Nursing Elites

1. A 49-year-old female client arrives at the clinic for an annual exam and asks the nurse why she becomes excessively diaphoretic and feels warm during nighttime. What is the nurse's best response?

• A. Explain the effects of follicle-stimulating and luteinizing hormones.
• B. Discuss perimenopause and related comfort measures.
• C. Assess lung fields and check for a cough productive of blood-tinged mucus.
• D. Inquire if a fever above 101°F (38.3°C) has occurred in the last 24 hours.

Correct answer: B

Rationale: The correct answer is B. The symptoms described by the client, excessive diaphoresis and feeling warm at night, are characteristic of perimenopause. During this period, lower estrogen levels lead to surges in follicle-stimulating hormone (FSH) and luteinizing hormone (LH), resulting in vasomotor instability, night sweats, and hot flashes. Therefore, discussing perimenopause and related comfort measures with the client is essential to provide education and support. Choice A is incorrect because explaining the effects of FSH and LH alone does not directly address the client's current symptoms. Choice C is irrelevant as it focuses on assessing lung fields and cough symptoms, which are not related to the client's menopausal symptoms. Choice D is not the best response as it is more focused on ruling out fever as a cause, which is not typically associated with the symptoms described by the client.

2. Which of the following lipid abnormalities is a risk factor for the development of atherosclerosis and peripheral vascular disease?

• A. Low concentration of triglycerides.
• B. High levels of high-density lipoprotein (HDL) cholesterol.
• C. High levels of low-density lipoprotein (LDL) cholesterol.
• D. Low levels of LDL cholesterol.

Correct answer: C

Rationale: The correct answer is C: High levels of low-density lipoprotein (LDL) cholesterol. High levels of LDL cholesterol contribute to the development of atherosclerosis and peripheral vascular disease by being deposited in the blood vessel walls, leading to the formation of plaques that can obstruct blood flow. Choice A is incorrect as a low concentration of triglycerides is not typically associated with an increased risk of atherosclerosis or PVD. Choice B is incorrect as high levels of high-density lipoprotein (HDL) cholesterol are actually considered protective against atherosclerosis as it helps remove cholesterol from arteries. Choice D is incorrect as low levels of LDL cholesterol are not typically considered a risk factor for atherosclerosis or PVD.

3. The nurse is assessing an older adult with a pacemaker who leads a sedentary lifestyle. The client reports being unable to perform activities that require physical exertion. The nurse should further assess the client for which of the following?

• A. Left ventricular atrophy.
• B. Irregular heartbeats.
• C. Peripheral vascular occlusion.
• D. Pacemaker function.

Correct answer: A

Rationale: The correct answer is A: Left ventricular atrophy. Older adults who lead sedentary lifestyles are at risk of developing left ventricular atrophy, which can lead to decreased cardiac output during physical exertion. This condition can contribute to the client's inability to perform activities requiring physical exertion. Choice B, irregular heartbeats, may be a consideration due to the presence of a pacemaker, but the client's reported inability to perform physically exerting activities is more indicative of a structural issue like left ventricular atrophy rather than a rhythm-related problem. Peripheral vascular occlusion (Choice C) is less likely to be the cause of the client's symptoms compared to the cardiac-related issue of left ventricular atrophy. While assessing pacemaker function (Choice D) is important, the client's symptoms are more suggestive of a cardiac structural issue rather than a malfunction of the pacemaker.

4. A nurse administers scopolamine as prescribed to a client in preparation for surgery. For which side effect of this medication does the nurse monitor the client?

• A. Pupil constriction
• B. Increased urine output
• C. Complaints of dry mouth
• D. Complaints of feeling sweaty

Correct answer: D

Rationale: The correct answer is D: 'Complaints of feeling sweaty.' Scopolamine, an anticholinergic medication, commonly causes the side effect of decreased sweating, not increased urine output or pupil constriction. While dry mouth is a possible side effect, it is less likely than the altered sweating pattern. Therefore, the nurse should monitor the client for complaints of feeling sweaty due to the potential side effect of decreased sweating associated with scopolamine.

5. Which of the following is a characteristic symptom of hypothyroidism?

• A. Fatigue.
• B. Weight gain.
• C. Cold intolerance.
• D. Heat intolerance.

Correct answer: C

Rationale: The correct answer is 'Cold intolerance.' Hypothyroidism is associated with a decreased metabolic rate, leading to a decreased ability to regulate body temperature and a feeling of being cold. Fatigue (Choice A) and weight gain (Choice B) are also common symptoms of hypothyroidism due to the overall slowing down of bodily functions. Heat intolerance (Choice D) is more commonly associated with hyperthyroidism, where the body's metabolism is overactive, leading to increased heat production.

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