Nursing Elites

1. When assessing a 7-year-old child's pain after an emergency appendectomy, what is the most appropriate tool for the nurse to use?

• A. Use a visual analog scale (VAS) to assess the pain.
• B. Ask the child to rate their pain on a scale of 0 to 10.
• C. Use the Wong-Baker FACES scale to assess the pain.
• D. Ask the parents to describe the child's pain behavior.

Correct answer: C

Rationale: The correct answer is to use the Wong-Baker FACES scale to assess the child's pain. This scale is specifically designed for children and uses facial expressions of varying intensities to help them communicate their pain levels effectively. Choices A and B may not be as suitable for a young child who may have difficulty understanding or using a numerical scale. Choice D involving parents may not provide an accurate reflection of the child's pain experience, as it is essential to assess the child's self-reporting.

2. In gout, a man has developed large, hard nodules around his toes and elbows. The phase of gout he is in is:

• A. asymptomatic.
• B. acute flare.
• C. the intercritical period.
• D. chronic gout.

Correct answer: D

Rationale: The man's presentation of large, hard nodules around his toes and elbows is indicative of tophi formation, which is characteristic of chronic gout. Tophi are deposits of uric acid crystals that can develop over time in untreated or poorly managed gout. During the chronic phase of gout, tophi can form in joints, soft tissues, and organs. Asymptomatic refers to a phase where there are no symptoms present. Acute flare is characterized by sudden and severe joint pain and inflammation. The intercritical period is the time between gout attacks when the patient is symptom-free.

3. A 55-year-old male patient is taking finasteride (Proscar) for benign prostatic hyperplasia (BPH). What patient teaching should the nurse provide regarding the use of this medication?

• A. Avoid taking over-the-counter antacids while on this medication.
• B. This medication may decrease libido.
• C. This medication may take several months to improve symptoms.
• D. This medication may cause increased hair growth.

Correct answer: C

Rationale: Correct Answer: The nurse should inform the patient that finasteride may take several months to improve symptoms of BPH. It is essential for patients to understand the delayed onset of action to manage their expectations and compliance. Choice A is incorrect because there is no significant interaction between finasteride and over-the-counter antacids. Choice B is incorrect as finasteride is more commonly associated with decreased libido rather than increased libido. Choice D is incorrect as finasteride is known to reduce hair growth rather than increase it.

4. An older adult patient comes to the clinic complaining of not being able to do what he used to be able to. You know that normal changes associated with aging include:

• A. Improved blood flow
• B. Slowed metabolic rate
• C. Increased brain weight
• D. Improved nerve fiber conduction

Correct answer: B

Rationale: Normal changes associated with aging include a slowed metabolic rate and decreased brain weight. Option A, 'Improved blood flow,' is incorrect as aging is generally associated with reduced vascular health rather than improved blood flow. Option D, 'Improved nerve fiber conduction,' is incorrect as aging typically leads to a decline in nerve function rather than improvement.

5. A patient is being educated about the use of raloxifene (Evista) for osteoporosis. What is the primary therapeutic action of this medication?

• A. It stimulates the formation of new bone.
• B. It decreases bone resorption and increases bone density.
• C. It increases the excretion of calcium through the kidneys.
• D. It increases calcium absorption in the intestines.

Correct answer: B

Rationale: The correct answer is B: 'It decreases bone resorption and increases bone density.' Raloxifene, a selective estrogen receptor modulator (SERM), works by decreasing bone resorption, which is the breakdown of bone, and increasing bone density. This action helps in preventing bone loss and maintaining bone strength. Choice A is incorrect because raloxifene does not stimulate the formation of new bone but rather prevents its breakdown. Choice C is incorrect as raloxifene does not increase the excretion of calcium but rather helps in maintaining calcium levels in the bones. Choice D is also incorrect as raloxifene does not directly increase calcium absorption in the intestines.

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