Nursing Elites

1. In the ICU setting, a client transported from surgery following open heart bypass grafting will likely have his or her core temperature measured by:

• A. oral thermometer.
• B. rectal thermometer.
• C. esophageal thermometer.
• D. temporal artery thermometer.

Correct answer: C

Rationale: An esophageal thermometer is commonly used in ICU settings to accurately measure core body temperature, especially in post-surgical patients. The esophageal thermometer provides a more precise measurement of core temperature compared to other methods like oral, rectal, or temporal artery thermometers. In the ICU, accuracy in temperature measurement is crucial for detecting and responding to changes promptly, making the esophageal thermometer the preferred choice in this scenario.

2. Which of the following hormones do the kidneys secrete to increase red blood cell production?

• A. Erythropoietin
• B. Insulin and glycogen
• C. Testosterone
• D. Thyroid stimulating hormone

Correct answer: A

Rationale: The correct answer is A: Erythropoietin. The kidneys produce erythropoietin to stimulate the production of red blood cells. Insulin and glycogen are not hormones secreted by the kidneys; insulin is produced by the pancreas, and glycogen is a stored form of glucose. Testosterone is a hormone primarily produced by the testes in males and to a lesser extent in females. Thyroid stimulating hormone is produced by the pituitary gland to regulate thyroid function, not red blood cell production.

3. A nurse is teaching a patient about the use of testosterone gel for the treatment of hypogonadism. What important instruction should the nurse provide?

• A. Apply the gel after showering, and allow it to dry completely before dressing.
• B. Apply the gel to the genitals for maximum absorption.
• C. Apply the gel before bedtime to enhance absorption during sleep.
• D. Apply the gel to the face and neck for improved results.

Correct answer: A

Rationale: The correct instruction is to apply testosterone gel after showering and allow it to dry completely before dressing. This helps prevent the transfer of the gel to others and ensures proper absorption. Choice B is incorrect because the gel should not be applied to the genitals. Choice C is incorrect as there is no specific benefit to applying the gel before bedtime. Choice D is incorrect as the gel should not be applied to the face and neck for the treatment of hypogonadism.

4. A 56-year-old woman has been experiencing memory loss and confusion for the past year. The client is diagnosed with Alzheimer's disease. Which finding is most characteristic of this disease?

• A. Neurofibrillary tangles in the brain
• B. Demyelination of neurons in the brain
• C. Accumulation of beta-amyloid plaques
• D. Formation of Lewy bodies

Correct answer: C

Rationale: The correct answer is C: Accumulation of beta-amyloid plaques. Alzheimer's disease is characterized by the accumulation of beta-amyloid plaques in the brain. These plaques are formed from the buildup of beta-amyloid protein fragments between nerve cells. Choice A, neurofibrillary tangles, are a hallmark of another neurodegenerative disease called Alzheimer's disease. Choice B, demyelination of neurons, is more characteristic of diseases like multiple sclerosis. Choice D, formation of Lewy bodies, is associated with Lewy body dementia, not Alzheimer's disease.

5. Which of the following birthmarks usually fade or regress as the child gets older?

• A. Hemangiomas
• B. Congenital dermal melanocytosis (i.e., Mongolian spots)
• C. Macular stains
• D. Hemangiomas, congenital dermal melanocytosis (i.e., Mongolian spots), and macular stains

Correct answer: D

Rationale: The correct answer is D. Hemangiomas, congenital dermal melanocytosis (i.e., Mongolian spots), and macular stains are birthmarks that usually fade or regress as the child gets older. Hemangiomas are vascular birthmarks that often shrink and fade over time. Congenital dermal melanocytosis (Mongolian spots) are blue-gray birthmarks commonly found on the lower back and buttocks of infants, which typically fade by adolescence. Macular stains, also known as salmon patches, are pink or red birthmarks that usually fade within the first few years of life. Choice D is correct because all the mentioned birthmarks tend to diminish as the child grows, unlike choices A, B, and C which do not fade or regress with age.

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