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. A client has experienced a pontine stroke which has resulted in severe hemiparesis. What priority assessment should the nurse perform prior to allowing the client to eat or drink from the food tray?

• A. Evaluate the client's gag reflex.
• B. Assess the client's bowel sounds.
• C. Check the client's pupil reaction.
• D. Monitor the client's heart rate.

Correct answer: A

Rationale: The correct answer is to evaluate the client's gag reflex. When a client has experienced a stroke resulting in severe hemiparesis, assessing the gag reflex is crucial before allowing them to eat or drink. This assessment helps prevent aspiration, a serious complication that can occur due to impaired swallowing ability. Assessing bowel sounds (Choice B), pupil reaction (Choice C), or heart rate (Choice D) are important assessments but are not the priority in this situation where the risk of aspiration is higher.

3. A 9-year-old girl has a diffuse collection of symptoms that are indicative of deficits in endocrine and autonomic nervous system control. She also suffers from persistent fluid and electrolyte imbalances. On which aspect of the nervous system listed below would her health care providers focus their diagnostic efforts?

• A. The thalamus
• B. The pituitary
• C. The hypothalamus
• D. The midbrain

Correct answer: C

Rationale: The correct answer is C: The hypothalamus. The hypothalamus plays a central role in regulating endocrine and autonomic functions, including fluid and electrolyte balance. In this case, the girl's symptoms of deficits in endocrine and autonomic nervous system control, along with fluid and electrolyte imbalances, point towards dysfunction in the hypothalamus. Choices A, B, and D are incorrect because the thalamus is mainly involved in sensory relay, the pituitary gland regulates various hormones but is controlled by the hypothalamus, and the midbrain is responsible for motor control and arousal, not endocrine or autonomic functions.

4. A client with atrial fibrillation is at risk for which of the following complications?

• A. Deep vein thrombosis (DVT)
• B. Pulmonary embolism
• C. Hypertensive crisis
• D. Myocardial infarction

Correct answer: B

Rationale: Corrected Rationale: A client with atrial fibrillation is at increased risk of thromboembolism due to blood stasis in the atria. This can lead to the formation of blood clots, which may travel to the lungs and cause a pulmonary embolism. Pulmonary embolism is a serious complication of atrial fibrillation. Choices A, C, and D are incorrect because while atrial fibrillation can lead to complications such as stroke or heart failure, it is specifically associated with an increased risk of pulmonary embolism due to the clot formation associated with the condition.

5. Medroxyprogesterone acetate (Provera) is indicated for the treatment of women with

• A. uterine bleeding.
• B. cervical cancer.
• C. ovarian cancer.
• D. fibromyalgia.

Correct answer: A

Rationale: Medroxyprogesterone acetate (Provera) is commonly used to treat conditions like abnormal uterine bleeding, amenorrhea, and endometriosis. It helps regulate the menstrual cycle and reduce excessive bleeding. Therefore, the correct answer is A. Choice B, cervical cancer, is incorrect because Provera is not indicated for the treatment of cancer. Choice C, ovarian cancer, is also incorrect as Provera is not a primary treatment for ovarian cancer. Choice D, fibromyalgia, is unrelated to the use of medroxyprogesterone acetate.

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