Nursing Elites

1. During a clinical assessment of a 68-year-old client who has suffered a head injury, a neurologist suspects that the client has sustained damage to her vagus nerve (CN X). Which assessment finding is most likely to lead the physician to this conclusion?

• A. The client has difficulty swallowing.
• B. The client has loss of gag reflex.
• C. The client has an inability to smell.
• D. The client has impaired eye movement.

Correct answer: B

Rationale: The correct answer is B. Damage to the vagus nerve can result in the loss of the gag reflex, which is a key indicator for the neurologist. Difficulty swallowing (Choice A) is more associated with issues related to the glossopharyngeal nerve (CN IX) and hypoglossal nerve (CN XII). An inability to smell (Choice C) is related to the olfactory nerve (CN I), and impaired eye movement (Choice D) is typically associated with damage to the oculomotor nerve (CN III), trochlear nerve (CN IV), or abducens nerve (CN VI), not the vagus nerve.

2. A nurse is providing discharge teaching to a patient who will be taking sildenafil (Viagra). Which of the following should the nurse include in the instructions?

• A. Take this medication 1 hour before sexual activity.
• B. Do not take more than one dose in a 24-hour period.
• C. Seek immediate medical attention if you experience vision or hearing loss.
• D. Take this medication on an empty stomach.

Correct answer: B

Rationale: The correct answer is B: 'Do not take more than one dose in a 24-hour period.' It is essential for the nurse to emphasize this instruction to prevent potential adverse effects from taking multiple doses of sildenafil. Choice A is incorrect because sildenafil should be taken approximately 30 minutes to 4 hours before sexual activity, not specifically 1 hour before. Choice C is important but not the priority; while vision or hearing loss are potential serious side effects of sildenafil, the immediate concern should be focused on dose frequency. Choice D is incorrect as sildenafil can be taken with or without food.

3. A nurse is educating a client with peripheral artery disease (PAD). Which statement made by the client indicates a need for further teaching?

• A. I should avoid walking for long periods to prevent leg pain.
• B. I should inspect my feet daily for any sores or wounds.
• C. I should wear compression stockings to improve circulation.
• D. I should avoid smoking to prevent further damage to my arteries.

Correct answer: A

Rationale: The correct answer is A. Walking is crucial in improving circulation in peripheral artery disease; therefore, the client should not avoid walking for long periods. Choices B, C, and D are correct statements for a client with PAD. Inspecting feet daily helps in early detection of sores or wounds, wearing compression stockings improves circulation, and avoiding smoking helps prevent further damage to arteries in PAD.

4. Which of the following is NOT an example of clinical manifestations of leukemia and lymphoma?

• A. Fatigue
• B. Increased risk of bleeding
• C. Increased risk of infections
• D. Increased energy and strength

Correct answer: D

Rationale: The correct answer is D: Increased energy and strength. Leukemia and lymphoma typically present with symptoms such as fatigue, weakness, increased risk of bleeding, and increased risk of infections. Patients with these conditions often experience a lack of energy and strength due to the disease's impact on the body. Therefore, increased energy and strength are not typical manifestations of leukemia and lymphoma.

5. A 70-year-old man has enjoyed good overall health for all of his adult life, but he has been experiencing urinary frequency and dribbling that has culminated in a diagnosis of benign prostatic hypertrophy (BPH). As a result, the patient has been prescribed finasteride (Proscar). When teaching the patient about the potential adverse effects of the drug, the nurse should ensure that he knows about the possibility of

• A. sexual dysfunction.
• B. urethral burning.
• C. kidney stones.
• D. visual disturbances.

Correct answer: A

Rationale: The correct potential adverse effect of finasteride (Proscar) that the nurse should educate the patient about is sexual dysfunction. Finasteride is known to cause sexual side effects such as decreased libido, erectile dysfunction, and ejaculation disorders. Urethral burning, kidney stones, and visual disturbances are not commonly associated with finasteride use, making them incorrect choices for this scenario.

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