue the medication if side effects occur.
• C. Take the medication with food to prevent gastrointestinal upset.
• D. Apply the medication once a week.

Correct answer: A

Rationale: The correct instruction for medroxyprogesterone acetate (Provera) is to take the medication at the same time each day to maintain consistent hormone levels and ensure its effectiveness. Choice B is incorrect because discontinuing the medication abruptly without consulting healthcare providers can be harmful. Choice C is incorrect as taking the medication with food is not necessary for this specific drug. Choice D is incorrect as medroxyprogesterone is typically taken orally, not applied topically.

5. Which of the following chronic inflammatory skin diseases is characterized by angiogenesis, immune cell activation (particularly T cells), and keratinocyte proliferation?

• A. Psoriasis
• B. Melanoma
• C. Atopic dermatitis
• D. Urticaria

Correct answer: A

Rationale: Psoriasis is the correct answer because it is a chronic inflammatory skin condition characterized by features such as angiogenesis (formation of new blood vessels), immune cell activation (especially T cells), and excessive keratinocyte proliferation. This results in the typical symptoms seen in psoriasis, such as red, scaly patches on the skin. Melanoma is a type of skin cancer arising from melanocytes, not characterized by the features mentioned. Atopic dermatitis is a different skin condition involving eczematous changes, not specifically associated with the described characteristics of psoriasis. Urticaria is a skin condition characterized by hives and does not involve the same pathophysiological processes as psoriasis.

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