Nursing Elites

1. After a transsphenoidal hypophysectomy, the nurse should assess the client for:

• A. Cerebrospinal fluid (CSF) leak.
• B. Fluctuating blood glucose levels.
• C. Cushing's syndrome.
• D. Cardiac arrhythmias.

Correct answer: A

Rationale: Following a transsphenoidal hypophysectomy, assessing the client for a cerebrospinal fluid (CSF) leak is crucial due to the risk of this serious complication. A CSF leak can lead to infection and increased intracranial pressure, which must be promptly identified and managed to prevent further complications. Fluctuating blood glucose levels (Choice B) are not directly associated with a transsphenoidal hypophysectomy. Cushing's syndrome (Choice C) is a condition related to prolonged exposure to high levels of cortisol and is not a common immediate concern post-transsphenoidal hypophysectomy. Cardiac arrhythmias (Choice D) are not typically a direct complication of this surgical procedure, making it a less relevant concern compared to a CSF leak.

2. The patient is receiving a high dose of tetracycline (Sumycin). Which laboratory values should the nurse monitor while caring for this patient?

• A. Blood urea nitrogen (BUN) and creatinine levels
• B. Complete blood counts
• C. Electrolytes
• D. Liver enzyme levels

Correct answer: A

Rationale: High doses of tetracyclines can lead to nephrotoxicity, especially when given along with other nephrotoxic drugs. Renal function tests, such as monitoring blood urea nitrogen (BUN) and creatinine levels, should be performed to assess for nephrotoxicity. Monitoring complete blood counts (choice B) is not directly related to tetracycline therapy. Checking electrolytes (choice C) is important but not the priority when monitoring for tetracycline-induced nephrotoxicity. Monitoring liver enzyme levels (choice D) is not typically indicated in the context of tetracycline therapy.

3. The client admitted with peripheral vascular disease (PVD) asks the nurse why her legs hurt when she walks. The nurse bases a response on the knowledge that the main characteristic of PVD is:

• A. Decreased blood flow.
• B. Increased blood flow.
• C. Slow blood flow.
• D. Thrombus formation.

Correct answer: A

Rationale: The correct answer is A: 'Decreased blood flow.' In peripheral vascular disease (PVD), there is a narrowing or blockage of blood vessels, leading to reduced blood flow to the extremities. This decreased blood flow results in inadequate oxygen supply to the muscles, causing pain, especially during physical activity when oxygen demand increases. Choice B, 'Increased blood flow,' is incorrect because PVD is characterized by impaired blood circulation rather than increased flow. Choice C, 'Slow blood flow,' is not precise as PVD involves a more significant reduction in blood flow. Choice D, 'Thrombus formation,' is related to the formation of blood clots within vessels, which can be a complication of PVD but is not its main characteristic.

4. A client is to have a transsphenoidal hypophysectomy to remove a large, invasive pituitary tumor. The nurse should instruct the client that the surgery will be performed through an incision in the:

• A. Back of the mouth.
• B. Nose.
• C. Sinus channel below the right eye.
• D. Upper gingival mucosa in the space between the upper gums and lip.

Correct answer: D

Rationale: The correct answer is D: Upper gingival mucosa in the space between the upper gums and lip. A transsphenoidal hypophysectomy involves accessing the pituitary gland through an incision in the upper gingival mucosa, providing direct access to the pituitary gland without external scars. Choices A, B, and C are incorrect because the surgery is not performed through the back of the mouth, the nose, or the sinus channel below the right eye. It is crucial for the client to understand the specific location of the incision to ensure accurate preoperative education and expectations.

5. In assessing cancer risk, which woman is at greatest risk of developing breast cancer?

• A. A 35-year-old multipara who never breastfed.
• B. A 50-year-old whose mother had unilateral breast cancer.
• C. A 55-year-old whose mother-in-law had bilateral breast cancer.
• D. A 20-year-old whose menarche occurred at age 9.

Correct answer: B

Rationale: The correct answer is B because family history of breast cancer, specifically in the mother, is a significant risk factor for developing breast cancer. The age of 50 is also a risk factor for breast cancer. Choice A is less likely as breastfeeding can actually reduce the risk of breast cancer. Choice C is less relevant since the risk is higher with a direct family member. Choice D, although early menarche is a risk factor, the age of the individual is much lower compared to the other age-related risk factors.

Similar Questions