Nursing Elites

1. A patient is taking testosterone for hypogonadism. What adverse effect should the nurse monitor for during this therapy?

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

Correct answer: B

Rationale: The correct adverse effect to monitor for when a patient is taking testosterone for hypogonadism is an increased risk of cardiovascular events. Testosterone therapy has been associated with an elevated risk of cardiovascular events such as heart attack and stroke, especially in older patients. Monitoring cardiovascular health is crucial during testosterone therapy. The other choices are incorrect because testosterone therapy is not primarily linked to liver dysfunction (choice A), prostate cancer (choice C), or bone fractures (choice D).

2. A client is brought to the emergency department after a motor vehicle accident in which she suffered a spinal cord injury at the level of C5. Which of the following assessments should be the priority?

• A. Monitoring urinary output
• B. Monitoring heart rate and rhythm
• C. Monitoring respiratory rate
• D. Monitoring the client's pain levels

Correct answer: B

Rationale: The correct answer is monitoring heart rate and rhythm. With a C5 spinal cord injury, monitoring heart rate and rhythm is crucial as it can impact autonomic regulation. This level of injury can affect cardiac function due to the disruption of sympathetic nerve fibers. Monitoring urinary output may be important to assess for urinary retention, but it is not the priority in this scenario. While monitoring respiratory rate is essential in all patients, in this case, cardiovascular stability takes precedence. Pain management is important but is not the priority when assessing a client with a C5 spinal cord injury.

3. A 9-year-old girl has a diffuse collection of symptoms that are indicative of deficits in endocrine and autonomic nervous system control. She also suffers from persistent fluid and electrolyte imbalances. On which aspect of the nervous system listed below would her health care providers focus their diagnostic efforts?

• A. The thalamus
• B. The pituitary
• C. The hypothalamus
• D. The midbrain

Correct answer: C

Rationale: The correct answer is C: The hypothalamus. The hypothalamus plays a central role in regulating endocrine and autonomic functions, including fluid and electrolyte balance. In this case, the girl's symptoms of deficits in endocrine and autonomic nervous system control, along with fluid and electrolyte imbalances, point towards dysfunction in the hypothalamus. Choices A, B, and D are incorrect because the thalamus is mainly involved in sensory relay, the pituitary gland regulates various hormones but is controlled by the hypothalamus, and the midbrain is responsible for motor control and arousal, not endocrine or autonomic functions.

4. 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.

5. Which of the following is a clinical manifestation in a patient with renal impairment associated with polycystic kidney disease?

• A. Suprapubic pain
• B. Periorbital edema
• C. Low serum creatinine level
• D. Palpable kidneys

Correct answer: D

Rationale: The correct answer is D: Palpable kidneys. Polycystic kidney disease often leads to the development of multiple fluid-filled cysts within the kidneys, causing them to enlarge. Enlarged kidneys can be palpated during a physical examination. Choices A, B, and C are incorrect. Suprapubic pain is not a typical clinical manifestation of polycystic kidney disease. Periorbital edema is more commonly associated with conditions like nephrotic syndrome or heart failure. Low serum creatinine level is not expected in patients with renal impairment due to polycystic kidney disease; instead, elevated serum creatinine levels are more likely.

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