Nursing Elites

1. A 70-year-old woman has difficulty with driving, and she has been frequently getting lost. Her husband said she has also been acting strangely and seems to want to sleep a lot. He said the other night she kept saying she was seeing animals such as lions in her room. He says her memory is not too bad, but he is very concerned about her health. Physical examination reveals an alert woman with stable vital signs. Bradykinesia and limb rigidity are noted. These findings are consistent with:

• A. Alzheimer's disease.
• B. vascular dementia.
• C. dementia with Lewy bodies.
• D. frontotemporal dementia.

Correct answer: C

Rationale: The correct answer is dementia with Lewy bodies (DLB). Hallucinations, parkinsonian symptoms (like bradykinesia and limb rigidity), and fluctuating cognition are characteristic of DLB. Alzheimer's disease (Choice A) typically presents with memory loss as a prominent feature. Vascular dementia (Choice B) is associated with a history of strokes and step-wise cognitive decline. Frontotemporal dementia (Choice D) often presents with changes in behavior and personality rather than the parkinsonian symptoms seen in this case.

2. Thrombocytopenia is which disorder below?

• A. Increased blood coagulation
• B. Increased platelet production
• C. Increased number of infections
• D. Decreased platelet production

Correct answer: D

Rationale: Thrombocytopenia is a disorder characterized by a decreased platelet count or decreased platelet production, which affects blood clotting. Choice A, 'Increased blood coagulation,' is incorrect as thrombocytopenia is associated with decreased platelets, leading to impaired clotting. Choice B, 'Increased platelet production,' is incorrect as thrombocytopenia is characterized by a decrease in platelet production. Choice C, 'Increased number of infections,' is unrelated to thrombocytopenia, which primarily involves low platelet levels.

3. A patient is prescribed estradiol (Estrace) for hormone replacement therapy (HRT). What should the nurse monitor during this therapy?

• A. Blood glucose levels
• B. Liver function tests
• C. Kidney function tests
• D. Blood pressure

Correct answer: B

Rationale: During estradiol therapy, monitoring liver function tests is essential due to the potential for liver dysfunction. Estradiol can affect liver function, making it crucial to monitor enzyme levels. Choice A, blood glucose levels, is not directly impacted by estradiol therapy, making it an incorrect choice. Choice C, kidney function tests, is not typically affected by estradiol therapy, so it is not the priority for monitoring. Choice D, blood pressure, is also not the primary parameter to monitor during estradiol therapy unless there are pre-existing conditions that warrant such monitoring.

4. What is reperfusion injury?

• A. Healing bone tissue after fracture
• B. Skin wound tunneling and shear
• C. Secondary injury after reestablishing blood flow
• D. Injury after blood transfusion

Correct answer: C

Rationale: Reperfusion injury refers to the secondary injury that occurs after blood flow is reestablished following ischemia. This process leads to tissue damage due to the sudden reintroduction of oxygen and nutrients, causing oxidative stress, inflammation, and cell death. Choice A is incorrect as it describes the normal healing process of bone tissue after a fracture. Choice B is incorrect as it describes specific mechanisms related to skin wounds, not reperfusion injury. Choice D is incorrect as it refers to a different concept, which is adverse reactions or complications that can occur after a blood transfusion, not reperfusion injury.

5. When taking medroxyprogesterone acetate (Provera) for the treatment of endometriosis, what important instruction should the nurse provide about taking this medication?

• A. Take the medication at the same time each day to maintain consistent hormone levels.
• B. Medroxyprogesterone should be taken without regard to meals.
• C. Discontinuing medroxyprogesterone should only be done under the guidance of a healthcare provider.
• D. Medroxyprogesterone is typically taken daily rather than weekly for the treatment of endometriosis.

Correct answer: A

Rationale: When taking medroxyprogesterone acetate for endometriosis, it is essential to maintain consistent hormone levels by taking the medication at the same time each day. This consistency helps optimize the effectiveness of the treatment. Choice B is incorrect because medroxyprogesterone should be taken without regard to meals, not necessarily with food. Choice C is incorrect because discontinuing the medication without consulting a healthcare provider can be harmful and may not address side effects appropriately. Choice D is incorrect as medroxyprogesterone is typically taken daily to manage endometriosis symptoms, not weekly, to ensure continuous therapy and symptom control.

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