Nursing Elites

1. In which patient would the manifestation of a headache be a sign of a serious underlying disorder?

• A. A 55-year-old man with new onset of headaches that are worse at night and reported mood swings according to his family
• B. A 30-year-old woman with a unilateral throbbing headache with photophobia and nausea
• C. A 60-year-old man with his head feeling full and throbbing and muscle aching around his neck and shoulders
• D. A 40-year-old woman who experiences food cravings, gets irritable, and then develops a pulsatile-like headache on the right side of her head

Correct answer: A

Rationale: The correct answer is A. New onset headaches in older adults, especially if worse at night, may indicate a serious condition like a brain tumor. Choice B describes symptoms commonly seen in migraines. Choice C describes tension-type headaches. Choice D describes symptoms of a menstrual migraine which is not typically associated with a serious underlying disorder.

2. Not realizing that its surface was hot, a woman has quickly withdrawn her hand from the surface of a bowl that she was removing from a microwave. Which phenomena has facilitated the rapid movement of her hand in response to the painful stimulus?

• A. Crossed-extensor reflex
• B. Flexor reflex
• C. Withdrawal reflex
• D. Stretch reflex

Correct answer: C

Rationale: The withdrawal reflex is a protective response that allows a person to quickly remove their hand from a painful stimulus.

3. What is a cause of the crystallization within the synovial fluid of the joint affected by gouty arthritis?

• A. Destruction of proteoglycans
• B. Underexcretion of uric acid
• C. Overexcretion of uric acid
• D. Increased absorption of uric acid

Correct answer: B

Rationale: The correct answer is B: Underexcretion of uric acid. In gouty arthritis, the crystallization within the synovial fluid of the affected joint is caused by the underexcretion of uric acid, leading to the accumulation and subsequent crystallization of urate crystals. Choice A, destruction of proteoglycans, is incorrect as it is not directly related to the crystallization process in gouty arthritis. Choice C, overexcretion of uric acid, is incorrect because gout is primarily associated with underexcretion or decreased excretion of uric acid rather than overexcretion. Choice D, increased absorption of uric acid, is also incorrect as the primary issue in gouty arthritis is the body's inability to properly eliminate uric acid.

4. A 58-year-old woman comes to the clinic for evaluation of a sharp, intermittent, severe, stabbing facial pain that she describes as 'like an electric shock.' The pain occurs only on one side of her face; it seems to be triggered when she chews, brushes her teeth, or sometimes when she merely touches her face. There is no numbness associated with the pain. What is most likely causing her pain?

• A. Temporal arteritis
• B. Trigeminal neuralgia
• C. Migraine headache
• D. Cluster headache

Correct answer: B

Rationale: The correct answer is B: Trigeminal neuralgia. Trigeminal neuralgia is characterized by severe, stabbing pain in the distribution of the trigeminal nerve, often triggered by light touch, chewing, or brushing teeth. In this case, the patient's symptoms of sharp, intermittent facial pain triggered by activities like chewing and touching her face are classic for trigeminal neuralgia. Choices A, C, and D are incorrect. Temporal arteritis typically presents with unilateral headache, jaw claudication, and visual symptoms. Migraine headaches are usually throbbing in nature and often associated with nausea, vomiting, and sensitivity to light and sound. Cluster headaches are characterized by severe unilateral pain around the eye with autonomic symptoms like lacrimation and nasal congestion.

5. Which of the following characteristics is common in both malignant and benign tumors?

• A. Uncontrolled cell growth
• B. Rapid growth
• C. Metastasis
• D. Invasion of surrounding tissue

Correct answer: A

Rationale: The correct answer is A: Uncontrolled cell growth. This characteristic is common to both malignant and benign tumors. Benign tumors are non-cancerous growths that do not invade nearby tissue or spread to other parts of the body. Therefore, choices B, C, and D are incorrect. Rapid growth, metastasis, and invasion of surrounding tissue are characteristics typically associated with malignant tumors.

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