Nursing Elites

1. Which of the following imbalances is found in clients with syndrome of inappropriate antidiuretic hormone (SIADH)?

• A. Decreased insulin production
• B. Decreased antidiuretic hormone (ADH) production
• C. Increased secretion of antidiuretic hormone (ADH)
• D. Increased production of insulin

Correct answer: C

Rationale: The correct answer is C: Increased secretion of antidiuretic hormone (ADH). Syndrome of inappropriate antidiuretic hormone (SIADH) is characterized by the excessive release of ADH, which leads to water retention and dilution of blood sodium levels. Choices A, B, and D are incorrect because SIADH is not associated with decreased insulin production, decreased ADH production, or increased production of insulin.

2. The unique clinical presentation of a 3-month-old infant in the emergency department leads the care team to suspect botulism. Which assessment question posed to the parents is likely to be most useful in the differential diagnosis?

• A. Have you ever given your child any honey or honey-containing products?
• B. Is there any family history of neuromuscular diseases?
• C. Has your baby ever been directly exposed to any chemical cleaning products?
• D. Is there any mold in your home that you know of?

Correct answer: A

Rationale: The correct answer is A. Botulism in infants is often linked to honey consumption. Asking the parents if they have ever given their child any honey or honey-containing products can provide crucial information for the differential diagnosis. This is important because infant botulism is commonly associated with the ingestion of honey contaminated with Clostridium botulinum spores. Choices B, C, and D are less relevant to botulism in infants as they do not directly relate to the typical causes of the condition. Family history of neuromuscular diseases (choice B) may be important for other conditions but not specifically for infant botulism. Direct exposure to chemical cleaning products (choice C) and the presence of mold in the home (choice D) are not typical risk factors for infant botulism.

3. A patient is taking raloxifene (Evista) for osteoporosis. What is the primary therapeutic effect of this medication?

• A. It stimulates the formation of new bone.
• B. It decreases bone resorption and increases bone density.
• C. It increases the excretion of calcium through the kidneys.
• D. It increases calcium absorption in the intestines.

Correct answer: B

Rationale: The correct answer is B. Raloxifene, a selective estrogen receptor modulator (SERM), primarily works by decreasing bone resorption and increasing bone density. This mechanism of action helps in the prevention and treatment of osteoporosis by maintaining or improving bone strength. Choice A is incorrect because raloxifene does not directly stimulate the formation of new bone but rather helps in preserving existing bone. Choice C is incorrect because raloxifene does not increase the excretion of calcium through the kidneys; instead, it acts on bone tissue. Choice D is incorrect as raloxifene does not directly increase calcium absorption in the intestines but rather focuses on bone health.

4. Nurse Sharie is assessing a parent who abused her child. Which of the following risk factors would the nurse expect to find in this case?

• A. Flexible role functioning between parents
• B. History of the parent having been abused as a child
• C. Single-parent home situation
• D. Presence of parental mental illness

Correct answer: B

Rationale: The correct answer is B: 'History of the parent having been abused as a child.' Research shows that a history of being abused as a child is a significant risk factor for child abuse. This cycle of abuse can sometimes continue from one generation to the next. Choices A, C, and D are incorrect. Flexible role functioning between parents, a single-parent home situation, and the presence of parental mental illness are important factors to consider in various contexts but may not specifically indicate a higher likelihood of child abuse in this case.

5. A client with amyotrophic lateral sclerosis (ALS) is admitted to the hospital. Which intervention should the nurse include in the plan of care?

• A. Administer muscle relaxants as prescribed.
• B. Assist the client with activities of daily living (ADLs).
• C. Provide nutritional support to prevent aspiration.
• D. Encourage the client to participate in physical therapy.

Correct answer: C

Rationale: The correct intervention for a client with ALS is to provide nutritional support to prevent aspiration. ALS causes muscle weakness, including the muscles used for swallowing, increasing the risk of aspiration. Providing proper nutrition and support can help prevent this complication. Administering muscle relaxants (Choice A) may not be suitable for ALS as it can further weaken muscles. While assisting with ADLs (Choice B) and encouraging physical therapy (Choice D) are important aspects of care, the priority for a client with ALS is to prevent complications related to swallowing and nutrition.

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