Nursing Elites

1. Which of the following is the drug of choice to decrease uric acid levels?

• A. prednisone (Colisone)
• B. allopurinol (Zyloprim)
• C. indomethacin (Indocin)
• D. hydrochlorothiazide (HydroDiuril)

Correct answer: B

Rationale: Allopurinol is the correct drug to decrease uric acid levels as it is used to treat gout by reducing uric acid formation. Prednisone is a corticosteroid that decreases inflammation, not uric acid levels. Indomethacin is an analgesic, anti-inflammatory, and antipyretic agent, not specifically used to reduce uric acid levels. Hydrochlorothiazide is a thiazide diuretic primarily used for treating hypertension and edema, not for reducing uric acid levels.

2. A client, age 28, was recently diagnosed with Hodgkin's disease. After staging, therapy is planned to include combination radiation therapy and systemic chemotherapy with MOPP"?nitrogen mustard, vincristine (Onconvin), prednisone, and procarbazine. In planning care for this client, the nurse should anticipate which of the following side effects to contribute to a sense of altered body image?

• A. Cushingoid appearance
• B. Alopecia
• C. Temporary or permanent sterility
• D. Pathologic fractures

Correct answer: B

Rationale: The correct answer is B: alopecia. Chemotherapy drugs like vincristine and nitrogen mustard commonly cause hair loss (alopecia), which can significantly impact body image. While a Cushingoid appearance can be a side effect of long-term steroid use, it is not typically associated with the chemotherapy regimen mentioned. Temporary or permanent sterility can result from chemotherapy, affecting fertility but not directly contributing to altered body image. Pathologic fractures are not commonly linked to Hodgkin's disease or its treatment, unlike alopecia which is a well-known side effect.

3. The client is undergoing an induction for fetal demise at 34 weeks. Immediately after delivery, the mother asks to see the infant. What is the nurse's best response?

• A. Bring the swaddled fetus to the mother
• B. Explain that the cause of death must be determined before she can see the baby
• C. Ask her if she is sure she wants to see the baby
• D. Tell her it would be better to wait until she is in her room before she sees the baby

Correct answer: A

Rationale: The nurse should bring the swaddled fetus to the mother as the best response. Allowing the mother to see the infant immediately after delivery is crucial for her grieving process. It provides her with the opportunity to bond, say goodbye, and start the grieving process. Choice B is incorrect because delaying the mother's request to see the baby can hinder her grieving process and prolong her suffering. Choice C is inappropriate as it questions the mother's decision at a sensitive time, potentially causing distress. Choice D is also not the best response as it suggests waiting, which may not be in the mother's best interest at that moment, as she needs immediate support and closure.

4. After experiencing a left frontal lobe CVA, a fifty-five-year-old man is being monitored by a nurse. The patient's family is not present in the room. What should the nurse observe most closely for?

• A. Changes in emotion and behavior
• B. Monitor loss of hearing
• C. Observe appetite and vision deficits
• D. Changes in facial muscle control

Correct answer: A

Rationale: The correct answer is to watch for changes in emotion and behavior. The frontal lobe, particularly the left side, is responsible for regulating behavior and emotions. Therefore, following a left frontal lobe CVA, monitoring for alterations in emotion and behavior is crucial. Choices B, C, and D are incorrect because loss of hearing, appetite and vision deficits, and changes in facial muscle control are not directly associated with a left frontal lobe CVA.

5. A nurse is caring for a client with an elevated cortisol level. The nurse can expect the client to exhibit symptoms of:

• A. urinary excess
• B. hyperpituitarism
• C. urinary deficit
• D. hyperthyroidism

Correct answer: C

Rationale: Elevated cortisol levels can lead to sodium and fluid retention and potassium deficit, resulting in urinary deficit. This imbalance in electrolytes and fluid can cause a decrease in urinary output. Choices B, hyperpituitarism, and D, hyperthyroidism, are incorrect as they do not directly relate to the symptoms expected with elevated cortisol levels. Option A, urinary excess, is also incorrect as high cortisol levels typically lead to fluid retention and urinary deficit, not excess.

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