Nursing Elites

1. A male client expresses concern about how a hypophysectomy will affect his sexual function. Which of the following statements provides the most accurate information about the physiologic effects of hypophysectomy?

• A. Removing the source of excess hormone should restore the client's libido, erectile function, and fertility.
• B. Potency will be restored, but the client will remain infertile.
• C. Fertility will be restored, but impotence and decreased libido will persist.
• D. Exogenous hormones will be needed to restore erectile function after the adenoma is removed.

Correct answer: A

Rationale: Choice A is the most accurate statement regarding the physiologic effects of hypophysectomy on sexual function. The client's sexual problems are directly related to excessive hormone levels. Removing the source of excess hormone secretion through hypophysectomy should allow the client to return to a normal physiologic pattern, which includes restoring libido, erectile function, and fertility. Choices B, C, and D are incorrect. Choice B incorrectly states that the client will remain infertile, which is not necessarily true after a hypophysectomy. Choice C inaccurately suggests that fertility will be restored while impotence and decreased libido will persist, which is not aligned with the expected outcomes of hypophysectomy. Choice D is incorrect because exogenous hormones are typically not needed to restore erectile function after the adenoma is removed; rather, the removal of the source of excessive hormone secretion should address the sexual function concerns.

2. After the administration of t-PA, what should the nurse do?

• A. Observe the client for chest pain.
• B. Monitor for fever.
• C. Review the 12-lead electrocardiogram (ECG).
• D. Auscultate breath sounds.

Correct answer: A

Rationale: After the administration of t-PA, the nurse should observe the client for chest pain. Chest pain post t-PA administration could indicate reocclusion of the coronary artery, a serious complication that requires immediate intervention. Monitoring for fever (choice B) is not specifically associated with t-PA administration. While reviewing the 12-lead ECG (choice C) is important for assessing cardiac function, it may not be the immediate priority right after t-PA administration. Auscultating breath sounds (choice D) is important for assessing respiratory status but is not the most crucial assessment following t-PA administration.

3. The client with chronic renal failure is being educated about the importance of a low-sodium diet. Which of the following statements by the client indicates a need for further teaching?

• A. I can eat canned vegetables as long as I rinse them first.
• B. I can use table salt sparingly.
• C. I can eat frozen dinners if they are labeled low-sodium.
• D. I can eat whatever I want as long as I avoid salty foods.

Correct answer: B

Rationale: The correct answer is B. Clients with chronic renal failure need to strictly limit their sodium intake. Advising the client to use table salt sparingly is incorrect as they should avoid table salt altogether to adhere to a low-sodium diet. Choice A is correct as rinsing canned vegetables can help reduce their sodium content. Choice C is correct as consuming frozen dinners labeled low-sodium can be a suitable option. Choice D is incorrect as it implies that avoiding only salty foods is sufficient, when in fact, overall sodium intake needs to be monitored closely.

4. What is the primary purpose of administering IV fluids to a patient in septic shock?

• A. To reduce blood pressure.
• B. To increase cardiac output.
• C. To stabilize blood glucose levels.
• D. To maintain adequate tissue perfusion.

Correct answer: D

Rationale: The primary purpose of administering IV fluids to a patient in septic shock is to maintain adequate tissue perfusion. In septic shock, there is a significant drop in blood pressure and systemic vascular resistance leading to poor tissue perfusion. IV fluids help to restore intravascular volume, improve perfusion to vital organs, and prevent organ failure. Choice A ('To reduce blood pressure') is incorrect because IV fluids in septic shock aim to restore tissue perfusion rather than lower blood pressure. Choice B ('To increase cardiac output') is incorrect as the primary goal is to improve tissue perfusion, not specifically increase cardiac output. Choice C ('To stabilize blood glucose levels') is unrelated to the primary purpose of administering IV fluids in septic shock, which is to address the compromised tissue perfusion.

5. A client with chronic renal failure is receiving erythropoietin therapy. The nurse should assess the client for which of the following side effects?

• A. Hypotension.
• B. Hypertension.
• C. Hyperglycemia.
• D. Hypercalcemia.

Correct answer: B

Rationale: The correct answer is B: Hypertension. Erythropoietin therapy can lead to an increase in blood pressure, making hypertension a common side effect that the nurse should closely monitor. Hypotension (choice A) is not typically associated with erythropoietin therapy. Hyperglycemia (choice C) and hypercalcemia (choice D) are not commonly linked to erythropoietin therapy in clients with chronic renal failure, making them incorrect choices.

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