Nursing Elites

1. An older adult man has moved to a long-term care facility, and the nurse is performing medication reconciliation. The resident's current medication regimen includes alfuzosin (Uroxatral). After considering the most likely indication for this drug, what potential problem should the nurse include in the resident's interdisciplinary plan of care?

• A. Impaired urinary elimination
• B. Ineffective sexual pattern
• C. Sexual dysfunction
• D. Functional urinary incontinence

Correct answer: C

Rationale: The correct answer is C, 'Sexual dysfunction.' Alfuzosin is commonly prescribed for benign prostatic hyperplasia (BPH), a condition that can lead to sexual dysfunction in older men. It is important to include this potential problem in the interdisciplinary plan of care to address the impact of the medication on the resident's sexual health. Choices A, B, and D are incorrect because while alfuzosin can affect urinary function, the primary concern related to this medication in this scenario is sexual dysfunction due to its indication for BPH.

2. What function does aldosterone serve in the body?

• A. Aldosterone causes a release of sodium from the body, decreases fluid volume, and decreases blood pressure
• B. Aldosterone causes a retention of sodium in the body, increases fluid volume, and increases blood pressure
• C. Aldosterone causes a release of sodium from the body, increases fluid volume, and decreases blood pressure
• D. Aldosterone enhances intracellular sodium production and lowers blood pressure

Correct answer: B

Rationale: Aldosterone functions by causing the retention of sodium in the body, which results in an increase in fluid volume and blood pressure. Choice A is incorrect because aldosterone actually promotes sodium retention rather than release. Choice C is incorrect as it states that aldosterone decreases fluid volume, which is not accurate. Choice D is incorrect because aldosterone does not enhance intracellular sodium production; instead, it primarily acts on sodium reabsorption in the kidneys.

3. What clinical manifestations would the nurse expect to find in a client who is experiencing anaphylaxis?

• A. Dilated bronchioles, constriction of peripheral blood vessels, decreased capillary permeability
• B. Asthma, deep vein thrombosis, hepatic encephalopathy
• C. Narrowing of the bronchioles, dilation of the peripheral blood vessels, increased capillary permeability
• D. Left-sided heart failure, pulmonary embolism, urinary tract infection

Correct answer: C

Rationale: In anaphylaxis, the client would present with narrowing of the bronchioles, dilation of the peripheral blood vessels, and increased capillary permeability. These manifestations lead to symptoms such as difficulty breathing, low blood pressure, and swelling. Choices A, B, and D are incorrect because they do not describe the typical clinical manifestations of anaphylaxis.

4. A woman is complaining that she feels like the room is spinning even though she is not moving. Which of the following is characteristic of benign positional vertigo?

• A. It usually occurs with a headache.
• B. Pupillary changes are common.
• C. It is usually triggered when the patient bends forward.
• D. Nystagmus continues even when eyes fixate on an object.

Correct answer: C

Rationale: Benign positional vertigo is typically triggered by changes in head position, such as bending forward or turning over in bed. This change in position leads to brief episodes of vertigo, often associated with nystagmus, which is rapid, involuntary eye movements. Pupillary changes and headaches are not typical features of benign positional vertigo, making choices B and A incorrect. Nystagmus in benign positional vertigo usually stops when the eyes fixate on an object, so choice D is also incorrect.

5. A 70-year-old woman has difficulty with driving, and she has been frequently getting lost. Her husband said she has also been acting strangely and seems to want to sleep a lot. He said the other night she kept saying she was seeing animals such as lions in her room. He says her memory is not too bad, but he is very concerned about her health. Physical examination reveals an alert woman with stable vital signs. Bradykinesia and limb rigidity are noted. These findings are consistent with:

• A. Alzheimer's disease.
• B. vascular dementia.
• C. dementia with Lewy bodies.
• D. frontotemporal dementia.

Correct answer: C

Rationale: The correct answer is dementia with Lewy bodies (DLB). Hallucinations, parkinsonian symptoms (like bradykinesia and limb rigidity), and fluctuating cognition are characteristic of DLB. Alzheimer's disease (Choice A) typically presents with memory loss as a prominent feature. Vascular dementia (Choice B) is associated with a history of strokes and step-wise cognitive decline. Frontotemporal dementia (Choice D) often presents with changes in behavior and personality rather than the parkinsonian symptoms seen in this case.

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