Nursing Elites

1. A client with a history of smoking presents with a chronic cough and shortness of breath. The nurse should suspect which condition?

• A. Pulmonary fibrosis
• B. Chronic obstructive pulmonary disease (COPD)
• C. Lung cancer
• D. Pulmonary edema

Correct answer: B

Rationale: The correct answer is B: Chronic obstructive pulmonary disease (COPD). COPD is often associated with a chronic cough and shortness of breath, especially in individuals with a history of smoking. Pulmonary fibrosis (choice A) typically presents with progressive dyspnea and dry cough. Lung cancer (choice C) may present with a chronic cough, shortness of breath, and other symptoms like weight loss and hemoptysis. Pulmonary edema (choice D) presents with symptoms such as acute shortness of breath, orthopnea, and pink, frothy sputum.

2. Which of the following are signs and symptoms of myocardial infarction?

• A. Persistent chest pain which may radiate to the arm
• B. Brief sternal chest pain on inspiration
• C. Rapid respirations with left-sided weakness and numbness
• D. Left upper quadrant abdominal pain which radiates to the back and shoulder

Correct answer: A

Rationale: The correct answer is A. Persistent chest pain that may radiate to the arm is a classic symptom of myocardial infarction. This pain is typically described as crushing, pressure-like, or squeezing. Choice B is incorrect because brief sternal chest pain on inspiration is not characteristic of myocardial infarction. Choice C is incorrect because rapid respirations with left-sided weakness and numbness are not typical symptoms of myocardial infarction. Choice D is incorrect because left upper quadrant abdominal pain that radiates to the back and shoulder is not a common presentation of myocardial infarction.

3. Which of the following statements describes an active cellular membrane exchange process?

• A. Sodium moving out of cells and potassium moving into cells
• B. The movement of water from an area of low solute concentration to an area of high solute concentration
• C. The movement of insulin using a protein to travel across the cell membrane
• D. Oxygen moving across the pulmonary capillaries to an area of high carbon dioxide

Correct answer: A

Rationale: The correct answer is A. In active transport, energy is expended to move substances against their concentration gradient. Sodium moving out of cells and potassium moving into cells is an example of active transport because it requires energy to pump these ions across the cell membrane against their concentration gradients. Choices B, C, and D describe passive processes where substances move along their concentration gradients without the input of energy.

4. A male patient receiving androgen therapy is concerned about side effects. What adverse effect should the nurse monitor for during this therapy?

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

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 such as heart attack and stroke, especially in older patients. Choice A is incorrect because androgen therapy usually does not significantly increase the risk of liver dysfunction. Choice C is incorrect as androgen therapy does not increase the risk of prostate cancer; in fact, it is sometimes used in the treatment of prostate cancer. Choice D is also incorrect as androgen therapy is more likely to improve bone density and reduce the risk of fractures.

5. A client with multiple sclerosis (MS) is experiencing a relapse. Which of the following factors is most likely contributing to the relapse?

• A. Taking an over-the-counter multivitamin
• B. Experiencing high levels of emotional stress
• C. Getting a flu shot
• D. Engaging in strenuous physical activity

Correct answer: B

Rationale: Emotional stress can trigger a relapse in multiple sclerosis by exacerbating symptoms. While taking an over-the-counter multivitamin and getting a flu shot are generally safe, they are not typically known to trigger MS relapses. Engaging in strenuous physical activity, if done carefully, can actually have benefits for individuals with MS by improving strength and mobility, so it is less likely to be the cause of a relapse.

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