Nursing Elites

1. A patient's anemia is described as having erythrocytes that demonstrate anisocytosis. The nurse would recognize the erythrocytes as:

• A. Pale in color
• B. Present in various sizes
• C. Able to assume various shapes
• D. Live only a few days

Correct answer: B

Rationale: The correct answer is B: 'Present in various sizes.' Anisocytosis refers to erythrocytes that are present in various sizes, indicating an abnormality in the uniformity of red blood cell size. Choice A is incorrect because anisocytosis does not refer to the color of erythrocytes. Choice C is incorrect as anisocytosis does not involve the shape of erythrocytes. Choice D is incorrect as anisocytosis does not determine the lifespan of erythrocytes.

2. Right-sided heart failure is characterized by:

• A. Immunosuppression
• B. Pulmonary edema
• C. Peripheral edema
• D. Coughing

Correct answer: C

Rationale: Right-sided heart failure is characterized by peripheral edema, which results from the buildup of fluid in the body. This fluid accumulates in the extremities due to the heart's inability to effectively pump blood forward. Choices A, B, and D are incorrect. Immunosuppression is not a typical feature of right-sided heart failure. Pulmonary edema is more commonly associated with left-sided heart failure, where fluid accumulates in the lungs. Coughing is a symptom that can be present in various conditions but is not a defining characteristic of right-sided heart failure.

3. A primiparous woman tells the nurse that she and her partner are highly reluctant to have their infant vaccinated, stating, “We've read that vaccines can potentially cause a lot of harm, so we're not sure we want to take that risk.” How should the nurse respond to this family's concerns?

• A. “Vaccinations are not without some risks, but these are far exceeded by the potential benefits they offer in preventing serious diseases.”
• B. “The potential risks of vaccinations have been investigated and determined to be minimal compared to the benefits of protecting your child from potentially life-threatening diseases.”
• C. “It is important to follow state laws regarding vaccines, but I understand your concerns. Let's discuss the specific risks and benefits of vaccines for your child.”
• D. “Vaccines indeed cause several serious adverse effects, but these are usually treated effectively, and the benefits of vaccination in preventing diseases far outweigh the risks.”

Correct answer: B

Rationale: When addressing concerns about vaccination, it is crucial to provide accurate information to help parents make informed decisions. Choice B is the most appropriate response as it acknowledges the concerns of the family while emphasizing that the potential risks of vaccinations are minimal compared to the significant benefits of protecting the child from serious diseases. This response shows empathy towards the parents' concerns while also highlighting the importance of vaccination in preventing life-threatening illnesses. Choice A is incorrect because it does not emphasize the significant benefits of vaccination in preventing diseases, which may not effectively address the family's concerns. Choice C is incorrect as it focuses more on state laws rather than addressing the family's specific concerns about vaccine safety. Choice D is incorrect as it may increase the family's anxiety by highlighting adverse effects without adequately emphasizing the benefits of vaccination in disease prevention.

4. Which of the following is a cause of edema?

• A. Decreased plasma proteins
• B. Hypotension
• C. Dehydration
• D. Polyuria

Correct answer: A

Rationale: The correct answer is A: Decreased plasma proteins. Edema can be caused by decreased plasma proteins, which reduce the osmotic pressure that keeps fluid in the blood vessels. Hypotension (choice B) is low blood pressure and is not a direct cause of edema. Dehydration (choice C) involves a lack of body fluid, but it is not a direct cause of edema. Polyuria (choice D) is excessive urination and not a direct cause of edema.

5. A patient is being treated with finasteride (Proscar) for benign prostatic hyperplasia (BPH). What expected outcome should the nurse include in the patient teaching?

• A. The medication will cure BPH after treatment is complete.
• B. The effects of the medication may take several weeks or months to become noticeable.
• C. The medication may cause increased hair growth.
• D. The medication may decrease libido.

Correct answer: B

Rationale: The correct answer is B. Finasteride is used to reduce the size of the prostate gland in patients with BPH, leading to decreased urinary frequency and urgency over several weeks or months. Choice A is incorrect because finasteride does not cure BPH but helps manage symptoms. Choice C is incorrect as increased hair growth is associated with another medication called minoxidil, not finasteride. Choice D is incorrect since finasteride may cause a decrease in libido as a side effect.

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