Nursing Elites

1. Which of the following disorders is more likely associated with blood in stool?

• A. Gastroesophageal reflux
• B. Crohn's disease
• C. Irritable bowel syndrome
• D. Colon cancer

Correct answer: D

Rationale: Colon cancer is more likely associated with blood in stool due to the presence of bleeding from the tumor in the colon. Gastroesophageal reflux (Choice A) typically presents with heartburn and regurgitation but not blood in stool. Crohn's disease (Choice B) can cause gastrointestinal symptoms, but bloody stools are more commonly associated with ulcerative colitis. Irritable bowel syndrome (Choice C) is characterized by abdominal pain, bloating, and changes in bowel habits, but it does not typically cause blood in stool. Therefore, the correct answer is D, Colon cancer.

2. A 30-year-old woman presents with joint pain, a malar rash, and photosensitivity. Which of the following is the most likely diagnosis?

• A. Rheumatoid arthritis
• B. Systemic lupus erythematosus
• C. Psoriatic arthritis
• D. Dermatomyositis

Correct answer: B

Rationale: The correct answer is B: Systemic lupus erythematosus. Joint pain, a malar rash, and photosensitivity are classic symptoms of systemic lupus erythematosus. Choice A, Rheumatoid arthritis, is incorrect as it typically presents with symmetric joint involvement and morning stiffness. Psoriatic arthritis (Choice C) is characterized by joint pain associated with psoriasis, which is not described in the case. Dermatomyositis (Choice D) presents with muscle weakness, skin rash, and elevated muscle enzymes, different from the symptoms presented in the case.

3. A family member expresses concern to a nurse about behavioral changes in an elderly aunt. Which would cause the nurse to suspect a cognitive impairment disorder?

• A. Decreased interest in activities that she once enjoyed
• B. Fear of being alone at night
• C. Increased complaints of physical ailments
• D. Problems with preparing a meal or balancing her checkbook

Correct answer: D

Rationale: The correct answer is D. Problems with tasks like meal preparation and balancing a checkbook can indicate cognitive impairment, as these activities involve cognitive functions such as memory, attention, and executive function. Choices A, B, and C are less indicative of cognitive impairment. Decreased interest in activities and increased complaints of physical ailments may be related to other factors like depression, while fear of being alone at night could be due to anxiety or other psychological issues.

4. A patient is receiving finasteride (Proscar) for the treatment of benign prostatic hyperplasia. Which of the following is an expected outcome of the medication?

• A. Decrease in the size of the prostate gland.
• B. Improved urinary flow and decreased symptoms of urinary retention.
• C. Increased production of prostate-specific antigen (PSA).
• D. Reduction in the number of nocturnal awakenings.

Correct answer: B

Rationale: The correct answer is B. Finasteride (Proscar) is used in the treatment of benign prostatic hyperplasia to improve urinary flow and decrease symptoms of urinary retention by reducing the size of the prostate gland. Choice A is incorrect because although finasteride may reduce the size of the prostate gland, the expected outcome relevant to the patient's symptoms is improved urinary flow rather than a specific change in gland size. Choice C is incorrect because finasteride actually decreases the production of prostate-specific antigen (PSA) due to its mechanism of action. Choice D is incorrect because although improved urinary flow may lead to a reduction in nocturnal awakenings, the main expected outcome of finasteride treatment is related to urinary symptoms.

5. A client diagnosed with heart failure displays bilateral pitting edema of the lower extremities. Which of the following terms is used to describe this finding?

• A. Contraindication
• B. Sign
• C. Symptom
• D. Subjective data

Correct answer: B

Rationale: The correct answer is 'B. Sign.' In this scenario, bilateral pitting edema is an objective finding that can be observed by others, making it a sign of heart failure. Choice A, 'Contraindication,' refers to a factor that makes a particular treatment or procedure potentially harmful. Choice C, 'Symptom,' is a subjective indication of a condition experienced by the client. Choice D, 'Subjective data,' is information that is reported by the client but cannot be directly observed or measured.

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