Nursing Elites

1. What occurs in a client with polycythemia?

• A. Deficient plasma in the blood
• B. Increased lymphatic fluid being produced
• C. Increased red blood cells being produced
• D. Deficient number of red blood cells

Correct answer: C

Rationale: The correct answer is C: Increased red blood cells being produced. Polycythemia is a condition characterized by an elevated number of red blood cells in the blood. This increased concentration of red blood cells can lead to blood thickening and potentially result in complications such as blood clots. Choices A, B, and D are incorrect because polycythemia does not involve deficient plasma, increased lymphatic fluid production, or a deficient number of red blood cells.

2. A patient with a history of hypertension presents with a severe headache, confusion, and visual disturbances. His blood pressure is 220/120 mm Hg. Which of the following is the most likely diagnosis?

• A. Migraine
• B. Cluster headache
• C. Hypertensive emergency
• D. Tension headache

Correct answer: C

Rationale: A patient with a history of hypertension presenting with a severe headache, confusion, and visual disturbances, along with a blood pressure of 220/120 mm Hg, likely has a hypertensive emergency. In this situation, the severely elevated blood pressure can lead to end-organ damage, causing symptoms such as headache and confusion. Migraine and tension headaches are not associated with such high blood pressure levels. Cluster headaches typically do not present with visual disturbances and confusion in the setting of severe hypertension.

3. A patient is prescribed dutasteride (Avodart) for benign prostatic hyperplasia (BPH). What outcome should the nurse expect to observe if the drug is having the desired effect?

• A. Decreased size of the prostate gland
• B. Increased urinary output
• C. Increased urine flow
• D. Decreased blood pressure

Correct answer: A

Rationale: The correct answer is A: Decreased size of the prostate gland. Dutasteride is a medication used for BPH to reduce the size of the prostate gland, thereby improving urinary flow and decreasing symptoms. Choice B, increased urinary output, is incorrect as dutasteride primarily targets the size of the prostate gland rather than directly affecting urinary output. Choice C, increased urine flow, is related to the expected outcome of dutasteride therapy but is not as direct as the reduction in the size of the prostate gland. Choice D, decreased blood pressure, is not an expected outcome of dutasteride therapy for BPH.

4. In which patient is alpha-1 antitrypsin deficiency the likely cause of chronic obstructive pulmonary disease?

• A. A 30-year-old who has smoked for 3 years
• B. A 65-year-old man who drove a taxi most of his life
• C. A 70-year-old woman who smoked for 40 years
• D. A 50-year-old with exposure to secondhand smoke

Correct answer: A

Rationale: Alpha-1 antitrypsin deficiency is a genetic cause of chronic obstructive pulmonary disease (COPD). It is more common in younger patients with a history of smoking at a younger age, like the 30-year-old who has smoked for 3 years. Choices B, C, and D are less likely to be associated with alpha-1 antitrypsin deficiency as COPD in these cases is more likely due to smoking and environmental exposures.

5. Which condition is characterized by a lack of antidiuretic hormone (ADH)?

• A. Diabetes mellitus
• B. Diabetes insipidus
• C. Cushing's disease
• D. Hyperthyroidism

Correct answer: B

Rationale: The correct answer is B, Diabetes insipidus. Diabetes insipidus is characterized by a lack of antidiuretic hormone (ADH), leading to excessive urination and thirst. Choice A, Diabetes mellitus, is a different condition characterized by high blood sugar levels. Choice C, Cushing's disease, is caused by prolonged exposure to high levels of cortisol. Choice D, Hyperthyroidism, involves an overactive thyroid gland producing excess thyroid hormones.

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