Nursing Elites

1. In which of the following conditions might increased cortisol levels be found?

• A. Cushing's syndrome
• B. Addison's disease
• C. Renal failure
• D. Congestive heart failure

Correct answer: A

Rationale: Cushing's syndrome is characterized by increased cortisol levels due to the overproduction of cortisol by the adrenal glands. This excess cortisol can lead to various symptoms and complications. Addison's disease is associated with decreased cortisol levels as it results from adrenal insufficiency, making it an incorrect choice in this context. Renal failure and congestive heart failure are not typically linked to abnormal cortisol levels, further indicating that they are not the conditions where increased cortisol levels are found.

2. During an annual physical exam, a client is diagnosed with Benign Prostatic Hyperplasia (BPH). This client is likely to have a consult with which type of physician?

• A. gynecologist
• B. physiatrist
• C. urologist
• D. proctologist

Correct answer: C

Rationale: A client diagnosed with Benign Prostatic Hyperplasia (BPH) would typically have a consult with a urologist. Urologists specialize in urinary tract and prostatic diseases, making them the appropriate choice for managing BPH. A gynecologist focuses on diseases of the female reproductive tract, so they are not relevant in this case. A physiatrist specializes in rehabilitation care, which is not directly related to the treatment of BPH. A proctologist specializes in lower colonic digestive diseases, which are unrelated to BPH.

3. At what point in the nurse-client relationship should termination first be addressed?

• A. in the working phase
• B. in the termination phase
• C. in the orientation phase
• D. when the client initially brings up the topic

Correct answer: C

Rationale: Termination in the nurse-client relationship should first be addressed in the orientation phase. This is because the client has a right to know the parameters of the relationship from the beginning. During the orientation phase, it is important to discuss if the relationship is time-limited, inform the client about the number of sessions, or explain that it is open-ended with the termination date to be negotiated later. Addressing termination in the orientation phase helps establish transparency and clear communication. Choices A, B, and D are incorrect because termination discussions should ideally start at the beginning of the relationship to set appropriate expectations.

4. How often should physical restraints be released?

• A. Every 2 hours
• B. Between 1 and 3 hours
• C. Every 30 minutes
• D. At least every 4 hours

Correct answer: A

Rationale: The correct answer is to release physical restraints every 2 hours. Releasing restraints every 2 hours helps prevent complications associated with prolonged immobilization. Releasing restraints every 30 minutes (choice C) may be too frequent and disruptive to the client's care. Releasing restraints between 1 and 3 hours (choice B) introduces variability that could lead to inconsistencies in care. Releasing restraints at least every 4 hours (choice D) does not adhere to the recommended frequency of every 2 hours.

5. Following an automobile accident that caused a head injury to an adult client, the nurse observes that the client sleeps for long periods of time. The nurse determines that the client has experienced injury to the:

• A. hypothalamus.
• B. thalamus.
• C. cortex.
• D. medulla.

Correct answer: A

Rationale: The hypothalamus is responsible for regulating sleep patterns among other functions. Injury to the hypothalamus can disrupt the sleep-wake cycle, leading to excessive sleepiness or changes in sleep patterns. Choices B, C, and D are incorrect as they do not primarily control sleep regulation. The thalamus is involved in relaying sensory information, the cortex is responsible for higher brain functions, and the medulla controls vital functions such as heartbeat and breathing.

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