Nursing Elites

1. Although stress exposure initiates integrated responses by multiple systems, which system first activates the most important changes?

• A. Pulmonary
• B. Gastrointestinal
• C. Neuroendocrine
• D. Cardiovascular

Correct answer: C

Rationale: The correct answer is C, the Neuroendocrine system. When the body is exposed to stress, the neuroendocrine system plays a crucial role in initiating the body's response. This system, particularly through the hypothalamic-pituitary-adrenal axis, triggers a cascade of physiological responses to stress. Choices A, B, and D are incorrect because while other systems like the cardiovascular and gastrointestinal systems also respond to stress, the neuroendocrine system is primarily responsible for the initial and significant changes in the body's stress response.

2. A male patient receiving androgen therapy is concerned about prostate cancer. What should the nurse explain about the risks associated with this therapy?

• A. Finasteride has been shown to reduce the risk of developing prostate cancer.
• B. Finasteride has no impact on the risk of developing prostate cancer.
• C. Finasteride may increase the risk of developing prostate cancer.
• D. Finasteride has no effect on the risk of prostate cancer.

Correct answer: A

Rationale: The correct answer is A. Finasteride, a type of androgen therapy, has been shown to reduce the risk of developing prostate cancer. It works by shrinking the prostate gland, which can help lower the risk of developing prostate cancer. However, while it may reduce the risk, regular screening is still recommended to monitor for any potential issues. Choice B is incorrect because finasteride does have an impact on reducing the risk of prostate cancer. Choice C is incorrect as finasteride is not known to increase the risk of developing prostate cancer. Choice D is incorrect as finasteride does have an effect on reducing the risk of prostate cancer.

3. When administering azoles in the home setting, the home health nurse should prioritize educational interventions that address what nursing diagnosis?

• A. Risk for injury related to antifungal therapy
• B. Risk for acute confusion related to antifungal therapy
• C. Risk for infection related to antifungal therapy
• D. Risk for falls related to antifungal therapy

Correct answer: A

Rationale: The correct answer is A: Risk for injury related to antifungal therapy. When administering azoles, the priority is to educate patients and caregivers about potential side effects that could lead to injury, such as hepatotoxicity or allergic reactions. Choices B, C, and D are incorrect because acute confusion, infection, and falls are not typically associated with azole therapy.

4. What symptoms would the nurse expect to see in a client with chronic obstructive pulmonary disease (COPD)?

• A. Dyspnea on exertion
• B. Normal lung sounds
• C. Normal arterial blood gases
• D. Onset of the disease during young adulthood

Correct answer: A

Rationale: The correct answer is A: Dyspnea on exertion. COPD typically manifests with symptoms like dyspnea on exertion due to impaired lung function. This symptom is a result of the airways being obstructed and the lungs not being able to expel air effectively. Choices B and C are incorrect because in COPD, abnormal lung sounds such as wheezing, crackles, or diminished breath sounds are often heard upon auscultation, and arterial blood gases are usually abnormal, showing low oxygen levels and high carbon dioxide levels. Choice D is incorrect as COPD is more commonly diagnosed in individuals over 40 who have a history of smoking or exposure to lung irritants.

5. On the advice of his brother, a 53-year-old man has made an appointment to request a prescription for Viagra. The nurse who works at the clinic is reviewing the man's medical history and would recognize what health problem as being prohibitive to this treatment?

• A. Type 2 diabetes, treated with metformin
• B. Hypercholesterolemia, treated with simvastatin
• C. Angina, treated with nitroglycerin
• D. Hypertension, treated with metoprolol

Correct answer: C

Rationale: Nitroglycerin is contraindicated with Viagra due to their combined effects on lowering blood pressure, which can result in a severe drop and potentially life-threatening complications. Using both medications together can lead to hypotension, putting the patient at risk. Therefore, the presence of angina treated with nitroglycerin would make prescribing Viagra unsafe. Choices A, B, and D are not directly contraindicated with Viagra and can be managed concurrently with this treatment.

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