Nursing Elites

1. In an adult patient suspected of having an androgen deficiency and considering treatment with testosterone, the use of testosterone would be most complicated by the presence of what preexisting health problem?

• A. Urinary incontinence
• B. BPH
• C. Chronic renal failure
• D. Type 2 diabetes

Correct answer: B

Rationale: The correct answer is BPH (Benign Prostatic Hyperplasia). Testosterone therapy can worsen symptoms of BPH by potentially increasing prostate size and stimulating the growth of prostate tissue. This can lead to complications such as urinary retention and the need for further medical interventions. Urinary incontinence (choice A) can have various causes but is not directly related to testosterone therapy. Chronic renal failure (choice C) and Type 2 diabetes (choice D) are not typically contraindications for testosterone therapy in the context of androgen deficiency.

2. A nurse is providing care for a 44-year-old male client who is admitted with a diagnosis of fever of unknown origin (FUO). Which characteristic of the client's history is most likely to have a bearing on his current diagnosis?

• A. The client is a smoker.
• B. The client has a history of IV drug use.
• C. The client was treated for an STD 2 years ago.
• D. The client has a family history of cardiac disease.

Correct answer: B

Rationale: A history of IV drug use is significant in cases of fever of unknown origin, as it increases the risk of infections like endocarditis, which can present with persistent fever. Smoking (Choice A) is not directly linked to FUO. While a history of STD treatment (Choice C) may be relevant, it is less likely to be associated with FUO compared to IV drug use. Family history of cardiac disease (Choice D) is not typically a primary factor in the diagnosis of FUO.

3. What is the primary function of the kidneys in acid-base balance?

• A. The kidneys remove hydrogen ions and retain bicarbonate ions.
• B. The kidneys convert ammonia into urea, which is excreted in the urine.
• C. The kidneys produce aldosterone to regulate sodium levels.
• D. The kidneys secrete renin to regulate blood pressure.

Correct answer: A

Rationale: The correct answer is A. The kidneys are crucial in maintaining acid-base balance by removing hydrogen ions to decrease acidity and retaining bicarbonate ions to increase alkalinity. Choice B is incorrect because the conversion of ammonia into urea is related to nitrogen waste excretion, not acid-base balance. Choice C is incorrect as aldosterone regulates sodium levels, not acid-base balance. Choice D is also incorrect as renin is involved in regulating blood pressure, not acid-base balance.

4. A toddler is displaying signs/symptoms of weakness and muscle atrophy. The pediatric neurologist suspects it may be a lower motor neuron disease called spinal muscular atrophy (SMA). The client's family asks how he got this. The nurse will respond:

• A. This could result from playing in soil and then ingesting bacteria that is now attacking his motor neurons.
• B. No one really knows how this disease is formed. We just know that in time, he may grow out of it.
• C. This is a degenerative disorder that tends to be inherited as an autosomal recessive trait.
• D. This is a segmental demyelination disorder that affects all nerve roots and eventually all muscle groups as well.

Correct answer: C

Rationale: The correct answer is C. Spinal muscular atrophy (SMA) is an inherited disorder, often autosomal recessive, that affects lower motor neurons. Choice A is incorrect because SMA is not caused by ingesting bacteria from playing in soil. Choice B is incorrect as SMA is not something that a person grows out of. Choice D is incorrect because SMA is not a demyelination disorder that affects nerve roots and muscle groups.

5. The patient should be taught that an improvement in symptoms will likely be noticed within

• A. 48 hours.
• B. a week to 10 days.
• C. 2 to 3 weeks.
• D. 4 to 6 weeks.

Correct answer: C

Rationale: When taking isoniazid and rifampin for active tuberculosis, patients should be taught that an improvement in symptoms will likely be noticed within 2 to 3 weeks. Choice A (48 hours) is too soon to expect significant improvement in symptoms. Choice B (a week to 10 days) is also too early for noticeable improvement with this medication regimen. Choice D (4 to 6 weeks) is too far out to expect a noticeable improvement in symptoms.

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