Nursing Elites

1. A client presents to the emergency department with lower right quadrant abdominal pain, fever, nausea, and occasional diarrhea. After palpating the abdomen, the client displays tenderness. What would the nurse anticipate the client to be experiencing?

• A. Pseudomembranous colitis
• B. Peptic ulcer disease
• C. Appendicitis
• D. Esophageal cancer

Correct answer: C

Rationale: The correct answer is C: Appendicitis. The symptoms described - lower right quadrant abdominal pain, fever, nausea, diarrhea, and tenderness upon palpation - are classic signs of appendicitis. Appendicitis is an inflammatory condition of the appendix that often presents with these symptoms and requires immediate medical attention. Choice A, Pseudomembranous colitis, typically presents with watery diarrhea and is associated with antibiotic use. Choice B, Peptic ulcer disease, commonly presents with epigastric pain related to meals and can be accompanied by nausea or vomiting, but it does not typically cause right lower quadrant pain. Choice D, Esophageal cancer, usually presents with symptoms related to swallowing difficulties, weight loss, and sometimes chest pain, but it is not associated with the symptoms described in the scenario.

2. A 45-year-old woman presents with fatigue, weight gain, and cold intolerance. Her thyroid function tests reveal low T3 and T4 levels and elevated TSH levels. Which of the following is the most likely diagnosis?

• A. Hyperthyroidism
• B. Hypothyroidism
• C. Euthyroid sick syndrome
• D. Subclinical hyperthyroidism

Correct answer: B

Rationale: The scenario describes a 45-year-old woman with fatigue, weight gain, cold intolerance, low T3 and T4 levels, and elevated TSH levels, which are indicative of hypothyroidism. In hypothyroidism, there is decreased production of thyroid hormones (T3 and T4) leading to elevated TSH levels as the pituitary gland tries to stimulate the thyroid gland to produce more hormones. Therefore, the correct answer is hypothyroidism (Choice B). Choice A, Hyperthyroidism, is incorrect as the patient's symptoms and thyroid function tests point towards decreased thyroid hormone levels, which is characteristic of hypothyroidism, not hyperthyroidism. Choice C, Euthyroid sick syndrome, is incorrect because this condition typically presents with normal to low T3 and T4 levels in the setting of non-thyroid illness, unlike the elevated TSH levels observed in this case. Choice D, Subclinical hyperthyroidism, is also incorrect as the patient has low T3 and T4 levels, which is not consistent with hyperthyroidism, whether clinical or subclinical.

3. A 22-year-old woman began using oral contraceptives several months ago and has presented for an appointment to discuss recent worrisome changes in her health status. Which of the following changes in the woman's health may the nurse potentially attribute to the use of oral contraceptives?

• A. Fatigue
• B. Frequent high blood pressure readings
• C. Frequent headaches without aura
• D. Nausea and vomiting

Correct answer: A

Rationale: The correct answer is A: Fatigue. Oral contraceptives can sometimes cause fatigue as a side effect. Frequent high blood pressure readings and frequent headaches without aura are less likely to be directly related to the use of oral contraceptives. Nausea and vomiting are common side effects of oral contraceptives but are not the changes typically associated with liver function affecting hormone metabolism as in the case of hepatitis C infection.

4. A male patient receiving androgen therapy is concerned about prostate cancer. What should the nurse explain about the risks associated with this therapy?

• A. Finasteride has been shown to reduce the risk of developing prostate cancer.
• B. Finasteride has no impact on the risk of developing prostate cancer.
• C. Finasteride may increase the risk of developing prostate cancer.
• D. Finasteride has no effect on the risk of prostate cancer.

Correct answer: A

Rationale: The correct answer is A. Finasteride, a type of androgen therapy, has been shown to reduce the risk of developing prostate cancer. It works by shrinking the prostate gland, which can help lower the risk of developing prostate cancer. However, while it may reduce the risk, regular screening is still recommended to monitor for any potential issues. Choice B is incorrect because finasteride does have an impact on reducing the risk of prostate cancer. Choice C is incorrect as finasteride is not known to increase the risk of developing prostate cancer. Choice D is incorrect as finasteride does have an effect on reducing the risk of prostate cancer.

5. A hospital patient's complex medical history includes a recent diagnosis of kidney cancer. Which of the following medications is used to treat metastatic kidney cancer?

• A. Filgrastim (Neupogen)
• B. Aldesleukin (Proleukin)
• C. Interferon alfa-2b (Intron A)
• D. Darbepoetin alfa (Aranesp)

Correct answer: B

Rationale: The correct answer is B: Aldesleukin (Proleukin). Aldesleukin is a medication used in the treatment of metastatic kidney cancer. It is a recombinant interleukin-2 that works by stimulating the immune system to attack cancer cells. Choice A, Filgrastim, is a medication used to stimulate the production of white blood cells. Choice C, Interferon alfa-2b, is used in the treatment of certain cancers but not specifically metastatic kidney cancer. Choice D, Darbepoetin alfa, is used to treat anemia by stimulating red blood cell production and is not indicated for metastatic kidney cancer.

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