Nursing Elites

1. A healthcare professional is assessing a client with suspected myasthenia gravis. Which symptom would the healthcare professional expect to find?

• A. Muscle atrophy
• B. Facial weakness
• C. Ptosis and diplopia
• D. Increased muscle tone

Correct answer: C

Rationale: Ptosis (drooping eyelid) and diplopia (double vision) are classic symptoms of myasthenia gravis. Muscle atrophy (Choice A) is not a typical early manifestation of myasthenia gravis. While facial weakness (Choice B) can occur, it is not as specific as ptosis and diplopia. Increased muscle tone (Choice D) is more indicative of conditions like spasticity, not myasthenia gravis.

2. A patient develops itching and burning of the vaginal vault while taking an anti-infective to treat strep throat. What fungal agent has most likely caused the burning and itching?

• A. Cryptococcus neoformans
• B. Candida albicans
• C. Aspergillus
• D. Dermatophytes

Correct answer: B

Rationale: The correct answer is B: Candida albicans. Candida albicans is a common fungal agent responsible for causing vaginal yeast infections characterized by itching and burning. It is known to overgrow in the vagina, especially when the normal vaginal flora is disrupted, such as during antibiotic use. Cryptococcus neoformans is more associated with causing meningitis in immunocompromised individuals, not vaginal symptoms. Aspergillus is more commonly associated with lung infections and allergic reactions, not vaginal infections. Dermatophytes typically cause skin infections like ringworm, not vaginal symptoms.

3. An imbalance of which of the following hormones could lead to increased calcium levels in the blood?

• A. Parathyroid hormone
• B. Antidiuretic hormone
• C. Calcitonin
• D. Melatonin

Correct answer: A

Rationale: The correct answer is Parathyroid hormone (Choice A). Parathyroid hormone plays a key role in regulating calcium levels in the blood. When there is an imbalance in parathyroid hormone secretion, it can lead to increased calcium levels in the blood. Antidiuretic hormone (Choice B) is involved in regulating water balance, not calcium levels. Calcitonin (Choice C) helps lower blood calcium levels and is unlikely to cause an increase. Melatonin (Choice D) regulates sleep-wake cycles and does not have a direct effect on calcium levels in the blood.

4. Which term should the nurse use to document a situation in which cells increase in size and function?

• A. Atrophy
• B. Hypertrophy
• C. Metaplasia
• D. Hyperplasia

Correct answer: B

Rationale: Hypertrophy is the correct term used to describe the situation in which cells increase in size and function. Atrophy (Choice A) is the opposite, indicating a decrease in cell size. Metaplasia (Choice C) refers to the reversible replacement of one mature cell type by another. Hyperplasia (Choice D) involves an increase in the number of cells, not just an increase in size and function as in hypertrophy.

5. 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.

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