Nursing Elites

1. A male patient receiving androgen therapy is concerned about side effects. What is the most serious adverse effect the nurse should monitor for during this therapy?

• A. Increased risk of cardiovascular events
• B. Increased risk of bone fractures
• C. Increased risk of venous thromboembolism
• D. Increased risk of mood changes

Correct answer: A

Rationale: The correct answer is A: Increased risk of cardiovascular events. Androgen therapy can significantly increase the risk of cardiovascular events, such as heart attack and stroke, especially in older patients. Monitoring for signs and symptoms of cardiovascular issues is crucial during this therapy. Choice B, increased risk of bone fractures, is not typically associated with androgen therapy. Choice C, increased risk of venous thromboembolism, is more commonly linked to estrogen therapy rather than androgen therapy. Choice D, increased risk of mood changes, can occur with androgen therapy but is not as serious or life-threatening as cardiovascular events.

2. What is the characteristic of the condition of leukemia?

• A. A benign growth of skin cells
• B. A malignant growth of skin cells
• C. A malignant growth of white blood cells
• D. A benign growth of white blood cells

Correct answer: C

Rationale: The correct answer is C: 'A malignant growth of white blood cells.' Leukemia is a type of cancer that affects the blood and bone marrow, leading to an overproduction of abnormal white blood cells. These cells are malignant and impair the normal function of healthy blood cells. Choices A, B, and D are incorrect because leukemia does not involve skin cells or benign growths; instead, it specifically refers to the abnormal proliferation of white blood cells.

3. A client diagnosed with heart failure displays bilateral pitting edema of the lower extremities. Which of the following terms is used to describe this finding?

• A. Contraindication
• B. Sign
• C. Symptom
• D. Subjective data

Correct answer: B

Rationale: The correct answer is 'B. Sign.' In this scenario, bilateral pitting edema is an objective finding that can be observed by others, making it a sign of heart failure. Choice A, 'Contraindication,' refers to a factor that makes a particular treatment or procedure potentially harmful. Choice C, 'Symptom,' is a subjective indication of a condition experienced by the client. Choice D, 'Subjective data,' is information that is reported by the client but cannot be directly observed or measured.

4. A tension pneumothorax requires a needle thoracostomy and/or chest tube placement as treatment to which component of the pathophysiology of the condition?

• A. An accumulation of blood in the pleural space, which makes it difficult for the lungs to exchange gases.
• B. Extreme pain caused by a fractured rib
• C. A large accumulation of trapped air in the pleural space affecting both the lungs and heart.
• D. Sudden failure of the respiratory system due to fluid accumulation in the alveoli

Correct answer: C

Rationale: A tension pneumothorax is characterized by a large accumulation of trapped air in the pleural space, creating pressure that affects both the lungs and heart. This condition can lead to life-threatening consequences by shifting mediastinal structures and impairing cardiac function. Treatment involves decompressing the trapped air to relieve the tension. Choices A, B, and D are incorrect as they do not describe the primary pathophysiological mechanism of tension pneumothorax, which is the accumulation of air in the pleural space, not blood, rib fractures, or alveolar fluid accumulation.

5. A patient with a diagnosis of renal failure is being treated with epoetin alfa (Epogen). Frequent assessment of which of the following laboratory values should be prioritized before and during treatment?

• A. AST
• B. C-reactive protein
• C. CBC
• D. ALT

Correct answer: A

Rationale: The correct answer is AST. Epoetin alfa is a medication used to treat anemia associated with chronic renal failure. During treatment with epoetin alfa, it is crucial to monitor AST levels as this medication can potentially lead to liver toxicity. Assessing AST levels before and throughout treatment helps in early detection of any liver abnormalities. C-reactive protein is not specifically related to the use of epoetin alfa in renal failure. While CBC (Complete Blood Count) monitoring is essential during treatment with epoetin alfa to evaluate the response to therapy, prioritizing AST assessment is more critical due to the potential for liver toxicity. ALT monitoring is also important but AST is prioritized in this scenario.

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