Nursing Elites

1. Macular degeneration occurs as a result of:

• A. loss of lens accommodation
• B. detachment of the retina
• C. increased intraocular pressure
• D. impaired blood supply leading to cellular waste accumulation and ischemia

Correct answer: D

Rationale: Macular degeneration is a condition that affects the macula, a part of the retina responsible for central vision. It is primarily caused by impaired blood supply to the macula, leading to cellular waste accumulation and ischemia. This results in the death of photoreceptor cells and ultimately vision loss. Choices A, B, and C are incorrect because macular degeneration is not related to the loss of lens accommodation, detachment of the retina, or increased intraocular pressure. The correct answer directly addresses the underlying pathophysiology of macular degeneration.

2. A home care nurse visits a patient who is bed-bound and lives in a 12-story high-rise apartment complex. Her daughter states that she has small red skin lesions over her body and she has been itching. What parasite is most likely responsible for this patient's skin lesions?

• A. Sarcoptes scabiei
• B. Pediculus humanus corporis
• C. Pediculus humanus pubis
• D. Toxoplasma gondii

Correct answer: A

Rationale: The correct answer is Sarcoptes scabiei. Sarcoptes scabiei is a parasitic mite that causes scabies, characterized by small red skin lesions and intense itching. Pediculosis corporis (choice B) refers to body lice, which do not cause the specific symptoms described. Pediculosis pubis (choice C) is caused by pubic lice and presents differently from the symptoms described. Toxoplasma gondii (choice D) is a parasite that causes toxoplasmosis, but it does not typically manifest with small red skin lesions and itching.

3. Which of the following is a clinical manifestation of hyperthyroidism?

• A. Tachycardia
• B. Constipation
• C. Weight gain
• D. Fatigue

Correct answer: A

Rationale: The correct answer is A: Tachycardia. Tachycardia, which is an increased heart rate, is a classic clinical manifestation of hyperthyroidism. In hyperthyroidism, there is an excess production of thyroid hormones, leading to an increased metabolic rate. This increased metabolism can cause symptoms such as a rapid heart rate. Choices B, C, and D are incorrect because constipation, weight gain, and fatigue are more commonly associated with hypothyroidism, where there is a deficiency of thyroid hormones leading to a slower metabolic rate.

4. A student is feeling inside her backpack to find her mobile phone. There are a number of other items in the bag other than the phone. The nurse knows that which term best describes one's ability to sense the shape and size of an object in the absence of visualization?

• A. Stereognosis
• B. Graphesthesia
• C. Proprioception
• D. Kinesthesia

Correct answer: A

Rationale: Stereognosis is the correct answer. It refers to the ability to recognize objects by touch, specifically determining their shape and size without relying on visual cues. Graphesthesia, on the other hand, is the ability to recognize symbols or numbers traced on the skin. Proprioception involves the awareness of body position and movement. Kinesthesia relates to the perception of body movement.

5. What important instruction should the nurse provide about taking medroxyprogesterone acetate (Provera) for a patient with endometriosis?

• A. Take the medication at the same time each day to maintain consistent hormone levels.
• B. Medroxyprogesterone should be taken with food to reduce gastrointestinal upset.
• C. Discontinue medroxyprogesterone if side effects occur.
• D. Medroxyprogesterone should be taken once a week to maintain effectiveness.

Correct answer: A

Rationale: The correct answer is to take the medication at the same time each day to maintain consistent hormone levels and effectiveness. This consistency is crucial for achieving therapeutic outcomes. Choice B is incorrect because medroxyprogesterone should be taken at the same time each day, regardless of food intake. Choice C is incorrect because side effects should be reported to the healthcare provider for further evaluation rather than discontinuing the medication abruptly. Choice D is incorrect as medroxyprogesterone is usually taken daily for the prescribed duration.

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