Nursing Elites

1. A client with a history of chronic alcoholism presents to the emergency department with a complaint of double vision. Which cranial nerve is most likely involved?

• A. Cranial nerve I (Olfactory)
• B. Cranial nerve III (Oculomotor)
• C. Cranial nerve VI (Abducens)
• D. Cranial nerve VII (Facial)

Correct answer: C

Rationale: The correct answer is Cranial nerve VI (Abducens). Chronic alcoholism can lead to damage to the abducens nerve, which controls the lateral movement of the eye. This damage can result in symptoms like double vision. Cranial nerve I (Olfactory) is responsible for the sense of smell and is not related to eye movement. Cranial nerve III (Oculomotor) controls most of the eye movements but is less likely to be affected in chronic alcoholism than the abducens nerve. Cranial nerve VII (Facial) is responsible for facial movements and is not associated with double vision.

2. Which of the following statements characterizes irritable bowel syndrome?

• A. Typically does not cause anemia
• B. Not generally associated with intestinal E. coli
• C. Can be associated with anxiety and/or depression
• D. Not often associated with bloody diarrhea

Correct answer: C

Rationale: Irritable bowel syndrome (IBS) is a gastrointestinal disorder characterized by abdominal pain, bloating, and changes in bowel habits. While IBS can lead to symptoms like diarrhea or constipation, it typically does not cause anemia (choice A), is not generally associated with intestinal E. coli (choice B), and is not often associated with bloody diarrhea (choice D). However, IBS can indeed be associated with anxiety and/or depression (choice C) due to the gut-brain axis, a bidirectional communication system between the gut and the brain. This association is well-documented in IBS patients, highlighting the importance of considering psychological factors in managing the condition.

3. Medroxyprogesterone acetate (Provera) is indicated for the treatment of women with

• A. uterine bleeding.
• B. cervical cancer.
• C. ovarian cancer.
• D. fibromyalgia.

Correct answer: A

Rationale: Medroxyprogesterone acetate (Provera) is commonly used to treat conditions like abnormal uterine bleeding, amenorrhea, and endometriosis. It helps regulate the menstrual cycle and reduce excessive bleeding. Therefore, the correct answer is A. Choice B, cervical cancer, is incorrect because Provera is not indicated for the treatment of cancer. Choice C, ovarian cancer, is also incorrect as Provera is not a primary treatment for ovarian cancer. Choice D, fibromyalgia, is unrelated to the use of medroxyprogesterone acetate.

4. Which of the following is a common cause of secondary hypertension?

• A. Primary aldosteronism
• B. Essential hypertension
• C. White coat hypertension
• D. Prehypertension

Correct answer: A

Rationale: Primary aldosteronism is a common cause of secondary hypertension. In primary aldosteronism, there is an overproduction of aldosterone from the adrenal glands, leading to increased sodium retention and potassium excretion, ultimately resulting in high blood pressure. Essential hypertension (Choice B) is the most common type of hypertension, but it is considered primary hypertension, not secondary. White coat hypertension (Choice C) refers to elevated blood pressure readings in a clinical setting due to anxiety but not in daily life. Prehypertension (Choice D) is a condition where blood pressure levels are elevated but not high enough to be classified as hypertension.

5. A patient is receiving oral nystatin suspension for a fungal infection of the mouth. Which of the following adverse effects is most likely to be experienced with this form of nystatin?

• A. Local irritation
• B. Burning
• C. Nausea
• D. Urinary urgency

Correct answer: A

Rationale: The correct answer is A: Local irritation. When using oral nystatin suspension for a fungal infection of the mouth, local irritation is the most likely adverse effect that a patient may experience. Nystatin is generally well-tolerated, but some patients may develop local irritation, such as mouth or throat irritation. Choices B, C, and D are less likely adverse effects of oral nystatin suspension. Burning, nausea, and urinary urgency are not commonly associated with nystatin use for a fungal infection of the mouth.

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