Nursing Elites

1. Which of the following is a common cause of mechanical small intestine obstruction?

• A. Infection
• B. Postoperative adhesions
• C. Tumors
• D. Foreign body

Correct answer: B

Rationale: Postoperative adhesions are a common cause of mechanical small intestine obstruction. Adhesions can form after abdominal surgery, causing bands of scar tissue that may twist or pull the intestines, leading to obstruction. This is a more common cause compared to infection, tumors, or foreign bodies. Infection may lead to inflammation but is not a typical cause of mechanical obstruction. Tumors and foreign bodies can cause blockages but are less common than postoperative adhesions.

2. Which of the following women is at highest risk for the development of endometrial cancer?

• A. A 50-year-old postmenopausal woman with a history of high-risk human papillomavirus
• B. A 45-year-old woman who is obese and has a menstrual pattern consisting of periods of amenorrhea and infrequent periods
• C. A 40-year-old woman who is overweight and has hypertension
• D. A 55-year-old woman who smokes

Correct answer: B

Rationale: The correct answer is a 45-year-old woman who is obese and has a menstrual pattern consisting of periods of amenorrhea and infrequent periods. Obesity and prolonged exposure to estrogen unopposed by progesterone due to infrequent ovulation are significant risk factors for endometrial cancer. Choices A, C, and D do not directly correlate with the increased risk of endometrial cancer. Postmenopausal status alone (Choice A), overweight with hypertension (Choice C), and smoking (Choice D) are not the primary risk factors for endometrial cancer.

3. A 57-year-old male presents to his primary care provider with a red face, hands, feet, ears, headache, and drowsiness. A blood smear reveals an increased number of erythrocytes, indicating:

• A. Leukemia
• B. Sideroblastic anemia
• C. Hemosiderosis
• D. Polycythemia vera

Correct answer: D

Rationale: In this case, the symptoms of a red face, hands, feet, ears, headache, and drowsiness along with an increased number of erythrocytes in the blood smear are indicative of polycythemia vera. This condition is characterized by the overproduction of red blood cells, leading to symptoms related to increased blood volume and viscosity. Leukemia (Choice A) is a cancer of the blood and bone marrow, but the presentation described here is more suggestive of polycythemia vera. Sideroblastic anemia (Choice B) is characterized by abnormal iron deposits in erythroblasts, not an increased number of erythrocytes. Hemosiderosis (Choice C) refers to abnormal accumulation of iron in the body, not an increase in red blood cells as seen in polycythemia vera.

4. When does pain in the lower extremities due to peripheral artery disease usually worsen?

• A. with rest because blood flow decreases.
• B. with elevation of the extremity because blood is diverted away.
• C. when the leg is in a dependent position because blood pools.
• D. when the leg is touched or massaged because cytokines are released.

Correct answer: B

Rationale: Pain in the lower extremities due to peripheral artery disease usually worsens with elevation of the extremity because blood is diverted away from the affected area, leading to decreased perfusion and exacerbation of symptoms. Choices A, C, and D are incorrect because resting, dependent position, and touch/massage do not typically worsen the pain associated with peripheral artery disease.

5. A patient is prescribed sildenafil (Viagra) for erectile dysfunction. What critical contraindication should the nurse review with the patient?

• A. Use of nitrates
• B. Use of antihypertensive medications
• C. History of hypertension
• D. History of peptic ulcer disease

Correct answer: A

Rationale: The correct answer is A: Use of nitrates. Sildenafil (Viagra) is contraindicated in patients taking nitrates due to the risk of severe hypotension. Nitrates and sildenafil both cause vasodilation, which can lead to a dangerous drop in blood pressure. Choice B (Use of antihypertensive medications) is incorrect because antihypertensive medications are not a critical contraindication for sildenafil use. Choice C (History of hypertension) is incorrect as it is not a contraindication for sildenafil; in fact, sildenafil is sometimes used in patients with hypertension. Choice D (History of peptic ulcer disease) is also incorrect as it is not a critical contraindication for sildenafil use.

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