Nursing Elites

1. A 52-year-old has made an appointment with his primary care provider and has reluctantly admitted that his primary health concern is erectile dysfunction (ED). He describes the problem as increasing in severity and consequent distress. Which of the nurse's assessment questions is most likely to address a common cause of ED?

• A. “How would you describe your overall health status?”
• B. “Are you taking any medications for high blood pressure?”
• C. “How has this issue been impacting your relationship?”
• D. “Have you experienced any recent injuries?”

Correct answer: B

Rationale: In the context of erectile dysfunction (ED), medication use is a crucial factor to consider. Many medications, including those used for high blood pressure, can contribute to ED as a side effect. Asking about medication use, particularly for conditions like high blood pressure, can help identify a common cause of ED. Choices A, C, and D do not directly address potential causes related to medication use, making them less likely to reveal a common underlying issue for ED in this case.

2. A 70-year-old client presents with weakness and sensory loss in the right hand and foot. The client also exhibits speech difficulties. Which condition is the client most likely experiencing?

• A. Transient ischemic attack (TIA)
• B. Brain tumor
• C. Cerebral infarction
• D. Multiple sclerosis

Correct answer: C

Rationale: The correct answer is C: Cerebral infarction (stroke). In this case, the client's symptoms of weakness and sensory loss in the right hand and foot, along with speech difficulties, are indicative of a stroke. These symptoms are commonly seen in individuals experiencing a cerebral infarction, where a blockage in blood flow to the brain leads to neurological deficits. Choices A, B, and D are less likely as transient ischemic attacks (TIAs) typically have temporary symptoms with no permanent damage, brain tumors may present with a different set of symptoms depending on their location, and multiple sclerosis usually presents with a relapsing-remitting pattern of neurological symptoms rather than sudden onset unilateral deficits.

3. An influenza outbreak has spread through a long-term care residence, affecting many of the residents with severe malaise, fever, and nausea and vomiting. In an effort to curb the outbreak, the nurse has liaised with a physician to see if residents may be candidates for treatment with what drug?

• A. Saquinavir mesylate
• B. Oseltamivir phosphate
• C. Lamivudine
• D. Ribavirin

Correct answer: B

Rationale: The correct answer is B: Oseltamivir phosphate. Oseltamivir is an antiviral medication used to treat influenza infections. It works by inhibiting the neuraminidase enzyme of the influenza virus, reducing the spread of the virus in the body. Saquinavir mesylate (choice A) is used in the treatment of HIV, not influenza. Lamivudine (choice C) is also an antiviral medication primarily used in the treatment of HIV and hepatitis B, not influenza. Ribavirin (choice D) is used to treat certain viral infections like hepatitis C, respiratory syncytial virus (RSV), and some viral hemorrhagic fevers, but it is not a first-line treatment for influenza.

4. The parents of a 3-year-old boy have brought him to a pediatrician for assessment of the boy's late ambulation and frequent falls. Subsequent muscle biopsy has confirmed a diagnosis of Duchenne muscular dystrophy. Which teaching point should the physician include when explaining the child's diagnosis to his parents?

• A. Your child may develop breathing difficulties as the disease progresses.
• B. Your child is likely to benefit from physical therapy and exercise.
• C. This condition can be cured with early intervention and treatment.
• D. The disease is caused by inflammation in the muscles, which leads to weakness.

Correct answer: A

Rationale: The correct teaching point that the physician should include when explaining Duchenne muscular dystrophy to the parents is that 'Your child may develop breathing difficulties as the disease progresses.' Duchenne muscular dystrophy is a progressive condition that affects muscle strength, including respiratory muscles, leading to breathing difficulties as the disease advances. Choice B is incorrect because while physical therapy and exercise can help maintain muscle function and mobility, they do not cure the condition. Choice C is incorrect because Duchenne muscular dystrophy is a genetic disorder with no known cure. Choice D is incorrect as Duchenne muscular dystrophy is primarily characterized by a lack of dystrophin protein due to genetic mutations, not inflammation in the muscles.

5. In which disorder does a Staphylococcus aureus organism produce a toxin leading to exfoliation and large blister formation?

• A. Herpes simplex I virus
• B. Herpes simplex II virus
• C. Necrotizing fasciitis
• D. Cellulitis

Correct answer: B

Rationale: The correct answer is 'Herpes simplex I virus.' This disorder is known as Staphylococcal scalded skin syndrome (SSSS), where a Staphylococcus aureus organism produces an exfoliative toxin leading to skin exfoliation and large blister formation. Choices B, C, and D are incorrect. Herpes simplex viruses (I and II) cause different types of skin lesions and do not lead to exfoliation and blister formation. Necrotizing fasciitis is a severe soft tissue infection, while cellulitis is a bacterial skin infection that does not typically involve exfoliation and blister formation like in SSSS.

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