Nursing Elites

1. What can multiple dark bands on the nails indicate?

• A. They are considered a normal variant.
• B. They can be associated with malignant melanoma.
• C. They are indicative of a nail fungus.
• D. They are associated with aging.

Correct answer: B

Rationale: Multiple dark bands on the nails can be associated with malignant melanoma, a serious type of skin cancer. While dark bands on the nails can sometimes be a normal variant, they should not be ignored as they could also be a sign of a serious condition like melanoma. Nail fungus typically presents with different symptoms such as thickened, discolored, or brittle nails. Dark bands on the nails are not directly associated with aging.

2. A nurse is providing care for a 44-year-old male client who is admitted with a diagnosis of fever of unknown origin (FUO). Which characteristic of the client's history is most likely to have a bearing on his current diagnosis?

• A. The client is a smoker.
• B. The client has a history of IV drug use.
• C. The client was treated for an STD 2 years ago.
• D. The client has a family history of cardiac disease.

Correct answer: B

Rationale: A history of IV drug use is significant in cases of fever of unknown origin, as it increases the risk of infections like endocarditis, which can present with persistent fever. Smoking (Choice A) is not directly linked to FUO. While a history of STD treatment (Choice C) may be relevant, it is less likely to be associated with FUO compared to IV drug use. Family history of cardiac disease (Choice D) is not typically a primary factor in the diagnosis of FUO.

3. A patient is prescribed sildenafil (Viagra) for erectile dysfunction. What key contraindication should the nurse review with the patient?

• A. Use of nitrates
• B. History of hypertension
• C. Use of antihypertensive medications
• D. Use of antihypertensive medications

Correct answer: A

Rationale: The correct answer is A: Use of nitrates. Sildenafil (Viagra) is contraindicated in patients taking nitrates due to the risk of severe hypotension. Nitrates and sildenafil both cause vasodilation, so their combined use can lead to a dangerous drop in blood pressure. Choices B, C, and D are incorrect because while a history of hypertension or use of antihypertensive medications may influence treatment decisions, they are not the key contraindication specifically related to sildenafil use.

4. A 74-year-old woman states that many of her peers underwent hormone replacement therapy (HRT) in years past. The woman asks the nurse why her primary care provider has not yet proposed this treatment for her. What fact should underlie the nurse's response to the woman?

• A. The risks of stroke and breast cancer are unacceptably high in women taking HRT.
• B. HRT was found to cause mood disturbances in many women who used it long term.
• C. HRT was found to be a significant risk factor for bone fractures and osteoporosis.
• D. The risks of chronic obstructive pulmonary disease were found to be significantly higher in women using HRT.

Correct answer: A

Rationale: The correct answer is A because the main reason HRT is not recommended for all women is due to the increased risks of stroke and breast cancer associated with its use. Hormone replacement therapy (HRT) has been linked to an elevated risk of stroke and breast cancer, which outweigh its potential benefits for many individuals. Choices B, C, and D are incorrect as they do not address the primary concerns regarding HRT use. While HRT can indeed cause mood disturbances and may affect bone health, the significant risks of stroke and breast cancer are the primary reasons why healthcare providers may choose not to recommend HRT for some women.

5. The canola plant's genome is altered to produce an herbicide-resistant crop. The canola oil produced from this crop is an example of a:

• A. pesticide-free food.
• B. saturated fat food.
• C. genetically modified food.
• D. product that is pure.

Correct answer: C

Rationale: The correct answer is C: genetically modified food. Canola plants with altered genomes to be herbicide-resistant are an example of genetically modified organisms (GMOs). Genetically modified foods have their genetic material modified for various purposes, such as enhancing resistance to pests, herbicides, or improving nutritional content. Choice A, 'pesticide-free food,' is incorrect because genetic modification does not necessarily make the food pesticide-free. Choice B, 'saturated fat food,' is incorrect as it does not relate to the genetic modification of the canola plant. Choice D, 'product that is pure,' is too vague and does not specifically address the genetic modification aspect of the canola plant.

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