Nursing Elites

1. If a patient complains of dizziness, which term below best describes this feeling?

• A. Contraindication
• B. Sign
• C. Objective data
• D. Symptom

Correct answer: D

Rationale: The correct answer is D: 'Symptom.' Dizziness is a symptom because it is a subjective experience reported by the patient. A 'contraindication' refers to a specific situation in which a drug, procedure, or surgery should not be used because it may be harmful. A 'sign' is an objective finding that can be observed or measured. 'Objective data' refers to measurable and observable information about a patient's condition, which is usually obtained through physical examination or diagnostic tests. Therefore, in this case, 'Symptom' is the best term to describe the patient's feeling of dizziness.

2. A child's thymus gland is fully formed and proportionately larger than an adult's. Which of the following processes that contribute to immunity takes place in the thymus gland?

• A. Differentiation of B cells
• B. Production of natural killer (NK) cells
• C. Proliferation of T cells
• D. Filtration of antigens from the blood

Correct answer: C

Rationale: The correct answer is C: Proliferation of T cells. The thymus gland is responsible for the maturation and proliferation of T cells, which play a crucial role in adaptive immunity. Option A, differentiation of B cells, is incorrect because B cell maturation primarily occurs in the bone marrow. Option B, production of natural killer (NK) cells, is incorrect as NK cells are mainly produced in the bone marrow and lymph nodes. Option D, filtration of antigens from the blood, is incorrect as antigen filtration is not a primary function of the thymus gland.

3. A patient is prescribed testosterone gel for hypogonadism. What important instruction should the nurse provide regarding the application of this medication?

• A. Apply the gel to the chest or upper arms.
• B. Apply the gel to the face and neck.
• C. Apply the gel to the genitals for maximum absorption.
• D. Apply the gel to the scalp and back.

Correct answer: A

Rationale: The correct answer is to apply the testosterone gel to the chest or upper arms. This is recommended to minimize the risk of unintentional transfer of the medication to others, especially women and children, through skin contact. Applying the gel to the face, neck, or genitals is not advised as it can lead to unintended exposure to others. Additionally, applying the gel to the scalp or back is not appropriate as these areas are not indicated for absorption of testosterone.

4. A woman has been prescribed Climara, a transdermal estradiol patch. Which of the following should she be instructed by the nurse regarding the administration?

• A. Avoid prolonged sun exposure at the patch site due to increased plasma concentrations.
• B. The application of heat at the patch site will decrease effectiveness and result in pregnancy.
• C. The medication, when exposed to sunlight, can increase the risk of breast cancer.
• D. Exposure of the medication to occasional cold will increase effectiveness with application.

Correct answer: A

Rationale: The correct answer is A. The Climara patch delivers estradiol transdermally, and patients should be instructed to avoid prolonged sun exposure at the patch site due to increased plasma concentrations. Sun exposure can accelerate the absorption of the medication, leading to higher systemic levels than intended. Choices B, C, and D are incorrect because heat at the patch site does not result in pregnancy but may alter absorption rates, there is no direct link between sunlight exposure and breast cancer risk related to this medication, and exposure to cold does not increase effectiveness of the transdermal patch.

5. In the ED, a homeless client is brought in with severe hypothermia. The police officers also state that they found a 'bottle of booze' on the sidewalk next to him. This puts the nurse on high alert since alcohol contributes to hypothermia by:

• A. interfering with the appetite center in the brain, causing the person to not respond to hunger cues.
• B. causing the person to have less insulation from body fat.
• C. dulling mental awareness, impairing judgment to seek shelter.
• D. increasing the basal metabolic rate, leading to faster depletion of ATP.

Correct answer: C

Rationale: Alcohol impairs judgment and dulls mental awareness, making a person less likely to seek shelter when experiencing hypothermia. This impaired judgment can lead to risky behaviors that exacerbate the effects of cold exposure. Choice A is incorrect because alcohol does not directly interfere with the appetite center in the brain to the extent described. Choice B is incorrect as alcohol consumption does not directly impact the amount of body fat present. Choice D is incorrect because alcohol does not increase the basal metabolic rate but rather slows it down.

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