Nursing Elites

1. A healthcare professional is assessing a client with suspected myasthenia gravis. Which symptom would the healthcare professional expect to find?

• A. Muscle atrophy
• B. Facial weakness
• C. Ptosis and diplopia
• D. Increased muscle tone

Correct answer: C

Rationale: Ptosis (drooping eyelid) and diplopia (double vision) are classic symptoms of myasthenia gravis. Muscle atrophy (Choice A) is not a typical early manifestation of myasthenia gravis. While facial weakness (Choice B) can occur, it is not as specific as ptosis and diplopia. Increased muscle tone (Choice D) is more indicative of conditions like spasticity, not myasthenia gravis.

2. In gout, a man has developed large, hard nodules around his toes and elbows. The phase of gout he is in is:

• A. asymptomatic.
• B. acute flare.
• C. the intercritical period.
• D. chronic gout.

Correct answer: D

Rationale: The man's presentation of large, hard nodules around his toes and elbows is indicative of tophi formation, which is characteristic of chronic gout. Tophi are deposits of uric acid crystals that can develop over time in untreated or poorly managed gout. During the chronic phase of gout, tophi can form in joints, soft tissues, and organs. Asymptomatic refers to a phase where there are no symptoms present. Acute flare is characterized by sudden and severe joint pain and inflammation. The intercritical period is the time between gout attacks when the patient is symptom-free.

3. A 30-year-old male was diagnosed with HIV. Which of the following treatments would be most effective?

• A. Reverse transcriptase inhibitors
• B. Protease inhibitors
• C. Entrance inhibitors
• D. Highly active antiretroviral therapy

Correct answer: D

Rationale: The correct answer is D: Highly active antiretroviral therapy (HAART). HAART involves a combination of different classes of antiretroviral drugs, which can effectively suppress the HIV virus, reduce the viral load, and improve the immune function. While choices A, B, and C are also used in HIV treatment, the most effective approach is a combination therapy like HAART due to its ability to target the virus at different stages of its life cycle, reducing the risk of drug resistance and improving treatment outcomes.

4. Rhabdomyolysis can result in serious complications. In addition to muscle pain and weakness, a patient will complain of:

• A. paresthesias.
• B. bone pain.
• C. dark urine.
• D. diarrhea.

Correct answer: C

Rationale: Dark urine is a classic symptom of rhabdomyolysis. When muscle breakdown occurs, myoglobin is released into the bloodstream and filtered by the kidneys, leading to dark urine. Paresthesias (choice A) refer to abnormal sensations like tingling or numbness and are not typically associated with rhabdomyolysis. Bone pain (choice B) is not a prominent symptom of rhabdomyolysis. Diarrhea (choice D) is not a common complaint in rhabdomyolysis cases and is not directly related to muscle breakdown.

5. A 74-year-old woman states that many of her peers underwent hormone replacement therapy (HRT) in years past. The woman asks the nurse why her primary care provider has not yet proposed this treatment for her. What fact should underlie the nurse's response to the woman?

• A. The risks of stroke and breast cancer are unacceptably high in women taking HRT.
• B. HRT was found to cause mood disturbances in many women who used it long term.
• C. HRT was found to be a significant risk factor for bone fractures and osteoporosis.
• D. The risks of chronic obstructive pulmonary disease were found to be significantly higher in women using HRT.

Correct answer: A

Rationale: The correct answer is A because the main reason HRT is not recommended for all women is due to the increased risks of stroke and breast cancer associated with its use. Hormone replacement therapy (HRT) has been linked to an elevated risk of stroke and breast cancer, which outweigh its potential benefits for many individuals. Choices B, C, and D are incorrect as they do not address the primary concerns regarding HRT use. While HRT can indeed cause mood disturbances and may affect bone health, the significant risks of stroke and breast cancer are the primary reasons why healthcare providers may choose not to recommend HRT for some women.

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