Nursing Elites

1. 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.

2. During a home visit to a family of three: a mother, father, and their child, the mother tells the community nurse that the father (who is not present) had hit the child on several occasions when he was drinking. The mother further explains that she has talked her husband into going to Alcoholics Anonymous and asks the nurse not to interfere so her husband won’t get angry and refuse treatment. Which of the following is the best response of the nurse?

• A. The nurse agrees not to interfere if the husband attends an Alcoholics Anonymous meeting that evening.
• B. The nurse commends the mother’s efforts and agrees to let her handle things.
• C. The nurse commends the mother’s efforts and also contacts protective services.
• D. The nurse confronts the mother’s failure to protect the child.

Correct answer: C

Rationale: In this situation, the best response for the nurse is to commend the mother's efforts in seeking help for her husband by encouraging him to attend Alcoholics Anonymous. However, it is crucial for the nurse to also contact protective services to ensure the safety and well-being of the child. Option A is incorrect as it is not appropriate to condition non-interference on the husband attending a meeting that evening. Option B is incorrect because solely letting the mother handle things might put the child at risk. Option D is incorrect as it does not address the immediate need to ensure the child's safety through involving protective services.

3. An MRI scan of a 33-year-old female client with new-onset seizures has revealed a lesion on her frontal lobe. Which of the following signs and symptoms would most likely be a direct result of this lesion?

• A. Changes in sensation or movement in the client's limbs
• B. Fluctuations in blood pressure
• C. Changes in speech and reasoning
• D. Increased intracranial pressure

Correct answer: C

Rationale: The correct answer is C: Changes in speech and reasoning. The frontal lobe is responsible for higher cognitive functions, including speech and reasoning. A lesion in this area can lead to difficulties in speech production, language comprehension, and reasoning abilities. Choices A, B, and D are incorrect. Changes in sensation or movement in the client's limbs are more associated with lesions in the motor or sensory cortices of the brain, not the frontal lobe. Fluctuations in blood pressure are often related to autonomic nervous system dysfunction, which is controlled by other brain regions. Increased intracranial pressure is typically seen in conditions like brain tumors or head trauma, not directly related to a frontal lobe lesion.

4. When a healthcare professional is reviewing lab results and notices that the erythrocytes contain an abnormally low concentration of hemoglobin, the healthcare professional calls these erythrocytes:

• A. Hyperchromic
• B. Hypochromic
• C. Macrocytic
• D. Microcytic

Correct answer: B

Rationale: Erythrocytes with an abnormally low concentration of hemoglobin are called hypochromic. Hyperchromic refers to erythrocytes with an abnormally high concentration of hemoglobin. Macrocytic indicates larger than normal red blood cells, while microcytic refers to smaller than normal red blood cells. Therefore, in this scenario, the correct term is hypochromic.

5. A 5-year-old male presents with low-set ears, a fish-shaped mouth, and involuntary rapid muscular contraction. Laboratory testing reveals decreased calcium levels. Which of the following diagnoses is most likely?

• A. B cell deficiency
• B. T cell deficiency
• C. Combined immunodeficiency
• D. Complement deficiency

Correct answer: B

Rationale: The correct answer is B: T cell deficiency. The symptoms described in the case, including low-set ears, a fish-shaped mouth, involuntary rapid muscular contraction, and decreased calcium levels, are indicative of DiGeorge syndrome. This syndrome is characterized by T cell deficiency due to thymic hypoplasia. B cell deficiency (Choice A), combined immunodeficiency (Choice C), and complement deficiency (Choice D) do not align with the clinical presentation and laboratory findings provided in the case. Therefore, T cell deficiency is the most likely diagnosis in this scenario.

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