Nursing Elites

1. Why does multiple sclerosis manifest as asymmetrical and in different parts of the body?

• A. Autoreactive lymphocytes are causing diffuse patchy damage to the myelin sheath in the central nervous system.
• B. Acetylcholine receptors are destroyed by immunoglobulin G.
• C. Autoreactive T lymphocytes cause progressive loss of neurons in the substantia nigra.
• D. Cortical motor cells degenerate.

Correct answer: C

Rationale: Multiple sclerosis is characterized by the immune system mistakenly attacking the myelin sheath in the central nervous system. This results in the formation of lesions that can occur in different parts of the central nervous system, leading to varied symptoms depending on the location of the damage. Choice A is the correct answer because it accurately describes the pathophysiology of multiple sclerosis. Choices B, C, and D are incorrect because they describe mechanisms or locations that are not associated with the pathogenesis of multiple sclerosis.

2. After a generalized seizure, a 27-year-old woman with epilepsy feels tired and falls asleep. This is:

• A. an ominous sign.
• B. normal and termed the postictal period.
• C. a reflection of an underlying brain tumor.
• D. only worrisome if there are focal neurologic deficits after.

Correct answer: B

Rationale: Choice B is the correct answer. The postictal period is the phase following a seizure, characterized by symptoms like fatigue, confusion, and sleepiness. It is a normal part of the seizure process and does not necessarily indicate a serious underlying issue. Choice A is incorrect because feeling tired and falling asleep after a seizure is expected and not an ominous sign. Choice C is incorrect as there is no indication in the scenario provided to suggest an underlying brain tumor. Choice D is incorrect because the presence of focal neurologic deficits would indeed be concerning, but the postictal state itself is a common and expected occurrence post-seizure.

3. A male patient with hypogonadism is receiving testosterone therapy. What is the most serious adverse effect the nurse should monitor for?

• A. Increased risk of breast cancer
• B. Increased risk of cardiovascular events
• C. Increased risk of liver dysfunction
• D. Increased risk of prostate cancer

Correct answer: B

Rationale: The correct answer is B: Increased risk of cardiovascular events. Testosterone therapy can lead to an increased risk of cardiovascular events such as heart attacks and strokes, especially in older patients. Monitoring for signs and symptoms of cardiovascular issues is crucial when administering testosterone therapy. Choices A, C, and D are incorrect because testosterone therapy does not typically lead to an increased risk of breast cancer, liver dysfunction, or prostate cancer.

4. A patient is prescribed sildenafil (Viagra) for erectile dysfunction. What key contraindication should the nurse review with the patient?

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

Correct answer: A

Rationale: The correct answer is A: Use of nitrates. Sildenafil (Viagra) is contraindicated in patients taking nitrates due to the risk of severe hypotension. Nitrates and sildenafil both cause vasodilation, so their combined use can lead to a dangerous drop in blood pressure. Choices B, C, and D are incorrect because while a history of hypertension or use of antihypertensive medications may influence treatment decisions, they are not the key contraindication specifically related to sildenafil use.

5. A male patient is concerned about the risk of prostate cancer while receiving finasteride (Proscar) for benign prostatic hyperplasia (BPH). What should the nurse explain about this risk?

• A. Finasteride has been shown to lower the risk of developing prostate cancer.
• B. Finasteride has no effect on the risk of developing prostate cancer.
• C. Finasteride may increase the risk of developing prostate cancer, so regular screening is important.
• D. Finasteride does not affect the risk of prostate cancer, so regular screening is unnecessary.

Correct answer: A

Rationale: The correct answer is A. Finasteride has been shown to lower the risk of developing prostate cancer. Studies have demonstrated that finasteride can reduce the incidence of prostate cancer. However, it is still recommended to have regular screening to monitor for any potential issues. Choice B is incorrect as finasteride has shown to have a positive effect on reducing prostate cancer risk. Choice C is inaccurate because finasteride decreases, not increases, the risk of prostate cancer. Choice D is incorrect as regular screening is still necessary despite the risk reduction associated with finasteride.

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