Nursing Elites

1. A patient with hyperthyroidism is prescribed propylthiouracil (PTU). What is the primary purpose of this medication?

• A. Increase thyroid hormone production
• B. Suppress thyroid hormone production
• C. Enhance iodine absorption
• D. Stimulate the thyroid gland

Correct answer: B

Rationale: Propylthiouracil (PTU) is a medication used to treat hyperthyroidism by suppressing the production of thyroid hormones. It works by inhibiting the enzyme responsible for the synthesis of thyroid hormones, thereby reducing their levels in the body. This helps to alleviate the symptoms of hyperthyroidism and restore thyroid hormone levels to normal range.

2. A 65-year-old man presents with weight loss, jaundice, and a palpable mass in the right upper quadrant. Laboratory tests reveal elevated bilirubin and alkaline phosphatase levels. What is the most likely diagnosis?

• A. Gallstones
• B. Hepatitis
• C. Pancreatic cancer
• D. Primary biliary cirrhosis

Correct answer: C

Rationale: The combination of weight loss, jaundice, a palpable mass in the right upper quadrant, and elevated bilirubin and alkaline phosphatase levels strongly suggests pancreatic cancer. The presentation is classic for pancreatic malignancy, which commonly presents with obstructive jaundice due to the tumor blocking the common bile duct, leading to elevated bilirubin and alkaline phosphatase levels. Weight loss is a common symptom of advanced pancreatic cancer. The palpable mass in the right upper quadrant corresponds to the location of the pancreas. Gallstones typically manifest with different symptoms, while hepatitis and primary biliary cirrhosis are less likely to present with a palpable mass and weight loss in this scenario.

3. When implementing patient teaching for a patient admitted with hyperglycemia and newly diagnosed diabetes mellitus scheduled for discharge the second day after admission, what is the priority action for the nurse?

• A. Instruct about the increased risk of cardiovascular disease.
• B. Provide detailed information about dietary glucose control.
• C. Teach glucose self-monitoring and medication administration.
• D. Give information about the effects of exercise on glucose control.

Correct answer: C

Rationale: The priority action for the nurse when time is limited is to focus on essential teaching. In this scenario, the patient should be educated on how to self-monitor glucose levels and administer medications to control glucose levels. This empowers the patient with immediate skills for managing their condition. Instructing about the increased risk of cardiovascular disease (choice A) is important but not as urgent as teaching self-monitoring and medication administration. Providing detailed information about dietary glucose control (choice B) can be beneficial but is secondary to ensuring the patient can monitor and manage their glucose levels. Teaching about the effects of exercise (choice D) is relevant but not as critical as immediate self-monitoring and medication administration education.

4. When assessing a client reporting severe pain in the right lower quadrant of the abdomen, which sign would most likely indicate appendicitis?

• A. Rebound tenderness at McBurney's point.
• B. Positive Murphy's sign.
• C. Rovsing's sign.
• D. Cullen's sign.

Correct answer: A

Rationale: Rebound tenderness at McBurney's point is a classic sign of appendicitis. This sign indicates peritoneal irritation, a common feature of appendicitis. McBurney's point is located in the right lower quadrant of the abdomen and is a focal point for assessing tenderness. Positive Murphy's sign is associated with cholecystitis, not appendicitis. Rovsing's sign is elicited by palpation of the left lower quadrant resulting in pain in the right lower quadrant, also suggestive of appendicitis. Cullen's sign is associated with acute pancreatitis and manifests as periumbilical ecchymosis.

5. For a patient with asthma, what is the primary purpose of prescribing montelukast?

• A. Relieve acute bronchospasm
• B. Prevent asthma attacks
• C. Thin respiratory secretions
• D. Suppress cough

Correct answer: B

Rationale: Montelukast, a leukotriene receptor antagonist, is primarily prescribed to prevent asthma attacks. It works by reducing inflammation and bronchoconstriction in the airways, thereby helping to control asthma symptoms and prevent exacerbations.

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