Nursing Elites

1. A 25-year-old just had a colonoscopy and was diagnosed with Crohn disease. Which of the following symptoms is consistent with this diagnosis?

• A. Right lower quadrant cramping
• B. Severe bloody diarrhea
• C. Nausea and vomiting
• D. Mostly affects the rectum

Correct answer: A

Rationale: The correct answer is A: Right lower quadrant cramping. Crohn's disease commonly presents with abdominal pain, particularly in the right lower quadrant. Choice B, severe bloody diarrhea, is more characteristic of ulcerative colitis, another type of inflammatory bowel disease. Choice C, nausea and vomiting, are not typical symptoms of Crohn's disease. Choice D is incorrect as Crohn's disease can affect any part of the gastrointestinal tract, not just the rectum.

2. Which of the following best describes Cushing’s syndrome?

• A. Hypersecretion of growth hormone
• B. Excessive production of cortisol by the adrenal glands
• C. Insufficient production of insulin
• D. Increased levels of ACTH

Correct answer: B

Rationale: Cushing’s syndrome is characterized by the excessive production of cortisol by the adrenal glands, not growth hormone (Choice A), insulin (Choice C), or ACTH (Choice D). The increased cortisol levels lead to a variety of symptoms associated with Cushing’s syndrome.

3. A male patient is being treated with testosterone gel for hypogonadism. What important instruction should the nurse provide regarding the application of this medication?

• A. Apply the gel to the chest or upper arms.
• B. Apply the gel to the lower abdomen or thighs.
• C. Apply the gel to the face and neck.
• D. Apply the gel to the scalp and back.

Correct answer: A

Rationale: The correct answer is to apply the testosterone gel to the chest or upper arms. This is important to minimize the risk of transfer to others. Applying the gel to the lower abdomen, thighs, face, or neck can increase the risk of transfer to others, especially women and children who should avoid contact with testosterone gel. Applying it to the scalp and back is not recommended as these areas are not suitable for absorption of the medication.

4. What important instruction should the nurse provide about taking medroxyprogesterone acetate (Provera) for a patient with endometriosis?

• A. Take the medication at the same time each day to maintain consistent hormone levels.
• B. Medroxyprogesterone should be taken with food to reduce gastrointestinal upset.
• C. Discontinue medroxyprogesterone if side effects occur.
• D. Medroxyprogesterone should be taken once a week to maintain effectiveness.

Correct answer: A

Rationale: The correct answer is to take the medication at the same time each day to maintain consistent hormone levels and effectiveness. This consistency is crucial for achieving therapeutic outcomes. Choice B is incorrect because medroxyprogesterone should be taken at the same time each day, regardless of food intake. Choice C is incorrect because side effects should be reported to the healthcare provider for further evaluation rather than discontinuing the medication abruptly. Choice D is incorrect as medroxyprogesterone is usually taken daily for the prescribed duration.

5. Which of the following characterizes ductal carcinoma in situ?

• A. It is less common than lobular carcinoma in situ.
• B. Malignant cells have not invaded the stroma.
• C. It is considered a cancer precursor.
• D. Malignant cells have not invaded the stroma; it is considered a cancer precursor and has a higher risk for invasive cancer compared to lobular carcinoma in situ.

Correct answer: D

Rationale: The correct answer is that ductal carcinoma in situ is characterized by malignant cells that have not invaded the stroma, making it a cancer precursor with a higher risk for invasive cancer compared to lobular carcinoma in situ. Choice A is incorrect because ductal carcinoma in situ is more common than lobular carcinoma in situ. Choice B is incorrect as it only partially describes ductal carcinoma in situ without mentioning its potential for progression to invasive cancer. Choice C is incorrect because it does not capture the complete characteristics of ductal carcinoma in situ, which include the risk for invasive cancer.

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