Nursing Elites

1. A patient with a history of osteoporosis is prescribed raloxifene (Evista). What is the primary therapeutic action of this medication?

• A. It stimulates the formation of new bone.
• B. It decreases bone resorption and increases bone density.
• C. It increases calcium absorption in the intestines.
• D. It increases the excretion of calcium through the kidneys.

Correct answer: B

Rationale: The correct answer is B: 'It decreases bone resorption and increases bone density.' Raloxifene, as a selective estrogen receptor modulator (SERM), works by reducing bone resorption (breakdown) and maintaining or increasing bone density. This mechanism helps in preventing further bone loss and can even increase bone mass. Choices A, C, and D are incorrect. Raloxifene does not stimulate the formation of new bone (choice A), increase calcium absorption in the intestines (choice C), or increase the excretion of calcium through the kidneys (choice D).

2. Which of the following describes the damage to the brain that results in cerebral palsy?

• A. Reversible with cognitive therapy in infancy
• B. Transient and resolves in adulthood through physical therapy
• C. Manifests in adulthood after regular childhood activities
• D. Irreversible and occurs before, during, or after birth or infancy

Correct answer: D

Rationale: The correct answer is D. Cerebral palsy involves irreversible damage to the brain that occurs before, during, or shortly after birth, impacting movement and coordination. Choices A, B, and C are incorrect because cerebral palsy is not reversible with cognitive therapy or physical therapy, does not resolve in adulthood, and does not manifest in adulthood after regular childhood activities.

3. What is the most sensitive indicator of altered brain function?

• A. The ability to perform complex mathematics
• B. Altered level of consciousness
• C. The lack of cerebrospinal fluid production
• D. Intact cranial nerve functions

Correct answer: B

Rationale: The correct answer is B: Altered level of consciousness. Changes in consciousness are the most sensitive indicator of altered brain function as they can signal underlying neurological issues. Option A, the ability to perform complex mathematics, though it involves brain function, is not as sensitive or direct an indicator as altered consciousness. Option C, the lack of cerebrospinal fluid production, is more related to conditions like hydrocephalus rather than a direct indicator of altered brain function. Option D, intact cranial nerve functions, indicate the normal functioning of peripheral nerves and are not as sensitive to changes in brain function as alterations in consciousness.

4. In a 41-year-old male patient with a complex medical history diagnosed with secondary hypogonadism, which of the following health problems is the most likely etiology of his diagnosis?

• A. Type 1 diabetes
• B. Mumps
• C. An inflammatory process in the testicles
• D. Testicular trauma

Correct answer: C

Rationale: The correct answer is C: An inflammatory process in the testicles. Secondary hypogonadism in males can be caused by various factors, including an inflammatory process in the testicles. Mumps (choice B) can lead to orchitis but is less common in adults. Type 1 diabetes (choice A) is not a common cause of secondary hypogonadism. Testicular trauma (choice D) can cause primary hypogonadism but is less likely to cause secondary hypogonadism.

5. A client asks a nurse about the cause of Parkinson's disease. How should the nurse respond?

• A. Parkinson's disease is caused by a lack of dopamine in the brain, which affects movement.
• B. Parkinson's disease is caused by an excess of acetylcholine in the brain, leading to tremors and rigidity.
• C. Parkinson's disease is caused by an autoimmune response that attacks the nervous system.
• D. Parkinson's disease is caused by a bacterial infection that needs to be treated with antibiotics.

Correct answer: A

Rationale: The correct answer is A. Parkinson's disease is caused by a deficiency of dopamine in the brain, which results in the characteristic motor symptoms such as tremors, rigidity, and bradykinesia. Choice B is incorrect because Parkinson's disease is not caused by an excess of acetylcholine. Choice C is incorrect because Parkinson's disease is not an autoimmune disorder. Choice D is incorrect because Parkinson's disease is not caused by a bacterial infection and cannot be treated with antibiotics.

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