Nursing Elites

1. An older adult patient comes to the clinic complaining of not being able to do what he used to be able to. You know that normal changes associated with aging include:

• A. Improved blood flow
• B. Slowed metabolic rate
• C. Increased brain weight
• D. Improved nerve fiber conduction

Correct answer: B

Rationale: Normal changes associated with aging include a slowed metabolic rate and decreased brain weight. Option A, 'Improved blood flow,' is incorrect as aging is generally associated with reduced vascular health rather than improved blood flow. Option D, 'Improved nerve fiber conduction,' is incorrect as aging typically leads to a decline in nerve function rather than improvement.

2. A patient's current medical condition is suggestive of impaired erythropoiesis. Which of the following laboratory studies would be most clinically relevant in diagnosing this health problem?

• A. White blood cell count with differential
• B. RBC, hemoglobin, and hematocrit
• C. INR and aPTT
• D. d-dimer and C-reactive protein

Correct answer: B

Rationale: In this scenario, where impaired erythropoiesis is suspected, the most clinically relevant laboratory studies would focus on red blood cell parameters. Therefore, assessing RBC count, hemoglobin levels, and hematocrit values would provide direct insights into erythropoiesis. Choices A, C, and D are not directly related to erythropoiesis assessment. White blood cell count with a differential is more indicative of immune response and infection. INR and aPTT are coagulation studies, while d-dimer and C-reactive protein levels are more associated with inflammation and thrombotic events.

3. Which of the following organs are primarily affected by poorly managed hypertension?

• A. The bladder and urethra
• B. The brain and skin
• C. The heart and kidneys
• D. The stomach and intestines

Correct answer: C

Rationale: Poorly managed hypertension primarily affects the heart and kidneys. The heart is at risk of conditions like heart failure due to the increased workload from elevated blood pressure. The kidneys can suffer damage from longstanding hypertension, leading to kidney disease. Choices A, B, and D are incorrect because the bladder, urethra, brain, skin, stomach, and intestines are not the primary organs affected by poorly managed hypertension.

4. 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.

5. What is the pathophysiologic process responsible for the decreased glomerular filtration rate in a patient with acute glomerulonephritis?

• A. Decreased renal-induced constriction of the renal arteries
• B. Immune complex deposition, increased capillary permeability, and cellular proliferation
• C. Necrosis of 70% or more of the nephrons secondary to increased kidney interstitial hydrostatic pressure
• D. Scar tissue formation throughout the proximal convoluted tubule secondary to toxin-induced collagen synthesis

Correct answer: B

Rationale: The correct answer is B: Immune complex deposition, increased capillary permeability, and cellular proliferation. Acute glomerulonephritis is characterized by inflammation of the glomeruli in the kidneys. This inflammation leads to the deposition of immune complexes, increased capillary permeability, and cellular proliferation, which collectively contribute to a decreased glomerular filtration rate. Choice A is incorrect as decreased renal-induced constriction of the renal arteries would not directly result in decreased glomerular filtration rate. Choice C is incorrect as necrosis of nephrons due to increased kidney interstitial hydrostatic pressure would affect kidney function differently. Choice D is incorrect as scar tissue formation in the proximal convoluted tubule due to toxin-induced collagen synthesis is not a typical feature of acute glomerulonephritis.

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