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. A patient being treated for tuberculosis is determined to be drug resistant. Which of the following medications will the patient be resistant to in the treatment of tuberculosis?

• A. Isoniazid (INH) and rifampin
• B. Carbamazepine (Tegretol) and phenytoin (Dilantin)
• C. Dextroamphetamine (Dexedrine) and doxapram (Dopram)
• D. Propranolol (Inderal) and sotalol (Betapace)

Correct answer: A

Rationale: In the treatment of tuberculosis, drug resistance commonly develops against medications like Isoniazid (INH) and rifampin. These two drugs are key components of the standard anti-tuberculosis treatment regimen. Choices B, C, and D are unrelated medications that are not used in the treatment of tuberculosis. Carbamazepine and phenytoin are anticonvulsants, dextroamphetamine is a stimulant, and propranolol and sotalol are used for cardiovascular conditions.

3. In which patient would the manifestation of a headache be a sign of a serious underlying disorder?

• A. A 55-year-old man with new onset of headaches that are worse at night and reported mood swings according to his family
• B. A 30-year-old woman with a unilateral throbbing headache with photophobia and nausea
• C. A 60-year-old man with his head feeling full and throbbing and muscle aching around his neck and shoulders
• D. A 40-year-old woman who experiences food cravings, gets irritable, and then develops a pulsatile-like headache on the right side of her head

Correct answer: A

Rationale: The correct answer is A. New onset headaches in older adults, especially if worse at night, may indicate a serious condition like a brain tumor. Choice B describes symptoms commonly seen in migraines. Choice C describes tension-type headaches. Choice D describes symptoms of a menstrual migraine which is not typically associated with a serious underlying disorder.

4. A male patient is being treated with testosterone gel for hypogonadism. What important instruction should the nurse provide?

• A. Apply the gel to the face and neck for maximum absorption.
• B. Apply the gel to the chest or upper arms and allow it to dry completely before dressing.
• C. Apply the gel to the scalp and back.
• D. Apply the gel to the genitals for improved results.

Correct answer: B

Rationale: The correct instruction for applying testosterone gel is to apply it to the chest or upper arms and allow it to dry completely before dressing. This is important to prevent the transfer of the medication to others. Applying it to the face and neck (Choice A) is incorrect as these areas are not recommended. Similarly, applying it to the scalp and back (Choice C) or the genitals (Choice D) is also incorrect and can lead to inappropriate absorption or undesirable effects.

5. A patient is prescribed sildenafil (Viagra) for erectile dysfunction. What condition would contraindicate the use of this medication?

• A. History of peptic ulcer disease
• B. Use of nitrates
• C. Use of antihypertensive medications
• D. History of hypertension

Correct answer: B

Rationale: The correct answer is B: Use of nitrates. Sildenafil (Viagra) is contraindicated in patients taking nitrates due to the risk of severe hypotension. Nitrates combined with sildenafil can lead to a dangerous drop in blood pressure. Choices A, C, and D are incorrect because a history of peptic ulcer disease, use of antihypertensive medications, or a history of hypertension are not direct contraindications for sildenafil use.

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