Nursing Elites

1. During childhood, the thymus decreases in size, and this is referred to as ______ atrophy.

• A. Physiologic
• B. Pathologic
• C. Disuse
• D. Neurogenic

Correct answer: A

Rationale: The correct answer is A, 'Physiologic.' Physiologic atrophy is a normal part of development, like the reduction in thymus size during childhood. Pathologic atrophy (choice B) refers to tissue wasting due to disease, not a normal process like the reduction in thymus size. Disuse atrophy (choice C) results from a lack of physical activity or stimulation, which is not the case with thymus size reduction. Neurogenic atrophy (choice D) is caused by damage to or diseases of the nerves supplying the muscles, not related to the thymus size reduction seen in childhood.

2. How should the nurse prepare a patient who is to receive a Schilling test for pernicious anemia?

• A. Administer radioactive cobalamin and measure its excretion time
• B. Measure antigen-antibody immune complexes
• C. Measure serum ferritin and total iron-binding capacity
• D. Administer folate and evaluate folate content in a blood serum sample

Correct answer: A

Rationale: The correct answer is A. To prepare a patient for a Schilling test for pernicious anemia, the nurse should administer radioactive cobalamin and measure its excretion time. This test is specifically designed to assess the absorption of vitamin B12. Choices B, C, and D are incorrect because they do not align with the preparation and procedure of a Schilling test. Measuring antigen-antibody immune complexes, serum ferritin, or total iron-binding capacity, as well as administering folate and evaluating folate content, are not part of the Schilling test protocol.

3. Cushing syndrome is characterized by which disorder?

• A. Hypocortisolism
• B. Exophthalmos
• C. Hypercortisolism
• D. Hyperpigmentation

Correct answer: C

Rationale: Cushing syndrome is characterized by hypercortisolism, which is an excessive amount of cortisol in the body. Choice A, 'Hypocortisolism,' is incorrect as Cushing syndrome is associated with elevated cortisol levels. Choice B, 'Exophthalmos,' refers to bulging eyes and is not a characteristic feature of Cushing syndrome. Hyperpigmentation, as mentioned in choice D, can be present in Cushing syndrome due to increased ACTH levels stimulating melanocytes, but it is not the defining characteristic of the syndrome.

4. A patient with a history of venous thromboembolism is being considered for hormone replacement therapy (HRT). What should the nurse discuss with the patient regarding the risks of HRT?

• A. Discuss the potential for increased bone density.
• B. Discuss the potential for an increased risk of cardiovascular events.
• C. Discuss the potential for a reduced risk of breast cancer.
• D. Discuss the potential for improved mood and energy levels.

Correct answer: B

Rationale: The correct answer is B because hormone replacement therapy (HRT) is associated with an increased risk of cardiovascular events, including venous thromboembolism. Patients with a history of venous thromboembolism are at higher risk, so discussing this potential risk is crucial. Choice A, increased bone density, is not a major risk of HRT. Choice C, reduced risk of breast cancer, is not a common discussion point regarding HRT risks. Choice D, improved mood and energy levels, is more related to the benefits of HRT rather than its risks.

5. A patient is starting on oral contraceptives. What should the nurse emphasize about the importance of taking the medication at the same time each day?

• A. Taking the medication at the same time each day helps maintain stable hormone levels and ensures effectiveness.
• B. Taking the medication at the same time each day reduces the risk of breakthrough bleeding.
• C. Taking the medication at the same time each day ensures consistent absorption and effectiveness.
• D. Taking the medication at the same time each day is important, but missing a dose occasionally is not a concern.

Correct answer: A

Rationale: The correct answer is A. Taking oral contraceptives at the same time each day helps maintain stable hormone levels and ensures their effectiveness in preventing pregnancy. Choice B is incorrect because the primary emphasis of consistent timing is on hormone levels and effectiveness, not on reducing breakthrough bleeding. Choice C is incorrect because while consistent absorption is a factor, the main focus is on maintaining stable hormone levels. Choice D is incorrect as missing doses can significantly impact contraceptive efficacy.

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