Nursing Elites

1. A 44-year-old man presents with muscle weakness and fatigue. He states that he has experienced difficulty climbing stairs and even holding his arms up to comb his hair. Which test is most likely to help confirm the diagnosis?

• A. Electromyography (EMG)
• B. Nerve conduction studies
• C. Muscle biopsy
• D. Blood test for autoantibodies

Correct answer: A

Rationale: The correct answer is Electromyography (EMG). EMG is commonly used to diagnose conditions involving muscle weakness and fatigue, such as myasthenia gravis. Nerve conduction studies primarily assess nerve function rather than muscle involvement. While a muscle biopsy can provide valuable information, EMG is more specific for evaluating muscle function in this context. A blood test for autoantibodies may be helpful in certain autoimmune conditions but is not the primary test for confirming the diagnosis based on the patient's symptoms of muscle weakness and fatigue.

2. 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.

3. A newborn is diagnosed with congenital intrinsic factor deficiency. Which of the following types of anemia will the nurse see documented on the chart?

• A. Iron deficiency anemia
• B. Sideroblastic anemia
• C. Pernicious anemia
• D. Hemolytic anemia

Correct answer: C

Rationale: The correct answer is C, Pernicious anemia. Pernicious anemia is associated with a congenital intrinsic factor deficiency, leading to the impaired absorption of vitamin B12. Iron deficiency anemia (Choice A) is not directly related to intrinsic factor deficiency. Sideroblastic anemia (Choice B) is characterized by defective iron uptake by developing erythrocytes and is not linked to intrinsic factor deficiency. Hemolytic anemia (Choice D) involves the premature destruction of red blood cells and is not specifically associated with intrinsic factor deficiency.

4. A 70-year-old woman has difficulty with driving, and she has been frequently getting lost. Her husband said she has also been acting strangely and seems to want to sleep a lot. He said the other night she kept saying she was seeing animals such as lions in her room. He says her memory is not too bad, but he is very concerned about her health. Physical examination reveals an alert woman with stable vital signs. Bradykinesia and limb rigidity are noted. These findings are consistent with:

• A. Alzheimer's disease.
• B. vascular dementia.
• C. dementia with Lewy bodies.
• D. frontotemporal dementia.

Correct answer: C

Rationale: The correct answer is dementia with Lewy bodies (DLB). Hallucinations, parkinsonian symptoms (like bradykinesia and limb rigidity), and fluctuating cognition are characteristic of DLB. Alzheimer's disease (Choice A) typically presents with memory loss as a prominent feature. Vascular dementia (Choice B) is associated with a history of strokes and step-wise cognitive decline. Frontotemporal dementia (Choice D) often presents with changes in behavior and personality rather than the parkinsonian symptoms seen in this case.

5. A client with cystic fibrosis is admitted with a pulmonary exacerbation. Which intervention should the nurse prioritize?

• A. Administer a high-calorie, high-protein diet.
• B. Initiate airway clearance techniques.
• C. Encourage the client to maintain an active lifestyle.
• D. Monitor for signs of respiratory distress.

Correct answer: B

Rationale: During a pulmonary exacerbation in cystic fibrosis, the priority intervention is to initiate airway clearance techniques. These techniques help clear mucus from the airways, improving ventilation and reducing the risk of respiratory complications. Administering a high-calorie, high-protein diet is beneficial for overall nutrition but is not the priority during an exacerbation. Encouraging an active lifestyle is important for long-term health but does not address the immediate need for managing exacerbations. Monitoring for signs of respiratory distress is important, but initiating airway clearance techniques takes precedence in the management of pulmonary exacerbations in cystic fibrosis.

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