Nursing Elites

1. Which scenario would be an example of a child born with congenital insensitivity to pain?

• A. A child who does not cry when injured and fails to respond to painful stimuli.
• B. A child who cries excessively and has a heightened response to pain.
• C. A child who experiences pain but has difficulty expressing it.
• D. A child who is sensitive to minor stimuli but has a delayed response to severe pain.

Correct answer: A

Rationale: The correct scenario depicting a child with congenital insensitivity to pain is when the child does not cry when injured and fails to respond to painful stimuli. This condition is characterized by the inability to feel and react to pain, resulting in a lack of typical responses such as crying or withdrawal when hurt. Choice B is incorrect as it describes a child with heightened pain sensitivity, opposite to the insensitivity seen in the condition. Choice C is incorrect as it suggests the child feels pain but struggles to communicate it, which is not the case with congenital insensitivity to pain. Choice D is incorrect as it describes a child who is sensitive to minor stimuli and has delayed responses to severe pain, which is not indicative of congenital insensitivity to pain.

2. A 30-year-old woman is taking an oral contraceptive and is concerned about the potential side effects. What should the nurse include in the patient education?

• A. Oral contraceptives can cause weight loss and increased energy levels.
• B. Oral contraceptives can cause increased appetite and weight gain.
• C. Oral contraceptives can cause headaches and breast tenderness.
• D. Oral contraceptives have no side effects.

Correct answer: C

Rationale: The correct answer is C: 'Oral contraceptives can cause headaches and breast tenderness.' It is essential for the nurse to educate the patient about common side effects of oral contraceptives, such as headaches and breast tenderness. Choices A, B, and D are incorrect. Weight loss and increased energy levels (Choice A) are not common side effects of oral contraceptives. Similarly, increased appetite and weight gain (Choice B) are not typical side effects. Finally, stating that oral contraceptives have no side effects (Choice D) is inaccurate as they can have various side effects, albeit usually mild and manageable.

3. How does tamsulosin (Flomax) primarily benefit male patients with benign prostatic hyperplasia (BPH)?

• A. Relaxation of the muscles in the prostate and bladder neck, leading to improved urinary flow.
• B. Reduction in prostate size and improvement in urinary symptoms.
• C. Increase in urine flow and relief of urinary obstruction.
• D. Improvement in erectile function.

Correct answer: A

Rationale: The correct answer is A: Tamsulosin works by relaxing the muscles in the prostate and bladder neck, which helps improve urinary flow in patients with BPH. This relaxation reduces the symptoms associated with BPH, such as urinary hesitancy, urgency, and frequency. Choice B is incorrect because tamsulosin does not directly reduce the size of the prostate gland. Choice C is incorrect as while tamsulosin does improve urine flow, its primary mechanism of action is through muscle relaxation rather than directly relieving obstruction. Choice D is incorrect as tamsulosin is not indicated for improving erectile function; its main therapeutic effect is targeted towards urinary symptoms related to BPH.

4. In which of the following cases is dehydration more likely to occur?

• A. A 50-year-old woman who is a bodybuilder
• B. A 50-year-old man who is morbidly obese
• C. A 10-year-old child who is thin
• D. A 30-year-old with multiple sclerosis

Correct answer: B

Rationale: Dehydration is more likely to occur in a 50-year-old man who is morbidly obese due to the increased risk of conditions like diabetes and heart disease that can lead to fluid imbalances. Being morbidly obese can also strain the body's systems, increasing the need for water. The other choices are less likely to experience dehydration as a primary concern. While being a bodybuilder may require strict hydration practices, dehydration is more prevalent in individuals with conditions like obesity.

5. A patient with severe peripheral vascular disease has developed signs of dry gangrene on the great toe of one foot. Which of the following pathophysiologic processes most likely contributed to this diagnosis?

• A. Inappropriate activation of apoptosis
• B. Bacterial invasion
• C. Impaired arterial blood supply
• D. Metaplastic cellular changes

Correct answer: C

Rationale: The correct answer is C: Impaired arterial blood supply. Dry gangrene is typically caused by impaired arterial blood supply, leading to tissue death without bacterial infection. Choices A, B, and D are incorrect. Inappropriate activation of apoptosis is not a common cause of dry gangrene. Bacterial invasion usually leads to wet gangrene, not dry gangrene. Metaplastic cellular changes are not directly associated with the development of dry gangrene.

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