Nursing Elites

1. In chronic obstructive pulmonary disease, the inflammatory response predominantly involves:

• A. eosinophils
• B. neutrophils
• C. monocytes
• D. cells

Correct answer: B

Rationale: In chronic obstructive pulmonary disease, the inflammatory response predominantly involves neutrophils. Neutrophils play a key role in COPD due to their involvement in initiating and sustaining the inflammatory process. Eosinophils are more commonly associated with asthma rather than COPD. Monocytes are less involved in the inflammatory response in COPD compared to neutrophils. The choice 'cells' is too broad and vague to be a specific answer in this context.

2. A patient is being treated with finasteride (Proscar) for benign prostatic hyperplasia (BPH). What expected outcome should the nurse include in the patient teaching?

• A. The medication will cure BPH after treatment is complete.
• B. The effects of the medication may take several weeks or months to become noticeable.
• C. The medication may cause increased hair growth.
• D. The medication may decrease libido.

Correct answer: B

Rationale: The correct answer is B. Finasteride is used to reduce the size of the prostate gland in patients with BPH, leading to decreased urinary frequency and urgency over several weeks or months. Choice A is incorrect because finasteride does not cure BPH but helps manage symptoms. Choice C is incorrect as increased hair growth is associated with another medication called minoxidil, not finasteride. Choice D is incorrect since finasteride may cause a decrease in libido as a side effect.

3. A 70-year-old woman has difficulty with driving, and she has been frequently getting lost. Her husband said she has also been acting strange and seems to want to sleep a lot. He said the other night she kept saying she was seeing animals such as lions in her room. He says her memory is not too bad, but he is very concerned about her health. Physical examination reveals an alert woman with stable vital signs. Bradykinesia and limb rigidity are noted. These findings are consistent with:

• A. Alzheimer's disease.
• B. Vascular dementia.
• C. Dementia with Lewy bodies.
• D. Frontotemporal dementia.

Correct answer: C

Rationale: The symptoms described in the scenario, such as visual hallucinations, fluctuations in cognition, and parkinsonism (bradykinesia and limb rigidity), are classic features of dementia with Lewy bodies (DLB). DLB is characterized by the presence of Lewy bodies in the brain, which are abnormal protein deposits. Alzheimer's disease (Choice A) typically presents with memory loss as a predominant symptom, which is not a major concern in this case. Vascular dementia (Choice B) is associated with a history of cerebrovascular disease and is not supported by the symptoms described. Frontotemporal dementia (Choice D) usually presents with changes in behavior and personality, rather than the symptoms described in the scenario.

4. Seizures are diagnosed by which of the following?

• A. Electroencephalogram (EEG) and ECG
• B. Seizure symptoms and complete blood count (CBC)
• C. Seizure symptoms and electrocardiogram (ECG)
• D. Seizure symptoms and EEG

Correct answer: D

Rationale: Seizures are most accurately diagnosed by EEG, which measures brain activity. Choice A is incorrect as ECG (electrocardiogram) measures heart activity, not brain activity. Choice B is incorrect as CBC (complete blood count) is a blood test and not used to diagnose seizures. Choice C is incorrect as an ECG (electrocardiogram) also measures heart activity, not brain activity, and is not the primary diagnostic tool for seizures.

5. A patient with benign prostatic hyperplasia (BPH) is prescribed finasteride (Proscar). What outcome should the nurse expect to observe if the medication is effective?

• A. Increased urinary frequency and urgency
• B. Decreased prostate size
• C. Increased prostate size
• D. Decreased blood pressure

Correct answer: B

Rationale: The correct answer is B: Decreased prostate size. Finasteride is a medication used to reduce the size of the prostate gland in patients with BPH. By decreasing the size of the prostate, symptoms such as urinary frequency and urgency are improved. Choice A is incorrect as the medication aims to decrease, not increase, urinary symptoms. Choice C is incorrect because the goal of finasteride is to reduce, not increase, the prostate size. Choice D is also incorrect as finasteride is not indicated for lowering blood pressure.

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