Nursing Elites

1. Which patient is at greatest risk for papilledema?

• A. An elderly patient with cataracts and macular degeneration
• B. A male patient with hypothyroidism
• C. A male patient with hyperthyroidism
• D. An adolescent with a closed head injury

Correct answer: D

Rationale: An adolescent with a closed head injury is at the highest risk for papilledema due to increased intracranial pressure. Papilledema is often a consequence of elevated intracranial pressure, which can occur in conditions like head trauma. Choices A, B, and C do not directly correlate with an increased risk of papilledema compared to a closed head injury, which is more likely to lead to elevated intracranial pressure and subsequent papilledema.

2. Which skin disorder most closely resembles and mimics dandruff?

• A. Lice infestation
• B. Scabies
• C. Dermatitis
• D. Acne vulgaris

Correct answer: C

Rationale: Dermatitis can closely resemble and mimic dandruff due to similar symptoms like flaking and itching. Lice infestation (choice A) is characterized by the presence of lice and their eggs attached to the hair shaft, different from dandruff. Scabies (choice B) is a contagious skin condition caused by mites, presenting as burrows, rashes, and intense itching, not typically resembling dandruff. Acne vulgaris (choice D) is a skin condition involving hair follicles and sebaceous glands, manifesting as pimples and inflammation, which is distinct from dandruff.

3. Diabetes insipidus is the result of:

• A. A diet high in sugar and carbohydrates.
• B. A complicated pregnancy.
• C. A disorder of the pancreas.
• D. A disorder of the pituitary gland.

Correct answer: D

Rationale: Diabetes insipidus is caused by a disorder of the pituitary gland affecting ADH regulation. This disorder results in the decreased production or release of antidiuretic hormone (ADH), leading to the inability of the kidneys to concentrate urine properly. Choices A, B, and C are incorrect as they do not relate to the underlying cause of diabetes insipidus.

4. Low birth weight is defined as a newborn's weight of:

• A. 2500 grams or less at birth, regardless of gestational age.
• B. 1500 grams or less at birth, regardless of gestational age.
• C. 2500 grams or less at birth, according to gestational age.
• D. 1500 grams or less at birth, according to gestational age.

Correct answer: A

Rationale: Low birth weight is defined as 2500 grams or less at birth, regardless of gestational age. This means that any newborn weighing 2500 grams or less is considered to have a low birth weight, irrespective of how many weeks they were in the womb. Choices B, C, and D are incorrect because they specify a weight of 1500 grams or less, which is not the standard definition of low birth weight. The correct definition is 2500 grams or less, not influenced by gestational age.

5. A client diagnosed with type 1 diabetes receives insulin. He asks the nurse why he can't just take pills instead. What is the best response by the nurse?

• A. Insulin must be injected because it needs to work quickly.
• B. Insulin can't be in a pill because it is destroyed in stomach acid.
• C. Have you talked to your doctor about taking pills instead?
• D. I know it is tough, but you will get used to the shots soon.

Correct answer: B

Rationale: The correct answer is B because insulin cannot be taken orally as it gets destroyed by stomach acid. Choice A is incorrect as the speed of action is not the reason why insulin can't be in pill form. Choice C is incorrect as it doesn't address the nature of insulin. Choice D is incorrect as it doesn't provide a factual reason why insulin can't be in pill form.

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