Nursing Elites

1. Which of the following are manifestations of Cushing syndrome?

• A. Truncal obesity with thin extremities.
• B. Enlargement of face, hands, and feet.
• C. Cachexia.
• D. Thick scalp hair.

Correct answer: A

Rationale: Truncal obesity with thin extremities is a classic manifestation of Cushing syndrome due to the redistribution of fat. Enlargement of face, hands, and feet is seen in conditions like acromegaly, not Cushing syndrome. Cachexia is a state of severe weight loss and muscle wasting, typically seen in conditions like cancer or advanced infections. Thick scalp hair is not typically associated with Cushing syndrome.

2. Cushing syndrome is characterized by which disorder?

• A. Hypocortisolism
• B. Exophthalmos
• C. Hypercortisolism
• D. Hyperpigmentation

Correct answer: C

Rationale: Cushing syndrome is characterized by hypercortisolism, which is an excessive amount of cortisol in the body. Choice A, 'Hypocortisolism,' is incorrect as Cushing syndrome is associated with elevated cortisol levels. Choice B, 'Exophthalmos,' refers to bulging eyes and is not a characteristic feature of Cushing syndrome. Hyperpigmentation, as mentioned in choice D, can be present in Cushing syndrome due to increased ACTH levels stimulating melanocytes, but it is not the defining characteristic of the syndrome.

3. A nurse practitioner is assessing a 7-year-old boy who has been brought to the clinic by his mother, who is concerned about her son's increasingly frequent, severe headaches. Which of the nurse's questions is least likely to yield data that will confirm or rule out migraines as the cause of his problem?

• A. Does your son experience nausea or vomiting when he has a headache?
• B. Does your son have a history of recent head injury?
• C. Does your son become sensitive to light when he has a headache?
• D. Does anyone in your family have a history of migraines?

Correct answer: B

Rationale: Asking about a history of recent head injury is less likely to yield data relevant to confirming or ruling out migraines. Migraines are often associated with symptoms like nausea, vomiting, sensitivity to light, and a family history of migraines. While head injuries can cause headaches, the focus of the assessment in this case should be on symptoms more specific to migraines to guide the diagnosis and management.

4. A patient with breast cancer is prescribed tamoxifen (Nolvadex). What critical information should the nurse provide during patient education?

• A. Tamoxifen may increase the risk of venous thromboembolism, so patients should be educated about the signs and symptoms of blood clots.
• B. Tamoxifen may decrease the risk of osteoporosis, so adequate calcium intake is important.
• C. Tamoxifen may cause weight gain, so patients should monitor their diet.
• D. Tamoxifen may increase the risk of breast cancer, so regular mammograms are essential.

Correct answer: A

Rationale: When a patient is prescribed tamoxifen, a critical piece of information that the nurse should provide during patient education is that tamoxifen may increase the risk of venous thromboembolism. Therefore, patients should be educated about the signs and symptoms of blood clots and advised to seek immediate medical attention if they occur. Choice B is incorrect because tamoxifen does not decrease the risk of osteoporosis. Choice C is incorrect as weight gain is a possible side effect of tamoxifen, but it is not a critical piece of information compared to the risk of venous thromboembolism. Choice D is incorrect because tamoxifen is actually used to treat breast cancer, not increase its risk.

5. Which of the following hormones helps to raise the blood sugar level to help maintain homeostasis?

• A. Antidiuretic hormone (ADH)
• B. Insulin
• C. Glucagon
• D. Thyroxine

Correct answer: C

Rationale: The correct answer is C, Glucagon. Glucagon helps raise blood sugar levels by stimulating the liver to release stored glucose into the bloodstream, thus aiding in maintaining homeostasis. Antidiuretic hormone (ADH), choice A, functions in regulating water balance in the body, not blood sugar levels. Insulin, choice B, lowers blood sugar levels by facilitating glucose uptake by cells. Thyroxine, choice D, is a hormone produced by the thyroid gland that regulates metabolism and has no direct effect on blood sugar levels.

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