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. Anemia of chronic inflammation is generally classified as:

• A. Hypochromic and microcytic.
• B. Hypochromic and macrocytic.
• C. Normochromic and microcytic.
• D. Normochromic and normocytic.

Correct answer: D

Rationale: Anemia of chronic inflammation is typically characterized by normochromic (normal hemoglobin content) and normocytic (normal cell size) red blood cells. Choice A, hypochromic and microcytic, is incorrect because hypochromic refers to reduced hemoglobin content and microcytic refers to smaller than normal red blood cells, which are not typically seen in anemia of chronic inflammation. Choice B, hypochromic and macrocytic, is also incorrect as macrocytic refers to larger than normal red blood cells. Choice C, normochromic and microcytic, is incorrect because microcytic red blood cells are smaller than normal. Therefore, the correct classification for anemia of chronic inflammation is normochromic and normocytic.

3. Which of the following organs are primarily affected by poorly managed hypertension?

• A. The bladder and urethra
• B. The brain and skin
• C. The heart and kidneys
• D. The stomach and intestines

Correct answer: C

Rationale: Poorly managed hypertension primarily affects the heart and kidneys. The heart is at risk of conditions like heart failure due to the increased workload from elevated blood pressure. The kidneys can suffer damage from longstanding hypertension, leading to kidney disease. Choices A, B, and D are incorrect because the bladder, urethra, brain, skin, stomach, and intestines are not the primary organs affected by poorly managed hypertension.

4. What should the nurse assess in a patient experiencing breakthrough bleeding while taking oral contraceptives?

• A. Adherence to the medication schedule
• B. The possibility of pregnancy
• C. The need for an increased dosage
• D. The effectiveness of the current oral contraceptive

Correct answer: A

Rationale: When a patient on oral contraceptives experiences breakthrough bleeding, the nurse should assess the patient's adherence to the medication schedule. Breakthrough bleeding is often a sign of non-adherence, potentially reducing the effectiveness of the contraceptives. Assessing the adherence to the schedule helps in determining if the medication is being taken correctly. The possibility of pregnancy (choice B) is less likely if the patient has been taking the contraceptives as prescribed. Increasing the dosage (choice C) without assessing adherence first can lead to unnecessary medication adjustments. Evaluating the effectiveness of the current oral contraceptive (choice D) comes after assessing adherence to the schedule.

5. When discussing the risks associated with hormone replacement therapy (HRT) with a patient who has a history of coronary artery disease, what should the nurse emphasize?

• A. HRT may increase the risk of cardiovascular events such as heart attack and stroke.
• B. HRT may increase the risk of osteoporosis.
• C. HRT may decrease the risk of venous thromboembolism.
• D. HRT may increase the risk of breast cancer.

Correct answer: A

Rationale: The correct answer is A. Hormone replacement therapy (HRT) is associated with an increased risk of cardiovascular events, such as heart attack and stroke, especially in patients with a history of coronary artery disease. Choice B is incorrect because HRT is actually known to decrease the risk of osteoporosis. Choice C is incorrect as HRT is associated with an increased risk of venous thromboembolism. Choice D is also incorrect as HRT may slightly increase the risk of breast cancer.

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