Nursing Elites

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

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

Correct answer: A

Rationale: The correct answer is A: Increased risk of cardiovascular events. Testosterone therapy for hypogonadism is associated with an increased risk of cardiovascular events, such as myocardial infarction and stroke. Monitoring for signs and symptoms of cardiovascular issues is crucial during testosterone therapy. Choices B, C, and D are incorrect because testosterone therapy is not typically associated with an increased risk of liver dysfunction, prostate cancer, or bone fractures.

2. Following cardiothoracic surgery where controlled therapeutic hypothermia was utilized to decrease metabolic demands, the nurse responsible for monitoring this client postoperatively should be assessing for which potential complication related to cold cardioplegia?

• A. Thrombocytopenia
• B. Hypokalemia
• C. Hyperglycemia
• D. Coagulopathy

Correct answer: D

Rationale: Coagulopathy is the correct answer. During therapeutic hypothermia, which lowers the body's temperature to reduce metabolic demands post-surgery, coagulopathy, or impaired blood clotting, is a potential complication due to the effects of cold cardioplegia. Thrombocytopenia (choice A) refers to a low platelet count and is not directly related to cold cardioplegia. Hypokalemia (choice B) is a condition of low potassium levels, and hyperglycemia (choice C) is high blood sugar levels, neither of which are primary complications of cold cardioplegia.

3. A 21-year-old female was recently diagnosed with iron deficiency anemia. In addition to fatigue and weakness, which of the following clinical signs and symptoms would she most likely exhibit?

• A. Hyperactivity
• B. Spoon-shaped nails
• C. Gait problems
• D. Petechiae

Correct answer: B

Rationale: The correct answer is B: Spoon-shaped nails. In iron deficiency anemia, spoon-shaped nails (koilonychia) are a common symptom due to changes in the nail bed. This condition is known as Plummer-Vinson syndrome. While fatigue and weakness are common in iron deficiency anemia, hyperactivity (choice A) is not typically associated with this condition. Gait problems (choice C) and petechiae (choice D) are more commonly seen in other medical conditions and are not characteristic of iron deficiency anemia.

4. What important instruction should the nurse provide regarding the application of testosterone gel in a patient with hypogonadism?

• A. Apply the gel to the chest or upper arms and allow it to dry completely before dressing.
• B. Apply the gel to the face and neck for maximum absorption.
• C. Apply the gel to the genitals for improved results.
• D. Apply the gel to the scalp and back for better results.

Correct answer: A

Rationale: The correct instruction for applying testosterone gel in a patient with hypogonadism is to apply it to the chest or upper arms and allow it to dry completely before dressing. This method helps avoid transfer to others. Applying the gel to the face, neck, or genitals is not recommended as it can lead to unintended exposure to others. Additionally, applying the gel to the scalp and back is not a standard or effective route of administration for testosterone gel. Therefore, choice A is the correct answer as it ensures proper application and safety.

5. A patient with systemic candidiasis has been prescribed flucytosine. The nurse should be aware of the need to administer this drug with which of the following?

• A. Vitamin D and calcium supplements
• B. Fluconazole (Diflucan)
• C. Amphotericin B
• D. Penicillin G

Correct answer: C

Rationale: The correct answer is C: Amphotericin B. When treating systemic candidiasis, Amphotericin B is the drug of choice, not flucytosine. Amphotericin B is an antifungal medication used to treat severe fungal infections like systemic candidiasis. Choices A, B, and D are incorrect because vitamin D and calcium supplements, fluconazole, and penicillin G are not the drugs of choice for treating systemic candidiasis.

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