Nursing Elites

1. In which disorder does a Staphylococcus aureus organism produce a toxin leading to exfoliation and large blister formation?

• A. Herpes simplex I virus
• B. Herpes simplex II virus
• C. Necrotizing fasciitis
• D. Cellulitis

Correct answer: B

Rationale: The correct answer is 'Herpes simplex I virus.' This disorder is known as Staphylococcal scalded skin syndrome (SSSS), where a Staphylococcus aureus organism produces an exfoliative toxin leading to skin exfoliation and large blister formation. Choices B, C, and D are incorrect. Herpes simplex viruses (I and II) cause different types of skin lesions and do not lead to exfoliation and blister formation. Necrotizing fasciitis is a severe soft tissue infection, while cellulitis is a bacterial skin infection that does not typically involve exfoliation and blister formation like in SSSS.

2. While assessing a critically ill client in the emergency department, the nurse notes on the cardiac monitor an R-on-T premature ventricular beat that develops into ventricular tachycardia (VT). Immediately, the client became unresponsive. The nurse knows that based on pathophysiologic principles, the most likely cause of the unresponsiveness is:

• A. metabolic acidosis that occurs spontaneously following any dysrhythmias.
• B. interruption of the blood/oxygen supply to the brain.
• C. massive cerebrovascular accident (CVA) resulting from increased perfusion.
• D. a blood clot coming from the heart and occluding the carotid arteries.

Correct answer: B

Rationale: The correct answer is B. Ventricular tachycardia (VT) can disrupt the normal heart function, leading to a decreased cardiac output. This decreased output can interrupt the blood supply to the brain, causing the client to become unresponsive. Metabolic acidosis (Choice A) is not the most likely cause of unresponsiveness in this scenario. A massive cerebrovascular accident (CVA) (Choice C) would not result from increased perfusion. A blood clot occluding the carotid arteries (Choice D) may lead to a stroke but is not the most likely cause of sudden unresponsiveness in this situation.

3. A male patient with hypogonadism is receiving testosterone therapy. What is the most serious adverse effect the nurse should monitor for?

• A. Increased risk of breast cancer
• B. Increased risk of cardiovascular events
• C. Increased risk of liver dysfunction
• D. Increased risk of prostate cancer

Correct answer: B

Rationale: The correct answer is B: Increased risk of cardiovascular events. Testosterone therapy can lead to an increased risk of cardiovascular events such as heart attacks and strokes, especially in older patients. Monitoring for signs and symptoms of cardiovascular issues is crucial when administering testosterone therapy. Choices A, C, and D are incorrect because testosterone therapy does not typically lead to an increased risk of breast cancer, liver dysfunction, or prostate cancer.

4. While in an induced coma for 3 weeks, a badly burned firefighter awakens and thanks his son for singing Happy Birthday to him a week earlier. Which part of the brain is responsible for allowing him to hear and comprehend while comatose?

• A. Cerebellum
• B. Thalamus
• C. Temporal lobe
• D. Occipital lobe

Correct answer: C

Rationale: The temporal lobe is responsible for processing auditory information, allowing the patient to hear and comprehend while in a coma. The cerebellum is primarily associated with coordination and balance, not auditory processing. The thalamus serves as a relay station for sensory information but is not specifically responsible for auditory processing. The occipital lobe is mainly involved in processing visual information, not auditory functions.

5. A nurse practitioner is assessing a 7-year-old boy who has been brought to the clinic by his mother, who is concerned about her son's increasingly frequent, severe headaches. Which of the nurse's questions is least likely to yield data that will confirm or rule out migraines as the cause of his problem?

• A. Does your son have a family history of migraines?
• B. When your son has a headache, does he ever have nausea and vomiting as well?
• C. Does your son have any food allergies that have been identified?
• D. Is your son generally pain-free during the intervals between headaches?

Correct answer: C

Rationale: The correct answer is C. In assessing a child for migraines, asking about food allergies is least likely to yield data that will confirm or rule out migraines as the cause of his headaches. Food allergies are unrelated to the typical symptoms and triggers of migraines, such as family history, associated symptoms like nausea and vomiting, and pain-free intervals between headaches. Therefore, in this scenario, focusing on food allergies is less relevant for identifying migraines as the cause of the boy's headaches.

Similar Questions