Nursing Elites

1. Which gland of the endocrine system secretes a hormone that assists with the sleep/wake cycle?

• A. Pituitary
• B. Pineal
• C. Pancreas
• D. Hypothalamus

Correct answer: B

Rationale: The correct answer is the Pineal gland. The Pineal gland, located in the brain, secretes melatonin, which plays a crucial role in regulating the sleep/wake cycle in response to exposure to light. The Pituitary gland (Choice A) secretes various hormones but not specifically related to the sleep/wake cycle. The Pancreas (Choice C) secretes insulin and digestive enzymes, not hormones related to the sleep/wake cycle. The Hypothalamus (Choice D) is involved in regulating many bodily functions, including hormone secretion, but it does not directly secrete the hormone that regulates the sleep/wake cycle.

2. What term is used to refer to generalized wasting of body tissues and malnutrition?

• A. Entropion
• B. Confabulation
• C. Induration
• D. Cachexia

Correct answer: D

Rationale: Cachexia is the correct term used to describe the generalized wasting of body tissues, ill health, and malnutrition associated with some chronic diseases. It involves a loss of fat tissue to protect the bones and joints. Clients with cachexia are at risk of pressure ulcers and other complications due to malnutrition and poor health. Entropion refers to an eyelid condition, confabulation is a memory disturbance, and induration is the abnormal hardening of a part of the body.

3. When teaching a patient to use the three-point gait technique of crutch use:

• A. The injured leg moves ahead at the same time as both crutches.
• B. One crutch moves at a time and is then followed by the injured leg.
• C. Both crutches move ahead at the same time followed by both legs at the same time.
• D. None of the above are correct.

Correct answer: A

Rationale: The correct technique for a three-point gait involves the injured leg moving simultaneously with both crutches, followed by the uninjured leg. This gait pattern is utilized when the patient is unable to bear full weight on one of their legs. Choice A accurately describes the appropriate sequence of movements for the three-point gait technique. Choices B and C do not accurately reflect the correct pattern of movement during the three-point gait technique, making them incorrect. Choice D is incorrect as there is a correct option among the choices provided.

4. The nurse receives change-of-shift report on the following four patients. Which patient should the nurse assess first?

• A. A 23-year-old patient with cystic fibrosis who has pulmonary function testing scheduled
• B. A 46-year-old patient on bed rest who is complaining of sudden onset of shortness of breath
• C. A 77-year-old patient with tuberculosis (TB) who has four antitubercular medications due in 15 minutes
• D. A 35-year-old patient who was admitted the previous day with pneumonia and has a temperature of 100.2 F (37.8 C)

Correct answer: B

Rationale: The correct answer is the 46-year-old patient on bed rest who is complaining of sudden onset of shortness of breath. Patients on bed rest who are immobile are at high risk for deep vein thrombosis (DVT). Sudden onset of shortness of breath in a patient with a DVT suggests a pulmonary embolism, which requires immediate assessment and action such as oxygen administration to maintain adequate oxygenation. The other patients should also be assessed as soon as possible, but they do not present with an immediate life-threatening condition that requires urgent intervention like the patient experiencing sudden shortness of breath.

5. Which of the following is the most likely cause of constipation in a client?

• A. Postponing bowel movement when the urge to defecate occurs
• B. Intestinal infection
• C. Antibiotic use
• D. Food allergies

Correct answer: A

Rationale: The correct answer is to postpone bowel movement when the urge to defecate occurs. Clients who delay bowel movements by ignoring the urge to defecate or not evacuating promptly, such as in situations where they are not near a bathroom, are at higher risk of developing constipation. This behavior leads to a decrease in bowel movement frequency, slowed intestinal motility, and increased fecal water absorption, resulting in hard, dry stools that are difficult to pass. Intestinal infection (choice B), antibiotic use (choice C), and food allergies (choice D) are less likely to be direct causes of constipation compared to postponing bowel movements.

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