Nursing Elites

1. Which of the following types of vitamin or mineral deficiency can cause megaloblastic anemia and is associated with lower extremity paresthesias?

• A. Vitamin B12
• B. Folate
• C. Iron
• D. Vitamin K

Correct answer: A

Rationale: The correct answer is Vitamin B12. Vitamin B12 deficiency can lead to megaloblastic anemia, a condition characterized by the production of abnormally large and immature red blood cells. Lower extremity paresthesias, such as tingling or numbness, are common neurological symptoms associated with vitamin B12 deficiency. Folate deficiency can also cause megaloblastic anemia but is not typically linked to lower extremity paresthesias. Iron deficiency leads to microcytic anemia, not megaloblastic anemia. Vitamin K deficiency is associated with bleeding tendencies, not megaloblastic anemia or paresthesias.

2. A patient with hypogonadism is being treated with testosterone gel. What application instructions should the nurse provide?

• A. Apply the gel to the face and neck for maximum absorption.
• B. Apply the gel to the chest or upper arms and allow it to dry completely before dressing.
• C. Apply the gel to the genitals for improved results.
• D. Apply the gel to the scalp and back.

Correct answer: B

Rationale: The correct answer is B. Testosterone gel should be applied to the chest or upper arms and allowed to dry completely before dressing to avoid transfer to others. Applying the gel to the face, neck, genitals, scalp, or back is not recommended as these areas may lead to unintentional transfer to others, inappropriate absorption, or potential side effects. Choice A is incorrect as applying the gel to the face and neck can lead to unwanted transfer. Choice C is incorrect as applying the gel to the genitals is not the recommended site for application. Choice D is incorrect as the scalp and back are not appropriate sites for applying testosterone gel.

3. A young man has received a diagnosis of androgen deficiency and has been prescribed testosterone. At clinic follow-up appointments, the nurse should prioritize which of the following assessments?

• A. Bladder ultrasound and urine testing for glucose and ketones
• B. Weight and measurement of blood pressure
• C. Hearing assessment and abdominal girth measurement
• D. Deep tendon reflexes and random blood glucose testing

Correct answer: B

Rationale: In a patient receiving testosterone therapy for androgen deficiency, monitoring weight and blood pressure is crucial. Testosterone therapy can lead to weight gain and hypertension, making regular assessments of these parameters important to detect and manage any adverse effects. Choices A, C, and D are not the priority assessments for a patient on testosterone therapy. Bladder ultrasound and urine testing for glucose and ketones, hearing assessment and abdominal girth measurement, and deep tendon reflexes and random blood glucose testing are not directly related to the common side effects or monitoring requirements of testosterone therapy.

4. What can multiple dark bands on the nails indicate?

• A. They are considered a normal variant.
• B. They can be associated with malignant melanoma.
• C. They are indicative of a nail fungus.
• D. They are associated with aging.

Correct answer: B

Rationale: Multiple dark bands on the nails can be associated with malignant melanoma, a serious type of skin cancer. While dark bands on the nails can sometimes be a normal variant, they should not be ignored as they could also be a sign of a serious condition like melanoma. Nail fungus typically presents with different symptoms such as thickened, discolored, or brittle nails. Dark bands on the nails are not directly associated with aging.

5. A 20-year-old college student has presented to the campus medical clinic seeking to begin oral contraceptive therapy. The nurse has recognized the need for adequate health education related to the patient's request. The nurse should emphasize the fact that successful prevention of pregnancy depends primarily on the patient's

• A. current health status.
• B. vigilant adherence to the drug regimen.
• C. knowledge of sexual health.
• D. risk factors for adverse effects.

Correct answer: B

Rationale: The correct answer is B: 'vigilant adherence to the drug regimen.' When initiating oral contraceptive therapy, the success of preventing pregnancy relies heavily on the patient's commitment to following the prescribed regimen consistently. Compliance with taking the oral contraceptives as directed is crucial for their effectiveness. Choice A, 'current health status,' is not the primary factor for successful prevention of pregnancy with oral contraceptives. Choice C, 'knowledge of sexual health,' while important, is not the primary determinant of contraceptive efficacy. Choice D, 'risk factors for adverse effects,' though relevant for monitoring and managing side effects, is not the primary focus for ensuring contraceptive success.

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