Nursing Elites

1. All of the following are clinical manifestations indicating male climacteric except:

• A. hot flashes
• B. loss of reproductive ability
• C. headaches
• D. heart palpitations

Correct answer: B

Rationale: Male climacteric, also known as andropause, is a stage in a man's life characterized by a decline in testosterone levels and various physical and emotional changes. While men may experience symptoms like hot flashes, headaches, and heart palpitations during male climacteric, they do not typically lose their reproductive ability. Although fertility may decrease with age due to reduced testosterone production, men do not entirely lose the ability to reproduce. Therefore, the correct answer is 'loss of reproductive ability.' Choices A, C, and D are symptoms that can be associated with male climacteric, making them incorrect answers.

2. As part of a routine health screening, the nurse notes the play of a 2-year-old child. Which of the following is an example of age-appropriate play at this age?

• A. builds towers with several blocks
• B. tries to color within the lines
• C. says "Mine!"? when playing with toys
• D. tries to jump rope

Correct answer: C

Rationale: For a 2-year-old child, saying 'Mine!' when playing with toys is an example of age-appropriate play. Toddlers at this age are possessive and asserting their sense of ownership. Building towers with blocks and trying to color within the lines involve more advanced motor skills and cognitive abilities that are typically not fully developed in a 2-year-old. Jumping rope requires coordination and balance beyond what a 2-year-old can usually achieve. Therefore, choices A, B, and D are not considered age-appropriate plays for a 2-year-old child.

3. A 37-year-old female client asks the nurse about contraception options and expresses interest in oral contraception pills. Which of the following statements would indicate that oral contraception is appropriate for this client?

• A. "I quit smoking last year, but I started again recently. Maybe I'll try to quit later this year."?
• B. "I am very diligent in taking my thyroid medications at the same time every day."?
• C. "I was hospitalized for deep vein thrombosis five years ago."?
• D. "I was recently diagnosed with breast cancer."?

Correct answer: C

Rationale: The correct answer is the statement mentioning a history of deep vein thrombosis five years ago. Oral contraceptives are generally not recommended for individuals with a history of deep vein thrombosis due to the increased risk of blood clots. Choice B, about being diligent in taking thyroid medications, does not directly relate to the safety of using oral contraceptives. Choice D, about a recent breast cancer diagnosis, would contraindicate the use of hormonal contraceptives. Choice A, mentioning a recent return to smoking, raises concerns about using hormonal contraceptives due to the increased risk of cardiovascular complications.

4. Which reported symptom(s) would indicate a client with Addison's disease has received too much fludrocortisone (Florinef) replacement?

• A. Oily skin and hair
• B. Weight gain of 6 pounds in one week
• C. Loss of muscle mass in arms and legs
• D. Increased blood glucose level

Correct answer: B

Rationale: Fludrocortisone replacement in Addison's disease involves mimicking the action of aldosterone, a mineralocorticoid that causes the retention of sodium and water. Excessive retention of sodium and water can lead to weight gain. Therefore, a sudden increase in weight, especially a significant amount like 6 pounds in one week, can indicate an overdose of fludrocortisone. Choices A, C, and D are incorrect because oily skin and hair, loss of muscle mass, and increased blood glucose levels are not typically associated with excessive fludrocortisone replacement.

5. When a nurse-midwife, performing a vaginal examination of a client who suspects that she is pregnant, documents the presence of the Chadwick sign, what does this indicate?

• A. That the cervix appears violet
• B. That cervical softening is present
• C. A positive sign of pregnancy
• D. A thinning of the cervix

Correct answer: A

Rationale: The correct interpretation of the Chadwick sign is that the cervix appears violet in color. This sign is a probable sign of pregnancy, characterized by the violet coloration of the cervix due to increased vascularity of the pelvic organs. It is not a definitive positive sign of pregnancy but rather a probable one. Choices B and D are incorrect as cervical softening is known as the Goodell sign, and thinning of the cervix is referred to as the Hegar sign. These signs are also probable signs of pregnancy, but they do not specifically indicate the Chadwick sign.

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