Nursing Elites

1. During a well-child checkup, a mother tells Nurse Rio about a recent situation in which her child needed to be disciplined by her husband. The child was slapped in the face for not getting her husband breakfast on Saturday, despite being told on Thursday never to prepare food for him. Nurse Rio analyzes the family system and concludes it is dysfunctional. All of the following factors contribute to this dysfunction except:

• A. Conflictual relationships between parents.
• B. Inconsistent communication patterns.
• C. Rigid, authoritarian roles.
• D. Use of violence to establish control.

Correct answer: C

Rationale: In a dysfunctional family system, conflictual relationships, inconsistent communication patterns, and the use of violence to establish control are factors contributing to dysfunction. However, rigid, authoritarian roles, though also dysfunctional, are not directly linked to the use of violence for control.

2. When assessing for potential signs and symptoms of cryptococcosis in a patient with HIV being treated with Amphotericin B, the nurse should prioritize what assessment?

• A. Neurological assessment
• B. Functional assessment
• C. Nutritional assessment
• D. Cardiac assessment

Correct answer: A

Rationale: In a patient with cryptococcosis and HIV, neurological assessment should be prioritized because cryptococcosis commonly affects the central nervous system, leading to symptoms such as headache, confusion, and altered mental status. This assessment is crucial in monitoring for any neurological complications and guiding appropriate interventions. Functional assessment focuses on the patient's ability to perform activities of daily living and is not directly associated with cryptococcosis. Nutritional assessment is important for overall health but is not the priority when assessing for cryptococcosis. Cardiac assessment is not a priority in cryptococcosis as the primary manifestations are related to the central nervous system.

3. A 30-year-old woman presents with joint pain, a malar rash, and photosensitivity. Which of the following is the most likely diagnosis?

• A. Rheumatoid arthritis
• B. Systemic lupus erythematosus
• C. Psoriatic arthritis
• D. Dermatomyositis

Correct answer: B

Rationale: The correct answer is B: Systemic lupus erythematosus. Joint pain, a malar rash, and photosensitivity are classic symptoms of systemic lupus erythematosus. Choice A, Rheumatoid arthritis, is incorrect as it typically presents with symmetric joint involvement and morning stiffness. Psoriatic arthritis (Choice C) is characterized by joint pain associated with psoriasis, which is not described in the case. Dermatomyositis (Choice D) presents with muscle weakness, skin rash, and elevated muscle enzymes, different from the symptoms presented in the case.

4. What typically causes contact dermatitis?

• A. Fungal infection
• B. Long-term disorder from gout
• C. Contact with a skin allergen
• D. Staphylococcal infection

Correct answer: C

Rationale: Contact dermatitis is typically caused by contact with a skin allergen that triggers an allergic reaction. Choice A, fungal infection, is incorrect as contact dermatitis is not caused by fungi. Choice B, long-term disorder from gout, is also incorrect as gout is not typically associated with contact dermatitis. Choice D, Staphylococcal infection, is incorrect as contact dermatitis is primarily an allergic reaction rather than a bacterial infection.

5. When taking medroxyprogesterone acetate (Provera) for the treatment of endometriosis, what important instruction should the nurse provide about taking this medication?

• A. Take the medication at the same time each day to maintain consistent hormone levels.
• B. Medroxyprogesterone should be taken without regard to meals.
• C. Discontinuing medroxyprogesterone should only be done under the guidance of a healthcare provider.
• D. Medroxyprogesterone is typically taken daily rather than weekly for the treatment of endometriosis.

Correct answer: A

Rationale: When taking medroxyprogesterone acetate for endometriosis, it is essential to maintain consistent hormone levels by taking the medication at the same time each day. This consistency helps optimize the effectiveness of the treatment. Choice B is incorrect because medroxyprogesterone should be taken without regard to meals, not necessarily with food. Choice C is incorrect because discontinuing the medication without consulting a healthcare provider can be harmful and may not address side effects appropriately. Choice D is incorrect as medroxyprogesterone is typically taken daily to manage endometriosis symptoms, not weekly, to ensure continuous therapy and symptom control.

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