Nursing Elites

1. What is a cause of the crystallization within the synovial fluid of the joint affected by gouty arthritis?

• A. Destruction of proteoglycans
• B. Underexcretion of uric acid
• C. Overexcretion of uric acid
• D. Increased absorption of uric acid

Correct answer: B

Rationale: The correct answer is B: Underexcretion of uric acid. Gouty arthritis is primarily caused by the underexcretion of uric acid, leading to its accumulation in joints and subsequent crystallization. Choices A, C, and D are incorrect as they do not directly relate to the pathophysiology of gout. Destruction of proteoglycans, overexcretion of uric acid, and increased absorption of uric acid are not primary causes of gouty arthritis.

2. What is the most common cause of cancer-related deaths in both men and women?

• A. Lung cancer
• B. Breast cancer
• C. Colorectal cancer
• D. Prostate cancer

Correct answer: A

Rationale: Lung cancer is the leading cause of cancer-related deaths in both men and women globally. It is strongly associated with smoking and exposure to environmental toxins. Breast cancer (choice B) primarily affects women, while colorectal cancer (choice C) and prostate cancer (choice D) are more gender-specific. Colorectal cancer is more common in both men and women but not the leading cause of cancer-related deaths.

3. A male patient is receiving androgen therapy for hypogonadism. What adverse effect should the nurse monitor for during this therapy?

• A. Increased risk of bone fractures
• B. Increased risk of cardiovascular events
• C. Increased risk of liver dysfunction
• D. Increased risk of prostate cancer

Correct answer: B

Rationale: The correct answer is B: Increased risk of cardiovascular events. Androgen therapy can lead to an increased risk of cardiovascular events like heart attacks and strokes, especially in older patients. Monitoring for signs and symptoms of cardiovascular issues is essential during this therapy. Choices A, C, and D are incorrect because androgen therapy is not typically associated with an increased risk of bone fractures, liver dysfunction, or prostate cancer.

4. What long-term risks should the nurse discuss with a patient being treated with hormone replacement therapy (HRT) for menopausal symptoms?

• A. HRT may increase the risk of cardiovascular events and breast cancer.
• B. HRT may decrease the risk of osteoporosis.
• C. HRT may improve mood and energy levels.
• D. HRT may increase the risk of venous thromboembolism.

Correct answer: A

Rationale: The correct answer is A. Long-term hormone replacement therapy (HRT) is associated with increased risks of cardiovascular events and breast cancer. These risks should be discussed with the patient to ensure they are aware of the potential adverse effects. Choice B is incorrect because HRT does not decrease the risk of osteoporosis; in fact, it has been linked to an increased risk of this condition. Choice C is incorrect as while HRT may have positive effects on mood and energy levels for some individuals, the focus here is on the long-term risks that need to be addressed. Choice D is incorrect as HRT is indeed associated with an increased risk of venous thromboembolism, but the primary focus of the question is on cardiovascular events and breast cancer.

5. A tension pneumothorax requires a needle thoracostomy and/or chest tube placement as treatment to which component of the pathophysiology of the condition?

• A. An accumulation of blood in the pleural space, which makes it difficult for the lungs to exchange gases.
• B. Extreme pain caused by a fractured rib
• C. A large accumulation of trapped air in the pleural space affecting both the lungs and heart.
• D. Sudden failure of the respiratory system due to fluid accumulation in the alveoli

Correct answer: C

Rationale: A tension pneumothorax is characterized by a large accumulation of trapped air in the pleural space, creating pressure that affects both the lungs and heart. This condition can lead to life-threatening consequences by shifting mediastinal structures and impairing cardiac function. Treatment involves decompressing the trapped air to relieve the tension. Choices A, B, and D are incorrect as they do not describe the primary pathophysiological mechanism of tension pneumothorax, which is the accumulation of air in the pleural space, not blood, rib fractures, or alveolar fluid accumulation.

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