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 term should the nurse use to document a situation in which cells increase in size and function?

• A. Atrophy
• B. Hypertrophy
• C. Metaplasia
• D. Hyperplasia

Correct answer: B

Rationale: Hypertrophy is the correct term used to describe the situation in which cells increase in size and function. Atrophy (Choice A) is the opposite, indicating a decrease in cell size. Metaplasia (Choice C) refers to the reversible replacement of one mature cell type by another. Hyperplasia (Choice D) involves an increase in the number of cells, not just an increase in size and function as in hypertrophy.

3. A patient is starting on alendronate (Fosamax) for osteoporosis. What instructions should the nurse provide to ensure the effectiveness of the medication?

• A. Take the medication with a full glass of water and remain upright for at least 30 minutes.
• B. Take the medication at bedtime to ensure absorption during sleep.
• C. Take the medication with milk to enhance calcium absorption.
• D. Take the medication with food to prevent gastrointestinal upset.

Correct answer: A

Rationale: The correct answer is to take alendronate with a full glass of water and remain upright for at least 30 minutes. This is essential to prevent esophageal irritation and ensure proper absorption. Choice B is incorrect because taking alendronate at bedtime can increase the risk of esophageal irritation due to lying down. Choice C is incorrect as taking alendronate with milk can reduce its absorption. Choice D is incorrect because alendronate should be taken on an empty stomach to enhance its effectiveness.

4. How will taking an oral contraceptive affect the physiologically of an insulin-dependent diabetic patient?

• A. Increase risk of hypoglycemia
• B. Increase heart rate
• C. Increase blood glucose
• D. Increase risk of metabolic alkalosis

Correct answer: C

Rationale: Taking an oral contraceptive can lead to an increase in blood glucose levels in insulin-dependent diabetic patients. This occurs due to the hormonal changes induced by the contraceptive, which can impact insulin sensitivity. Therefore, diabetic patients need to closely monitor their blood glucose levels when starting an oral contraceptive to prevent complications. The other choices are incorrect as oral contraceptives do not typically lead to an increase in heart rate, risk of hypoglycemia, or risk of metabolic alkalosis in this context.

5. In discussing sex hormone production with the patient, the nurse should describe that testosterone is normally secreted in response to

• A. sexual arousal.
• B. stimulation by luteinizing hormone.
• C. ACTH release by the adrenal cortex.
• D. decreased cortisol levels.

Correct answer: B

Rationale: Testosterone production is regulated by the hypothalamic-pituitary-gonadal axis. Luteinizing hormone (LH) stimulates the Leydig cells in the testes to produce testosterone. Therefore, the correct answer is B. Choice A, 'sexual arousal,' is incorrect because testosterone secretion is not directly linked to arousal but rather to hormonal stimulation. Choice C, 'ACTH release by the adrenal cortex,' is incorrect as testosterone production is not primarily regulated by adrenocorticotropic hormone (ACTH). Choice D, 'decreased cortisol levels,' is also incorrect as cortisol and testosterone are regulated by separate endocrine pathways.

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