Nursing Elites

1. A patient with severe peripheral vascular disease has developed signs of dry gangrene on the great toe of one foot. Which of the following pathophysiologic processes most likely contributed to this diagnosis?

• A. Inappropriate activation of apoptosis
• B. Bacterial invasion
• C. Impaired arterial blood supply
• D. Metaplastic cellular changes

Correct answer: C

Rationale: The correct answer is C: Impaired arterial blood supply. Dry gangrene is typically caused by impaired arterial blood supply, leading to tissue death without bacterial infection. Choices A, B, and D are incorrect. Inappropriate activation of apoptosis is not a common cause of dry gangrene. Bacterial invasion usually leads to wet gangrene, not dry gangrene. Metaplastic cellular changes are not directly associated with the development of dry gangrene.

2. A 51-year-old woman has the following clinical findings: thin hair, exophthalmos, hyperreflexia, and pretibial edema. These findings are consistent with:

• A. Subacute thyroiditis.
• B. Autoimmune thyroiditis.
• C. Graves disease.
• D. Hashimoto’s disease.

Correct answer: C

Rationale: The clinical findings of thin hair, exophthalmos, hyperreflexia, and pretibial edema are classic features of Graves disease, an autoimmune disorder that results in hyperthyroidism. Exophthalmos (bulging eyes) and pretibial edema (swelling in the lower legs) are particularly associated with Graves disease due to the autoimmune stimulation of the thyroid gland, leading to increased thyroid hormone production. Subacute thyroiditis (Choice A) typically presents with neck pain and tenderness, while autoimmune thyroiditis (Choice B) is commonly known as Hashimoto's thyroiditis, which presents with hypothyroidism symptoms. Hashimoto's disease (Choice D) is characterized by goiter and hypothyroidism, which contrasts with the hyperthyroidism seen in this patient.

3. What is the most appropriate nursing diagnosis for the client's son based on the information provided?

• A. Risk for other-directed violence
• B. Disturbed sleep pattern
• C. Caregiver role strain
• D. Social isolation

Correct answer: C

Rationale: The correct answer is 'Caregiver role strain.' In the scenario presented, the son expresses that his father's constant confusion, incontinence, and tendency to wander are intolerable. These challenges indicate that the son is experiencing strain in his role as a caregiver. 'Risk for other-directed violence' is not appropriate because there is no indication of violent behavior. 'Disturbed sleep pattern' is not the most relevant nursing diagnosis given the information provided. 'Social isolation' is not the most appropriate choice as the son's concerns are related to the challenges of caregiving, not isolation.

4. If the client's dorsal columns are not functioning, the nurse will observe which response during neuro testing, where the nurse asks the client to close his eyes and then proceeds to touch corresponding parts of the body on each side simultaneously with two sharp points?

• A. The client will not be able to distinguish between the two points.
• B. The client will feel only one point of contact.
• C. The client will accurately identify both points.
• D. The client will report no sensation in the touched areas.

Correct answer: A

Rationale: If the client's dorsal columns are not functioning, the ability to distinguish between two closely spaced points is impaired. This results in the client not being able to differentiate between the two points when touched simultaneously. Choice B is incorrect because the client feeling only one point suggests an intact dorsal column function. Choice C is incorrect as accurately identifying both points indicates normal discrimination ability. Choice D is incorrect as reporting no sensation does not correspond to the specific impairment related to dorsal column dysfunction.

5. Which of the following is a common cause of secondary hypertension?

• A. Primary aldosteronism
• B. Essential hypertension
• C. White coat hypertension
• D. Prehypertension

Correct answer: A

Rationale: Primary aldosteronism is a common cause of secondary hypertension. In primary aldosteronism, there is an overproduction of aldosterone from the adrenal glands, leading to increased sodium retention and potassium excretion, ultimately resulting in high blood pressure. Essential hypertension (Choice B) is the most common type of hypertension, but it is considered primary hypertension, not secondary. White coat hypertension (Choice C) refers to elevated blood pressure readings in a clinical setting due to anxiety but not in daily life. Prehypertension (Choice D) is a condition where blood pressure levels are elevated but not high enough to be classified as hypertension.

Similar Questions