Nursing Elites

1. Mrs. Mendoza is a 75-year-old client who has dementia of the Alzheimer’s type and confabulates. The nurse understands that this client:

• A. Denies confusion by being jovial.
• B. Pretends to be someone else.
• C. Rationalizes various behaviors.
• D. Fills in memory gaps with fantasy.

Correct answer: D

Rationale: Confabulation, a common symptom in dementia, involves filling in memory gaps with fabricated stories rather than intentionally pretending to be someone else (Choice B), denying confusion by being jovial (Choice A), or rationalizing various behaviors (Choice C). Confabulation is not a deliberate act but a memory error that results in the creation of false memories.

2. Which of the following is a cause of hypothyroidism?

• A. Overproduction of cortisol
• B. Autoimmune destruction of the thyroid gland
• C. Overactivity of the thyroid gland
• D. Insufficient iodine intake

Correct answer: B

Rationale: The correct answer is B: Autoimmune destruction of the thyroid gland. In hypothyroidism, the thyroid gland does not produce enough hormones to meet the body's needs. This can be due to autoimmune destruction of the thyroid gland, where the body's immune system mistakenly attacks the thyroid tissue. Choices A, C, and D are incorrect. Overproduction of cortisol is associated with conditions like Cushing's syndrome, overactivity of the thyroid gland is a characteristic of hyperthyroidism, and insufficient iodine intake can lead to goiter but not necessarily hypothyroidism.

3. A patient has been prescribed conjugated estrogens for the treatment of menopausal symptoms. What should the nurse include in the patient teaching?

• A. Increase the intake of calcium-rich foods.
• B. Decrease the intake of high-fat foods.
• C. Avoid the use of tobacco.
• D. Avoid exposure to sunlight.

Correct answer: A

Rationale: The correct answer is A: Increase the intake of calcium-rich foods. Patients taking conjugated estrogens should increase their intake of calcium-rich foods to help prevent osteoporosis. Estrogen therapy can lead to an increased risk of osteoporosis, so ensuring an adequate intake of calcium is crucial. Choices B, decreasing high-fat foods, and C, avoiding tobacco, are general health recommendations but not directly related to the prescription of conjugated estrogens. Choice D, avoiding exposure to sunlight, is not a direct concern when taking conjugated estrogens.

4. Why is the administration of benzene hexachloride (Lindane) for the treatment of scabies applied in small quantities?

• A. Excessive applications will lead to central nervous system toxicity.
• B. Excessive applications will cause irritation, rash, and inflammation.
• C. Excessive applications will cause headaches, dizziness, and diarrhea.
• D. Excessive applications will lead to anorexia and cachexia.

Correct answer: A

Rationale: The rationale for instructing the patient to apply benzene hexachloride (Lindane) in small quantities for scabies treatment is that excessive applications can lead to central nervous system toxicity. Lindane is a neurotoxin, and overuse or incorrect application can result in adverse effects on the central nervous system, such as seizures, dizziness, and even death. Choices B, C, and D are incorrect because they do not reflect the specific toxic effects associated with Lindane, which primarily affects the central nervous system rather than causing skin irritation, gastrointestinal symptoms, or metabolic issues.

5. A patient with breast cancer is prescribed tamoxifen (Nolvadex). What important information should the nurse provide during patient education?

• A. Tamoxifen may increase the risk of venous thromboembolism, so patients should be educated about the signs and symptoms of blood clots.
• B. Tamoxifen may cause weight gain, so patients should monitor their diet.
• C. Tamoxifen may decrease the risk of osteoporosis, so patients should ensure adequate calcium intake.
• D. Tamoxifen may increase the risk of breast cancer, so regular mammograms are essential.

Correct answer: A

Rationale: The correct answer is A. Tamoxifen increases the risk of venous thromboembolism, a serious side effect, so patients should be educated about the signs and symptoms of blood clots. This information is crucial as early recognition and prompt treatment of blood clots can prevent complications. Choices B, C, and D are incorrect because tamoxifen is not associated with causing weight gain, decreasing the risk of osteoporosis, or increasing the risk of breast cancer. Providing accurate information is essential for patient safety and understanding.

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