Nursing Elites

1. What causes type I diabetes?

• A. Overproduction of insulin from the beta cells of the pancreas
• B. Destruction of the beta cells within the pancreas, resulting in an inability to produce insulin
• C. Loss of insulin receptors on the target cells, resulting in insulin resistance
• D. A pituitary tumor in the brain, resulting in increased antidiuretic hormone production

Correct answer: B

Rationale: Type I diabetes is caused by the destruction of the beta cells in the pancreas, leading to an inability to produce insulin. This results in a lack of insulin, leading to hyperglycemia. Choice A is incorrect as type I diabetes is characterized by a deficiency of insulin production, not overproduction. Choice C describes the pathophysiology of type 2 diabetes, where insulin receptors become less responsive to insulin. Choice D is unrelated to type I diabetes as it describes a pituitary tumor causing increased antidiuretic hormone production.

2. In an adult patient suspected of having an androgen deficiency and considering treatment with testosterone, the use of testosterone would be most complicated by the presence of what preexisting health problem?

• A. Urinary incontinence
• B. BPH
• C. Chronic renal failure
• D. Type 2 diabetes

Correct answer: B

Rationale: The correct answer is BPH (Benign Prostatic Hyperplasia). Testosterone therapy can worsen symptoms of BPH by potentially increasing prostate size and stimulating the growth of prostate tissue. This can lead to complications such as urinary retention and the need for further medical interventions. Urinary incontinence (choice A) can have various causes but is not directly related to testosterone therapy. Chronic renal failure (choice C) and Type 2 diabetes (choice D) are not typically contraindications for testosterone therapy in the context of androgen deficiency.

3. What is a cause of the crystallization within the synovial fluid of the joint affected by gouty arthritis?

• A. Destruction of proteoglycans
• B. Underexcretion of uric acid
• C. Overexcretion of uric acid
• D. Increased absorption of uric acid

Correct answer: B

Rationale: The correct answer is B: Underexcretion of uric acid. In gouty arthritis, the crystallization within the synovial fluid of the affected joint is caused by the underexcretion of uric acid, leading to the accumulation and subsequent crystallization of urate crystals. Choice A, destruction of proteoglycans, is incorrect as it is not directly related to the crystallization process in gouty arthritis. Choice C, overexcretion of uric acid, is incorrect because gout is primarily associated with underexcretion or decreased excretion of uric acid rather than overexcretion. Choice D, increased absorption of uric acid, is also incorrect as the primary issue in gouty arthritis is the body's inability to properly eliminate uric acid.

4. A 70-year-old man has enjoyed good overall health for all of his adult life, but he has been experiencing urinary frequency and dribbling that has culminated in a diagnosis of benign prostatic hypertrophy (BPH). As a result, the patient has been prescribed finasteride (Proscar). When teaching the patient about the potential adverse effects of the drug, the nurse should ensure that he knows about the possibility of

• A. sexual dysfunction.
• B. urethral burning.
• C. kidney stones.
• D. visual disturbances.

Correct answer: A

Rationale: The correct potential adverse effect of finasteride (Proscar) that the nurse should educate the patient about is sexual dysfunction. Finasteride is known to cause sexual side effects such as decreased libido, erectile dysfunction, and ejaculation disorders. Urethral burning, kidney stones, and visual disturbances are not commonly associated with finasteride use, making them incorrect choices for this scenario.

5. A patient is diagnosed with ischemic heart disease. She is prescribed filgrastim (Neupogen). What effect will this medication provide in the treatment of ischemic heart disease?

• A. Increase platelets
• B. Decrease platelets
• C. Promote angiogenesis
• D. Prevent thrombus formation

Correct answer: C

Rationale: Filgrastim (Neupogen) is a medication that promotes the growth of white blood cells. In the context of ischemic heart disease, promoting angiogenesis, the formation of new blood vessels, can improve blood flow to the heart muscle, reducing ischemia and potentially improving cardiac function. Therefore, the correct answer is C. Choices A and B are incorrect because filgrastim does not directly affect platelet levels. Choice D is also incorrect as filgrastim does not prevent thrombus formation.

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