Nursing Elites

1. Which symptoms should the nurse expect a client to exhibit who is diagnosed with a pheochromocytoma?

• A. Numbness, tingling, and cramps in the extremities.
• B. Headache, diaphoresis, and palpitations.
• C. Cyanosis, fever, and classic signs of shock.
• D. Nausea, vomiting, and muscular weakness.

Correct answer: B

Rationale: Correct. Pheochromocytoma is a catecholamine-secreting non-cancerous tumor of the adrenal medulla. The classic triad of symptoms includes headache, diaphoresis (excessive sweating), and palpitations, which result from the overproduction of catecholamines like epinephrine and norepinephrine. Numbness, tingling, and cramps in the extremities (Option A) are not characteristic of pheochromocytoma. Cyanosis, fever, and classic signs of shock (Option C) are not typical symptoms of this condition. Nausea, vomiting, and muscular weakness (Option D) are not commonly associated with pheochromocytoma.

2. The healthcare provider is developing standards of care for a client with gastroesophageal reflux disease and wants to review current evidence for practice. Which one of the following resources will provide the most helpful information?

• A. A review in the Cochrane Library.
• B. A literature search in a database, such as the Cumulative Index to Nursing and Allied Health Literature (CINAHL).
• C. An online nursing textbook.
• D. The policy and procedure manual at the healthcare agency.

Correct answer: A

Rationale: The Cochrane Library provides systematic reviews of primary research in healthcare, making it a reliable resource for evidence-based practice. Choice B, a literature search in a database like CINAHL, may also be useful but does not guarantee the same level of systematic review and reliability as the Cochrane Library. Choice C, an online nursing textbook, may offer information but might not provide the most current or evidence-based practices. Choice D, the policy and procedure manual at the healthcare agency, is unlikely to offer the comprehensive evidence-based information needed for developing standards of care.

3. The patient is receiving sulfadiazine. The healthcare provider knows that this patient’s daily fluid intake should be at least which amount?

• A. 1000 mL/day
• B. 1200 mL/day
• C. 2000 mL/day
• D. 2400 mL/day

Correct answer: C

Rationale: Sulfadiazine may lead to crystalluria, a condition where crystals form in the urine. Adequate fluid intake helps prevent this adverse effect by ensuring urine is dilute enough to prevent crystal formation. The recommended daily fluid intake for a patient receiving sulfadiazine is at least 2000 mL/day. Choices A, B, and D are incorrect because they do not provide a sufficient amount of fluid intake to prevent crystalluria in patients on sulfadiazine.

4. In a patient with chronic obstructive pulmonary disease (COPD), which of the following interventions is most important?

• A. Encouraging the patient to stop smoking.
• B. Administering bronchodilators.
• C. Monitoring oxygen saturation.
• D. Providing nutritional support.

Correct answer: C

Rationale: Monitoring oxygen saturation is the most important intervention in a patient with COPD because it helps assess the adequacy of oxygenation. In COPD, patients often have compromised lung function, leading to decreased oxygen levels in the blood. Monitoring oxygen saturation allows healthcare providers to promptly identify and address any potential hypoxemia, which is vital in managing COPD exacerbations. While encouraging the patient to stop smoking (Choice A) is critical for long-term management, monitoring oxygen saturation takes precedence in the immediate care of a COPD patient. Administering bronchodilators (Choice B) and providing nutritional support (Choice D) are important aspects of managing COPD but are secondary to monitoring oxygen saturation, which directly impacts the patient's oxygenation status.

5. What is the most common cause of coronary artery disease?

• A. Atherosclerosis.
• B. Hyperlipidemia.
• C. Diabetes.
• D. Smoking.

Correct answer: A

Rationale: The correct answer is Atherosclerosis. It is the primary cause of coronary artery disease, as it involves the buildup of plaque in the arteries, restricting blood flow to the heart. Hyperlipidemia (choice B) contributes to atherosclerosis by increasing cholesterol levels in the blood but is not the direct cause of coronary artery disease. Diabetes (choice C) can accelerate atherosclerosis due to high blood sugar levels, but it is not the most common cause. Smoking (choice D) is a significant risk factor for developing coronary artery disease but is not the primary cause.

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