Nursing Elites

1. A patient is starting on alendronate (Fosamax) for the treatment of osteoporosis. What instructions should the nurse provide to ensure the effectiveness of the medication?

• A. Take the medication with a full glass of water and remain upright for at least 30 minutes.
• B. Take the medication with milk to enhance calcium absorption.
• C. Take the medication at bedtime to ensure absorption during sleep.
• D. Take the medication with food to prevent nausea.

Correct answer: A

Rationale: The correct answer is A. Alendronate should be taken with a full glass of water, and patients should remain upright for at least 30 minutes to prevent esophageal irritation and ensure proper absorption. Taking the medication with milk (choice B) is not recommended as it may interfere with alendronate absorption. Taking it at bedtime (choice C) is not necessary and may increase the risk of esophageal irritation. Taking the medication with food (choice D) can reduce its absorption and effectiveness.

2. The unique clinical presentation of a 3-month-old infant in the emergency department leads the care team to suspect botulism. Which assessment question posed to the parents is likely to be most useful in the differential diagnosis?

• A. Has your child received all recommended vaccinations?
• B. Has your child been feeding poorly or showing signs of constipation?
• C. Has your child been exposed to any sick individuals?
• D. Has your child been displaying signs of respiratory distress?

Correct answer: B

Rationale: The correct answer is B. Poor feeding and constipation are common early symptoms of infant botulism, which is caused by a neurotoxin that impairs muscle function. Option A is unrelated to the presentation of botulism. Option C does not directly relate to the symptoms of botulism. Option D is more indicative of respiratory issues rather than the constellation of symptoms seen in botulism.

3. Which of the following describes the condition in the body of clients experiencing hypovolemia?

• A. Increased urine retention
• B. Insufficient circulating blood volume
• C. Bounding peripheral pulses
• D. Crackles auscultated in the lungs

Correct answer: B

Rationale: The correct answer is B: Insufficient circulating blood volume. Hypovolemia is a condition characterized by a decrease in the volume of blood plasma. This reduction in circulating blood volume can lead to inadequate perfusion of tissues and organs, potentially resulting in shock if left untreated. Choices A, C, and D are incorrect because increased urine retention, bounding peripheral pulses, and crackles auscultated in the lungs are not typical manifestations of hypovolemia.

4. A young man has received a diagnosis of androgen deficiency and has been prescribed testosterone. At clinic follow-up appointments, the nurse should prioritize which of the following assessments?

• A. Bladder ultrasound and urine testing for glucose and ketones
• B. Weight and measurement of blood pressure
• C. Hearing assessment and abdominal girth measurement
• D. Deep tendon reflexes and random blood glucose testing

Correct answer: B

Rationale: In a patient receiving testosterone therapy for androgen deficiency, monitoring weight and blood pressure is crucial. Testosterone therapy can lead to weight gain and hypertension, making regular assessments of these parameters important to detect and manage any adverse effects. Choices A, C, and D are not the priority assessments for a patient on testosterone therapy. Bladder ultrasound and urine testing for glucose and ketones, hearing assessment and abdominal girth measurement, and deep tendon reflexes and random blood glucose testing are not directly related to the common side effects or monitoring requirements of testosterone therapy.

5. Which of the following are manifestations of Cushing syndrome?

• A. Truncal obesity with thin extremities.
• B. Enlargement of face, hands, and feet.
• C. Cachexia.
• D. Thick scalp hair.

Correct answer: A

Rationale: Truncal obesity with thin extremities is a classic manifestation of Cushing syndrome due to the redistribution of fat. Enlargement of face, hands, and feet is seen in conditions like acromegaly, not Cushing syndrome. Cachexia is a state of severe weight loss and muscle wasting, typically seen in conditions like cancer or advanced infections. Thick scalp hair is not typically associated with Cushing syndrome.

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