Nursing Elites

1. During a well-child checkup, a mother tells Nurse Rio about a recent situation in which her child needed to be disciplined by her husband. The child was slapped in the face for not getting her husband breakfast on Saturday, despite being told on Thursday never to prepare food for him. Nurse Rio analyzes the family system and concludes it is dysfunctional. All of the following factors contribute to this dysfunction except:

• A. Conflictual relationships between parents.
• B. Inconsistent communication patterns.
• C. Rigid, authoritarian roles.
• D. Use of violence to establish control.

Correct answer: C

Rationale: In a dysfunctional family system, conflictual relationships, inconsistent communication patterns, and the use of violence to establish control are factors contributing to dysfunction. However, rigid, authoritarian roles, though also dysfunctional, are not directly linked to the use of violence for control.

2. 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.

3. Which of the following describes the etiology of a cerebrovascular accident (CVA)?

• A. A blow to the head from a hard object
• B. Lack of blood flow to part of the brain
• C. Excessive exercise, such as running
• D. A ruptured artery in the heart

Correct answer: B

Rationale: The correct answer is B. A cerebrovascular accident (CVA), or stroke, is often caused by a lack of blood flow to part of the brain. This leads to damage in the brain tissue due to the deprived oxygen and nutrients. Choices A, C, and D are incorrect. A blow to the head from a hard object can cause a traumatic brain injury but is not the etiology of a CVA. Excessive exercise like running does not typically lead to a stroke. A ruptured artery in the heart may result in a heart attack, not a cerebrovascular accident.

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 are normal arterial blood gas values?

• A. PH 7.25, PaCO2 52 mm Hg, PaO2 75 mm Hg, HCO3 18 mEq/L
• B. PH 7.50, PaCO2 30 mm Hg, PaO2 80 mm Hg, HCO3 28 mEq/L
• C. PH 7.40, PaCO2 40 mm Hg, PaO2 90 mm Hg, HCO3 24 mEq/L
• D. PH 7.15, PaCO2 30 mm Hg, PaO2 50 mm Hg, HCO3 24 mEq/L

Correct answer: C

Rationale: The correct answer is C: PH 7.40, PaCO2 40 mm Hg, PaO2 90 mm Hg, HCO3 24 mEq/L. These values represent a balanced state for arterial blood gas. Choice A has lower than normal PH and HCO3 levels and higher PaCO2 and lower PaO2 levels. Choice B has higher than normal PH and HCO3 levels, lower PaCO2, and a normal PaO2 level. Choice D has a significantly lower PH and PaO2 level, normal HCO3 level, and low PaCO2 level, indicating an acidic state with impaired oxygenation.

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