Nursing Elites

1. A patient is hospitalized with active tuberculosis. The patient is receiving antitubercular drug therapy and is not responding to the medications. What do you suspect the patient is suffering from?

• A. Human immunodeficiency virus
• B. Drug-resistant tuberculosis
• C. Methicillin-resistant Staphylococcus aureus
• D. Vancomycin-resistant Staphylococcus aureus

Correct answer: B

Rationale: When a patient with active tuberculosis is not responding to antitubercular drug therapy, drug-resistant tuberculosis should be suspected. Drug-resistant tuberculosis occurs when the bacteria causing tuberculosis become resistant to the medications being used. Choices A, C, and D are incorrect because the scenario described does not align with HIV infection, methicillin-resistant Staphylococcus aureus, or vancomycin-resistant Staphylococcus aureus.

2. What serious adverse effect should the nurse monitor for during testosterone therapy?

• A. Testosterone therapy increases the risk of cardiovascular events, so regular monitoring is essential.
• B. Testosterone therapy can cause liver dysfunction, so liver function tests should be monitored regularly.
• C. Testosterone therapy can lead to prostate cancer, so regular screenings are recommended.
• D. Testosterone therapy can lead to bone fractures, so bone density should be monitored.

Correct answer: A

Rationale: The correct answer is A. Testosterone therapy is associated with an increased risk of cardiovascular events. Therefore, the nurse should monitor the patient for cardiovascular complications. While monitoring liver function tests (choice B) and bone density (choice D) may be important in some cases, the primary concern during testosterone therapy is the risk of cardiovascular events. Prostate cancer screenings (choice C) are not directly related to testosterone therapy's adverse effects.

3. Which of the following is found in clients with Parkinson’s disease?

• A. Mobility and functioning
• B. The liver and kidneys
• C. Too much dopamine in the brain
• D. Skeletal muscle flaccidity

Correct answer: C

Rationale: The correct answer is C: Too much dopamine in the brain. Parkinson's disease is characterized by a deficiency of dopamine in the brain, not an excess. This deficiency leads to the motor symptoms associated with the disease. Choices A, B, and D are incorrect. Mobility and functioning are affected in Parkinson's disease due to the lack of dopamine, not an excess. The liver and kidneys are not directly related to Parkinson's disease. Skeletal muscle flaccidity is not typically a primary symptom of Parkinson's disease, which is more characterized by rigidity and tremors.

4. During admission, 82-year-old Mr. Robeson is brought to the medical-surgical unit for diagnostic confirmation and management of probable delirium. Which statement by the client’s daughter best supports the diagnosis?

• A. “Maybe it’s just caused by aging. This usually happens by age 82.”
• B. “The changes in his behavior came on so quickly! I wasn’t sure what was happening.”
• C. “Dad just didn’t seem to know what he was doing. He would forget what he had for breakfast.”
• D. “Dad has always been so independent. He’s lived alone for years since mom died.”

Correct answer: B

Rationale: The correct answer is B because sudden onset of behavioral changes is a typical symptom of delirium. Delirium is characterized by an acute and fluctuating disturbance in attention, awareness, and cognition. Choice A is incorrect because delirium is not a normal part of aging. Choice C describes memory issues, which can be seen in delirium but are less specific than sudden behavioral changes. Choice D, while it mentions the patient's independence, does not directly support the diagnosis of delirium.

5. A patient is prescribed sildenafil (Viagra) for erectile dysfunction. What is a key contraindication that the nurse should review with the patient?

• A. History of hypertension
• B. Use of nitrates
• C. Use of antihypertensive medications
• D. History of peptic ulcer disease

Correct answer: B

Rationale: The correct answer is B: 'Use of nitrates.' Sildenafil (Viagra) is contraindicated in patients taking nitrates due to the risk of severe hypotension. Nitrates and sildenafil both act as vasodilators, and their combined use can lead to a dangerous drop in blood pressure. Choices A, C, and D are incorrect because having a history of hypertension, using antihypertensive medications, or having a history of peptic ulcer disease are not key contraindications for sildenafil use.

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