Nursing Elites

1. A 50-year-old woman has had a relapse of her multiple sclerosis (MS) after several years of being symptom-free. Which of the following factors is most likely to have contributed to her relapse?

• A. Emotional stress
• B. Dietary indiscretion
• C. Physical overexertion
• D. Adequate rest and relaxation

Correct answer: C

Rationale: The correct answer is C: Physical overexertion. In individuals with multiple sclerosis (MS), physical overexertion can exacerbate symptoms and contribute to a relapse. It is important for individuals with MS to balance physical activity to avoid triggering symptom reoccurrence. Choices A, B, and D are less likely to have directly contributed to the relapse. Emotional stress and dietary indiscretion may play a role in exacerbating symptoms in some individuals, but physical overexertion is more commonly associated with MS relapses. Adequate rest and relaxation are important for overall well-being but are not typically linked to MS relapses.

2. Which of the following is not included in the care plan of a client with moderate cognitive impairment involving dementia of the Alzheimer’s type?

• A. Daily structured schedule
• B. Positive reinforcement for performing activities of daily living
• C. Stimulating environment
• D. Use of validation techniques

Correct answer: C

Rationale: In the care plan for a client with moderate cognitive impairment involving Alzheimer's type dementia, a stimulating environment is not included as it can potentially increase confusion. Therefore, it is important to provide a familiar, structured, and predictable environment to reduce stress and disorientation. Daily structured schedules help in maintaining routine and familiarity, positive reinforcement encourages engagement in activities, and validation techniques help in communicating effectively with the client by acknowledging their feelings and reality orientation.

3. What does a client's symptoms of headache, vomiting, blurred vision, and loss of consciousness following a concussion indicate?

• A. Increased intracranial pressure
• B. Lower extremity compartment syndrome
• C. Consuming too much food at once
• D. Improved kidney function

Correct answer: A

Rationale: The symptoms of headache, vomiting, blurred vision, and loss of consciousness following a concussion are indicative of increased intracranial pressure. These symptoms suggest a serious condition that can occur after head trauma, requiring immediate medical attention. Lower extremity compartment syndrome presents with symptoms related to pressure build-up in the muscles of the legs, not the head. Consuming too much food at once does not manifest with these neurological symptoms. Improved kidney function would not present with symptoms such as headache, vomiting, blurred vision, and loss of consciousness.

4. Why is a beta-blocker prescribed to a client with a history of myocardial infarction?

• A. To reduce myocardial oxygen demand.
• B. To increase cardiac output.
• C. To prevent arrhythmias.
• D. To prevent the development of angina.

Correct answer: A

Rationale: The primary reason for administering a beta-blocker to a client with a history of myocardial infarction is to reduce myocardial oxygen demand. By reducing myocardial oxygen demand, beta-blockers help decrease the workload on the heart, making it easier for the heart to function effectively. This is crucial for clients with a history of myocardial infarction to prevent further damage to the heart. Choice B is incorrect because beta-blockers do not aim to increase cardiac output; instead, they help improve cardiac function by reducing workload. Choice C is incorrect because while beta-blockers can help prevent certain arrhythmias, the primary reason for their use in this case is to reduce myocardial oxygen demand. Choice D is incorrect as preventing angina is not the primary purpose of administering beta-blockers to a client with a history of myocardial infarction.

5. A patient with benign prostatic hyperplasia (BPH) is prescribed finasteride (Proscar). What outcome should the nurse expect to observe if the medication is effective?

• A. Increased urinary frequency and urgency
• B. Decreased prostate size
• C. Increased prostate size
• D. Decreased blood pressure

Correct answer: B

Rationale: The correct answer is B: Decreased prostate size. Finasteride is a medication used to reduce the size of the prostate gland in patients with BPH. By decreasing the size of the prostate, symptoms such as urinary frequency and urgency are improved. Choice A is incorrect as the medication aims to decrease, not increase, urinary symptoms. Choice C is incorrect because the goal of finasteride is to reduce, not increase, the prostate size. Choice D is also incorrect as finasteride is not indicated for lowering blood pressure.

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