Nursing Elites

1. 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.

2. How will taking an oral contraceptive affect the physiologically of an insulin-dependent diabetic patient?

• A. Increase risk of hypoglycemia
• B. Increase heart rate
• C. Increase blood glucose
• D. Increase risk of metabolic alkalosis

Correct answer: C

Rationale: Taking an oral contraceptive can lead to an increase in blood glucose levels in insulin-dependent diabetic patients. This occurs due to the hormonal changes induced by the contraceptive, which can impact insulin sensitivity. Therefore, diabetic patients need to closely monitor their blood glucose levels when starting an oral contraceptive to prevent complications. The other choices are incorrect as oral contraceptives do not typically lead to an increase in heart rate, risk of hypoglycemia, or risk of metabolic alkalosis in this context.

3. Nurse Isabelle enters the room of a client with a cognitive impairment disorder and asks what day of the week it is, what the date, month, and year are, and where the client is. The nurse is attempting to assess:

• A. confabulation.
• B. delirium.
• C. orientation.
• D. perseveration.

Correct answer: C

Rationale: The correct answer is C: "orientation." Nurse Isabelle is assessing the client's orientation by asking questions about time (day, date, month, year), place, and person. This assessment helps determine the client's awareness of their surroundings and situation. Confabulation (choice A) is the unintentional fabrication of details or events to fill in memory gaps and is not being assessed in this scenario. Delirium (choice B) is a state of acute confusion and disorientation, usually with a rapid onset, which is different from assessing orientation. Perseveration (choice D) refers to the persistent repetition of a response, statement, or behavior and is not the focus of the assessment being conducted by Nurse Isabelle in this situation.

4. A client on an acute medicine unit of a hospital with a diagnosis of small bowel obstruction is reporting intense, diffuse pain in her abdomen. Which physiologic phenomenon is most likely contributing to her complaint?

• A. Somatic pain resulting from pressure on the parietal peritoneum
• B. Referred pain from her small bowel
• C. Visceral pain resulting from distension and ischemia
• D. Neuropathic pain resulting from autonomic dysfunction

Correct answer: C

Rationale: Visceral pain is associated with distension, ischemia, and inflammation of internal organs. In the case of a small bowel obstruction, the intense, diffuse pain reported by the client is likely due to the distension and ischemia of the small bowel. Somatic pain (Choice A) would be more localized and sharp, typically arising from the parietal peritoneum. Referred pain (Choice B) is pain perceived at a site distant from the actual pathology. Neuropathic pain (Choice D) involves dysfunction or damage to the nervous system and is not typically associated with the described physiologic phenomenon of distension and ischemia in the context of a small bowel obstruction.

5. A 50-year-old female was diagnosed with sideroblastic anemia. Which of the following assessment findings would most likely occur?

• A. Bronze-colored skin
• B. Decreased iron
• C. Normochromic erythrocytes
• D. Aplastic bone marrow

Correct answer: A

Rationale: The correct answer is A: 'Bronze-colored skin.' Sideroblastic anemia is characterized by excess iron deposition, leading to bronze-colored skin. This occurs due to the abnormal accumulation of iron in tissues. Choices B, C, and D are incorrect because sideroblastic anemia does not typically present with decreased iron levels, normochromic erythrocytes, or aplastic bone marrow.

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