Nursing Elites

1. Which of the following would the nurse expect to see in a client experiencing hypoventilation?

• A. Increased oxygenation in the alveoli
• B. Increased carbon dioxide in the bloodstream
• C. Decreased hemoglobin in the bloodstream
• D. Decreased carbon dioxide in the alveoli

Correct answer: B

Rationale: In hypoventilation, there is inadequate ventilation leading to decreased removal of carbon dioxide. This results in increased carbon dioxide in the bloodstream. The other choices are incorrect because hypoventilation does not improve oxygenation in the alveoli (Choice A), decrease hemoglobin in the bloodstream (Choice C), or decrease carbon dioxide in the alveoli (Choice D).

2. A 45-year-old woman presents with fatigue, weight gain, and cold intolerance. Her thyroid function tests reveal low T3 and T4 levels and elevated TSH levels. Which of the following is the most likely diagnosis?

• A. Hyperthyroidism
• B. Hypothyroidism
• C. Euthyroid sick syndrome
• D. Subclinical hyperthyroidism

Correct answer: B

Rationale: The scenario describes a 45-year-old woman with fatigue, weight gain, cold intolerance, low T3 and T4 levels, and elevated TSH levels, which are indicative of hypothyroidism. In hypothyroidism, there is decreased production of thyroid hormones (T3 and T4) leading to elevated TSH levels as the pituitary gland tries to stimulate the thyroid gland to produce more hormones. Therefore, the correct answer is hypothyroidism (Choice B). Choice A, Hyperthyroidism, is incorrect as the patient's symptoms and thyroid function tests point towards decreased thyroid hormone levels, which is characteristic of hypothyroidism, not hyperthyroidism. Choice C, Euthyroid sick syndrome, is incorrect because this condition typically presents with normal to low T3 and T4 levels in the setting of non-thyroid illness, unlike the elevated TSH levels observed in this case. Choice D, Subclinical hyperthyroidism, is also incorrect as the patient has low T3 and T4 levels, which is not consistent with hyperthyroidism, whether clinical or subclinical.

3. A patient is prescribed estradiol (Estrace) for hormone replacement therapy (HRT). What should the nurse monitor during this therapy?

• A. Blood glucose levels
• B. Liver function tests
• C. Kidney function tests
• D. Blood pressure

Correct answer: B

Rationale: During estradiol therapy, monitoring liver function tests is essential due to the potential for liver dysfunction. Estradiol can affect liver function, making it crucial to monitor enzyme levels. Choice A, blood glucose levels, is not directly impacted by estradiol therapy, making it an incorrect choice. Choice C, kidney function tests, is not typically affected by estradiol therapy, so it is not the priority for monitoring. Choice D, blood pressure, is also not the primary parameter to monitor during estradiol therapy unless there are pre-existing conditions that warrant such monitoring.

4. A patient is taking testosterone for hypogonadism. What adverse effect should the nurse monitor for during this therapy?

• A. Increased risk of liver dysfunction
• B. Increased risk of cardiovascular events
• C. Increased risk of prostate cancer
• D. Increased risk of bone fractures

Correct answer: B

Rationale: The correct adverse effect to monitor for when a patient is taking testosterone for hypogonadism is an increased risk of cardiovascular events. Testosterone therapy has been associated with an elevated risk of cardiovascular events such as heart attack and stroke, especially in older patients. Monitoring cardiovascular health is crucial during testosterone therapy. The other choices are incorrect because testosterone therapy is not primarily linked to liver dysfunction (choice A), prostate cancer (choice C), or bone fractures (choice D).

5. How can a nurse determine the efficacy of a child's mebendazole treatment for roundworm after 3 weeks?

• A. Liver function tests
• B. Stool for ova and parasites
• C. Colonoscopy or sigmoidoscopy
• D. Rectal swab for culture

Correct answer: B

Rationale: The correct answer is B: Stool for ova and parasites. To assess the efficacy of treatment for roundworm, the nurse would examine the stool for ova (eggs) and parasites. This test helps determine if the infection has been cleared. Choices A, C, and D are incorrect because liver function tests are not commonly used to monitor roundworm treatment efficacy, and colonoscopy/sigmoidoscopy as well as rectal swab for culture are not routine diagnostic tests for assessing the effectiveness of mebendazole treatment for roundworm.

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