Nursing Elites

1. A 60-year-old male client with a long history of back pain has had little success with a variety of analgesic regimens that his family physician has prescribed. He has recently been diagnosed with a chronic pain disorder. Which teaching points about chronic pain would his physician most likely emphasize to the client?

• A. Chronic pain is often difficult to treat and requires a multimodal approach.
• B. Chronic pain indicates that an underlying injury has not healed properly.
• C. Chronic pain can be managed with a single long-term medication.
• D. Chronic pain is typically less severe than acute pain but lasts longer.

Correct answer: A

Rationale: The correct answer is A. Chronic pain is often complex and challenging to treat, necessitating a multimodal approach that may include medication, physical therapy, and behavioral therapy. Choice B is incorrect because chronic pain does not always indicate that an underlying injury has not healed properly; it can persist even after the initial injury has healed. Choice C is incorrect as chronic pain management usually involves a combination of treatments rather than relying solely on a single long-term medication. Choice D is incorrect because chronic pain is not necessarily less severe than acute pain; it can vary in intensity and duration depending on the individual and underlying condition.

2. An older adult patient has just sheared the skin on her elbow while attempting to boost herself up in bed, an event that has precipitated acute inflammation in the region surrounding the wound. Which of the following events will occur during the vascular stage of the patient's inflammation?

• A. Outpouring of exudate into interstitial spaces
• B. Chemotaxis
• C. Accumulation of leukocytes along epithelium
• D. Phagocytosis of cellular debris

Correct answer: A

Rationale: During the vascular stage of inflammation, there is an outpouring of exudate into the interstitial spaces, leading to swelling and edema. Choice B, chemotaxis, occurs during the cellular stage of inflammation, where leukocytes move to the site of injury in response to chemical signals. Choice C, accumulation of leukocytes along the epithelium, is not a typical event during the vascular stage. Phagocytosis of cellular debris, as in choice D, mainly occurs during the resolution stage of inflammation.

3. When discussing the risks associated with hormone replacement therapy (HRT) with a patient who has a history of coronary artery disease, what should the nurse emphasize?

• A. HRT may increase the risk of cardiovascular events such as heart attack and stroke.
• B. HRT may increase the risk of osteoporosis.
• C. HRT may decrease the risk of venous thromboembolism.
• D. HRT may increase the risk of breast cancer.

Correct answer: A

Rationale: The correct answer is A. Hormone replacement therapy (HRT) is associated with an increased risk of cardiovascular events, such as heart attack and stroke, especially in patients with a history of coronary artery disease. Choice B is incorrect because HRT is actually known to decrease the risk of osteoporosis. Choice C is incorrect as HRT is associated with an increased risk of venous thromboembolism. Choice D is also incorrect as HRT may slightly increase the risk of breast cancer.

4. A client with a history of rheumatic fever presents with signs of heart failure. What is the likely underlying cause?

• A. Infective endocarditis
• B. Coronary artery disease
• C. Mitral valve stenosis
• D. Aortic regurgitation

Correct answer: C

Rationale: The correct answer is C: Mitral valve stenosis. Rheumatic fever can lead to scarring and thickening of the heart valves, often affecting the mitral valve. This stenosis can impede blood flow from the left atrium to the left ventricle, eventually causing heart failure. Choice A, infective endocarditis, is an infection of the endocardium, the inner lining of the heart chambers and valves, and is not directly related to rheumatic fever. Choice B, coronary artery disease, involves the obstruction of coronary arteries supplying the heart muscle with blood, leading to ischemia and not typically associated with rheumatic fever. Choice D, aortic regurgitation, is the backflow of blood from the aorta to the left ventricle and is not a common consequence of rheumatic fever.

5. A 9-year-old girl has a diffuse collection of symptoms that are indicative of deficits in endocrine and autonomic nervous system control. She also suffers from persistent fluid and electrolyte imbalances. On which aspect of the nervous system listed below would her health care providers focus their diagnostic efforts?

• A. The thalamus
• B. The pituitary
• C. The hypothalamus
• D. The midbrain

Correct answer: C

Rationale: The correct answer is C: The hypothalamus. The hypothalamus plays a central role in regulating endocrine and autonomic functions, including fluid and electrolyte balance. In this case, the girl's symptoms of deficits in endocrine and autonomic nervous system control, along with fluid and electrolyte imbalances, point towards dysfunction in the hypothalamus. Choices A, B, and D are incorrect because the thalamus is mainly involved in sensory relay, the pituitary gland regulates various hormones but is controlled by the hypothalamus, and the midbrain is responsible for motor control and arousal, not endocrine or autonomic functions.

Similar Questions