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. A patient is administered isoniazid (INH) for tuberculosis. Which of the following adverse effects will result in discontinuation of the medication?

• A. Weight gain
• B. Jaundice
• C. Fever
• D. Arthralgia

Correct answer: B

Rationale: The correct answer is B: Jaundice. Isoniazid (INH) is known to cause hepatotoxicity, which can manifest as jaundice. Jaundice is a serious adverse effect that warrants immediate discontinuation of the medication to prevent further liver damage. Weight gain, fever, and arthralgia are not typically associated with isoniazid use and would not necessitate discontinuation of the medication.

3. A patient is prescribed sildenafil (Viagra) for erectile dysfunction. What critical contraindication should the nurse review with the patient?

• A. Use of nitrates
• B. Use of antihypertensive medications
• C. History of hypertension
• D. History of peptic ulcer disease

Correct answer: A

Rationale: The correct answer is A: Use of nitrates. Sildenafil (Viagra) is contraindicated in patients taking nitrates due to the risk of severe hypotension. Nitrates and sildenafil both cause vasodilation, which can lead to a dangerous drop in blood pressure. Choice B (Use of antihypertensive medications) is incorrect because antihypertensive medications are not a critical contraindication for sildenafil use. Choice C (History of hypertension) is incorrect as it is not a contraindication for sildenafil; in fact, sildenafil is sometimes used in patients with hypertension. Choice D (History of peptic ulcer disease) is also incorrect as it is not a critical contraindication for sildenafil use.

4. In menopausal women, what is the primary goal of estrogen therapy?

• A. To relieve menopausal symptoms
• B. To prevent osteoporosis
• C. To increase calcium absorption
• D. To maintain bone strength

Correct answer: B

Rationale: The primary goal of estrogen therapy in menopausal women is to prevent osteoporosis by maintaining bone density. Estrogen helps in preserving bone mass and reducing the risk of fractures. While estrogen therapy may alleviate some menopausal symptoms, such as hot flashes, its primary focus is on bone health rather than symptom management. Increasing calcium absorption and maintaining bone strength are outcomes of preventing osteoporosis rather than the primary goal of estrogen therapy.

5. A 75-year-old male presents with chest pain on exertion. The chest pain is most likely due to hypoxic injury secondary to:

• A. Malnutrition
• B. Free radicals
• C. Ischemia
• D. Chemical toxicity

Correct answer: C

Rationale: The correct answer is C: Ischemia. In this scenario, the 75-year-old male experiences chest pain on exertion, which is indicative of angina. Angina is primarily caused by reduced blood flow to the heart muscle, leading to hypoxic injury. This condition is known as ischemia. Options A, B, and D are incorrect. Malnutrition does not typically cause chest pain related to exertion. Free radicals and chemical toxicity are not common causes of chest pain in the context described. Therefore, the most likely cause of chest pain in this case is ischemia due to reduced blood flow.

Similar Questions