Nursing Elites

1. Which of the following disturbances would cause a client to experience gout?

• A. Serotonin receptors
• B. Uric acid metabolism
• C. Liver function
• D. Cardiac function

Correct answer: B

Rationale: Gout is caused by a disturbance in uric acid metabolism, leading to the accumulation of uric acid crystals in joints. Serotonin receptors (Choice A) are not related to gout. Liver function (Choice C) is important for metabolism but is not directly linked to gout development. Cardiac function (Choice D) is primarily related to the heart's functioning and not associated with gout.

2. In gout, a man has developed large, hard nodules around his toes and elbows. The phase of gout he is in is:

• A. asymptomatic.
• B. acute flare.
• C. the intercritical period.
• D. chronic gout.

Correct answer: D

Rationale: The man's presentation of large, hard nodules around his toes and elbows is indicative of tophi formation, which is characteristic of chronic gout. Tophi are deposits of uric acid crystals that can develop over time in untreated or poorly managed gout. During the chronic phase of gout, tophi can form in joints, soft tissues, and organs. Asymptomatic refers to a phase where there are no symptoms present. Acute flare is characterized by sudden and severe joint pain and inflammation. The intercritical period is the time between gout attacks when the patient is symptom-free.

3. A woman of childbearing age is diagnosed with breast cancer. She is currently taking hormonal contraceptives. What information should the woman be given regarding the hormonal contraceptives?

• A. The hormonal contraceptives do not affect the course of the disease.
• B. The hormonal contraceptives will stimulate uterine bleeding.
• C. The hormonal contraceptives will impair uterine bleeding.
• D. The hormonal contraceptives will stimulate tumor growth.

Correct answer: A

Rationale: The correct answer is A. Hormonal contraceptives should be discontinued in women diagnosed with breast cancer because they can potentially stimulate cancer growth. Choice B is incorrect as hormonal contraceptives do not stimulate uterine bleeding. Choice C is also incorrect as hormonal contraceptives typically do not impair uterine bleeding. Choice D is incorrect because hormonal contraceptives are not meant to stimulate tumor growth.

4. A male patient is being treated with testosterone gel for hypogonadism. What important instruction should the nurse provide?

• A. Apply the gel to the face and neck for maximum absorption.
• B. Apply the gel to the chest or upper arms and allow it to dry completely before dressing.
• C. Apply the gel to the scalp and back.
• D. Apply the gel to the genitals for improved results.

Correct answer: B

Rationale: The correct instruction for applying testosterone gel is to apply it to the chest or upper arms and allow it to dry completely before dressing. This is important to prevent the transfer of the medication to others. Applying it to the face and neck (Choice A) is incorrect as these areas are not recommended. Similarly, applying it to the scalp and back (Choice C) or the genitals (Choice D) is also incorrect and can lead to inappropriate absorption or undesirable effects.

5. DiGeorge syndrome is a primary immune deficiency caused by:

• A. Failure of B cells to mature
• B. Congenital lack of thymic tissue
• C. Failure of formed elements of blood to develop
• D. Selective IgG deficiency

Correct answer: B

Rationale: DiGeorge syndrome is caused by a congenital lack of thymic tissue, which plays a crucial role in T cell development and maturation, leading to immune deficiency. Choice A is incorrect because DiGeorge syndrome primarily affects T cells, not B cells. Choice C is incorrect as it is too broad and not specific to the thymus. Choice D is incorrect as selective IgG deficiency is a different condition unrelated to DiGeorge syndrome.

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