Nursing Elites

1. In an adult patient suspected of having an androgen deficiency and considering treatment with testosterone, the use of testosterone would be most complicated by the presence of what preexisting health problem?

• A. Urinary incontinence
• B. BPH
• C. Chronic renal failure
• D. Type 2 diabetes

Correct answer: B

Rationale: The correct answer is BPH (Benign Prostatic Hyperplasia). Testosterone therapy can worsen symptoms of BPH by potentially increasing prostate size and stimulating the growth of prostate tissue. This can lead to complications such as urinary retention and the need for further medical interventions. Urinary incontinence (choice A) can have various causes but is not directly related to testosterone therapy. Chronic renal failure (choice C) and Type 2 diabetes (choice D) are not typically contraindications for testosterone therapy in the context of androgen deficiency.

2. A patient with a history of breast cancer is being prescribed tamoxifen (Nolvadex). What should the nurse include in the patient education about the use of this medication?

• A. Tamoxifen may increase the risk of venous thromboembolism, so the patient should be aware of the signs and symptoms of blood clots.
• B. Tamoxifen may cause hot flashes, so the patient should be prepared for this side effect.
• C. Tamoxifen may decrease the risk of osteoporosis, so the patient should ensure adequate calcium intake.
• D. Tamoxifen may cause weight gain, so the patient should monitor their diet and exercise regularly.

Correct answer: A

Rationale: The correct answer is A. Tamoxifen is known to increase the risk of venous thromboembolism, a serious side effect. Patients should be educated about the signs and symptoms of blood clots, such as swelling, pain, or redness in the affected limb, and the importance of seeking immediate medical attention if they occur. Choice B is incorrect because hot flashes are a common side effect of tamoxifen but not a critical concern like venous thromboembolism. Choice C is incorrect as tamoxifen is not associated with a decreased risk of osteoporosis. Choice D is incorrect because while weight gain can occur with tamoxifen, it is not as crucial to educate the patient about as the risk of venous thromboembolism.

3. A client on an acute medicine unit of a hospital with a diagnosis of small bowel obstruction is reporting intense, diffuse pain in her abdomen. Which physiologic phenomenon is most likely contributing to her complaint?

• A. Somatic pain resulting from pressure on the parietal peritoneum
• B. Referred pain from her small bowel
• C. Visceral pain resulting from distension and ischemia
• D. Neuropathic pain resulting from autonomic dysfunction

Correct answer: C

Rationale: Visceral pain is associated with distension, ischemia, and inflammation of internal organs. In the case of a small bowel obstruction, the intense, diffuse pain reported by the client is likely due to the distension and ischemia of the small bowel. Somatic pain (Choice A) would be more localized and sharp, typically arising from the parietal peritoneum. Referred pain (Choice B) is pain perceived at a site distant from the actual pathology. Neuropathic pain (Choice D) involves dysfunction or damage to the nervous system and is not typically associated with the described physiologic phenomenon of distension and ischemia in the context of a small bowel obstruction.

4. What is the cause of swelling during acute inflammation?

• A. Collagenase
• B. Fluid exudate
• C. Lymphocytic margination
• D. Anaerobic glycolysis

Correct answer: B

Rationale: Swelling during acute inflammation is primarily caused by the accumulation of fluid exudate in the affected tissues. This fluid exudate contains proteins and cells that leak from blood vessels due to increased vascular permeability. Collagenase (Choice A) is an enzyme that breaks down collagen and is not directly responsible for swelling. Lymphocytic margination (Choice C) is the process where white blood cells line up along the blood vessel walls, which does not directly cause swelling. Anaerobic glycolysis (Choice D) is a metabolic process that occurs in the absence of oxygen and is not related to the mechanism of swelling in acute inflammation.

5. After studying about viruses, which information indicates the student has a good understanding of viruses? Viruses:

• A. Contain no RNA or DNA
• B. Are capable of independent reproduction
• C. Replicate their genetic material inside host cells
• D. Are killed easily by antimicrobials

Correct answer: C

Rationale: The correct answer is C. Viruses replicate their genetic material inside host cells, which is a fundamental aspect of their life cycle. Choice A is incorrect because viruses contain either RNA or DNA. Choice B is incorrect as viruses cannot reproduce independently and rely on host cells for replication. Choice D is incorrect as viruses are not easily killed by antimicrobials due to their unique structure and mechanisms of infection.

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