Nursing Elites

1. A client with heart failure is experiencing pulmonary edema. Which intervention should be prioritized?

• A. Administer diuretics to reduce fluid overload.
• B. Position the client in high-Fowler's position.
• C. Administer oxygen therapy to improve oxygenation.
• D. Restrict fluid intake to prevent further fluid overload.

Correct answer: C

Rationale: In a client experiencing pulmonary edema due to heart failure, the priority intervention is to administer oxygen therapy to improve oxygenation. This helps in increasing the oxygen levels in the blood, thereby improving tissue perfusion and reducing the workload on the heart. Positioning the client in high-Fowler's position can also aid in improving oxygenation, but administering oxygen therapy directly addresses the immediate need for increased oxygen levels. Administering diuretics to reduce fluid overload and restricting fluid intake are important interventions in heart failure management, but in the acute situation of pulmonary edema, oxygen therapy takes precedence to ensure adequate oxygen supply to vital organs.

2. A patient is being treated with hormone replacement therapy (HRT) for menopausal symptoms. What are the risks associated with long-term HRT that the nurse should discuss with the patient?

• A. HRT may increase the risk of cardiovascular events and breast cancer.
• B. HRT may decrease the risk of osteoporosis.
• C. HRT may increase the risk of venous thromboembolism.
• D. HRT may improve mood and energy levels.

Correct answer: A

Rationale: The correct answer is A. Long-term HRT is associated with increased risks of cardiovascular events and breast cancer. These risks should be discussed with the patient to ensure they are informed about the potential adverse effects. Choice B is incorrect because HRT does not decrease the risk of osteoporosis; in fact, it may increase the risk of certain conditions like cardiovascular events. Choice C is incorrect as HRT is associated with an increased risk of venous thromboembolism, not a decreased risk. Choice D is incorrect because while HRT may have positive effects like improving symptoms of menopause, it is not primarily indicated for improving mood and energy levels.

3. A male patient is being treated with testosterone gel for hypogonadism. What important instruction should the nurse provide regarding the application of this medication?

• A. Apply the gel to the chest or upper arms.
• B. Apply the gel to the lower abdomen or thighs.
• C. Apply the gel to the face and neck.
• D. Apply the gel to the scalp and back.

Correct answer: A

Rationale: The correct answer is to apply the testosterone gel to the chest or upper arms. This is important to minimize the risk of transfer to others. Applying the gel to the lower abdomen, thighs, face, or neck can increase the risk of transfer to others, especially women and children who should avoid contact with testosterone gel. Applying it to the scalp and back is not recommended as these areas are not suitable for absorption of the medication.

4. 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.

5. Which patient is most likely to be diagnosed with complex regional pain syndrome II (CRPS II)?

• A. A patient who has experienced a spinal cord injury and reports severe, burning pain in his legs.
• B. A patient who reports severe pain in her hand following a surgery for carpal tunnel syndrome.
• C. A patient who develops pain in his foot following a fracture and immobilization with a cast.
• D. A patient who experiences chronic pain and swelling in his arm following a brachial plexus injury.

Correct answer: D

Rationale: Complex regional pain syndrome II (CRPS II) typically occurs after an injury to a peripheral nerve. In this case, a brachial plexus injury involves damage to the nerves that control muscles in the arm and hand, leading to chronic pain and swelling. Choices A, B, and C describe pain related to other conditions such as spinal cord injury, carpal tunnel surgery, and fracture immobilization, which are not typically associated with CRPS II.

Similar Questions