Nursing Elites

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

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

Correct answer: B

Rationale: The correct answer is B: Increased risk of cardiovascular events. Testosterone therapy can lead to an increased risk of cardiovascular events such as heart attacks and strokes, especially in older patients. Monitoring for signs and symptoms of cardiovascular issues is crucial when administering testosterone therapy. Choices A, C, and D are incorrect because testosterone therapy does not typically lead to an increased risk of breast cancer, liver dysfunction, or prostate cancer.

2. A 20-year-old male shoots his hand with a nail gun while replacing roofing shingles. Which of the following cell types would be the first to aid in killing bacteria to prevent infection in his hand?

• A. Eosinophils
• B. Neutrophils
• C. Leukotrienes
• D. Monocytes

Correct answer: B

Rationale: Neutrophils are the first responders to bacterial infections. When there is a breach in the skin like in this scenario, neutrophils are quickly recruited to the site of injury to phagocytize and kill bacteria. Eosinophils are primarily involved in parasitic infections and allergic reactions, making choice A incorrect. Leukotrienes are lipid mediators involved in inflammation but are not cells, so choice C is incorrect. Monocytes are precursors to macrophages and play a role in immune response, but they are not the first cells to arrive at the site of a bacterial infection, making choice D incorrect.

3. Multiple sclerosis manifests as asymmetrical and in different parts of the body because:

• A. Autoreactive lymphocytes are causing diffuse patchy damage to the myelin sheath in the central nervous system.
• B. Acetylcholine receptors are destroyed by immunoglobulin G.
• C. Autoreactive T lymphocytes cause progressive loss of neurons in the substantia nigra.
• D. Cortical motor cells degenerate.

Correct answer: A

Rationale: The correct answer is A. Multiple sclerosis is characterized by the immune system attacking the myelin sheath in the central nervous system. This attack leads to patchy damage on the myelin sheath, resulting in asymmetrical neurological symptoms. Choices B, C, and D are incorrect because they do not accurately describe the pathophysiology of multiple sclerosis. In multiple sclerosis, it is the autoreactive lymphocytes that target and damage the myelin sheath, not acetylcholine receptors, T lymphocytes, or cortical motor cells.

4. A patient suffers from dysmenorrhea. Which oral medication will be prescribed that has the ability to provide physiological actions on the neuroendocrine control of ovarian function?

• A. Estrogen
• B. Progestins
• C. Naproxen
• D. Ibuprofen

Correct answer: B

Rationale: Progestins are prescribed for dysmenorrhea as they help reduce menstrual pain by inhibiting ovulation and decreasing the production of prostaglandins. Estrogen (Choice A) is not typically used alone in dysmenorrhea treatment as it can worsen symptoms. Naproxen (Choice C) and Ibuprofen (Choice D) are nonsteroidal anti-inflammatory drugs (NSAIDs) commonly used to relieve pain associated with dysmenorrhea, but they do not directly affect the neuroendocrine control of ovarian function like progestins do.

5. A 22-year-old woman began using oral contraceptives several months ago and has presented for an appointment to discuss recent worrisome changes in her health status. Which of the following changes in the woman's health may the nurse potentially attribute to the use of oral contraceptives?

• A. Fatigue
• B. Frequent high blood pressure readings
• C. Frequent headaches without aura
• D. Nausea and vomiting

Correct answer: A

Rationale: The correct answer is A: Fatigue. Oral contraceptives can sometimes cause fatigue as a side effect. Frequent high blood pressure readings and frequent headaches without aura are less likely to be directly related to the use of oral contraceptives. Nausea and vomiting are common side effects of oral contraceptives but are not the changes typically associated with liver function affecting hormone metabolism as in the case of hepatitis C infection.

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