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 client with a history of hypertension presents with a severe headache and blurred vision. What is the nurse's priority action?

• A. Administer pain relief medication.
• B. Obtain a stat head CT scan.
• C. Administer antihypertensive medications as prescribed.
• D. Call the healthcare provider immediately.

Correct answer: C

Rationale: The correct answer is to administer antihypertensive medications as prescribed. In a client with a history of hypertension presenting with severe headache and blurred vision, these symptoms could indicate a hypertensive crisis. The priority action is to lower the blood pressure promptly to prevent complications such as stroke, heart attack, or organ damage. Administering antihypertensive medications is crucial in this situation. Administering pain relief medication (Choice A) may temporarily alleviate symptoms but does not address the underlying issue of elevated blood pressure. Obtaining a stat head CT scan (Choice B) may be necessary to rule out other causes but should not delay the administration of antihypertensive medications. Calling the healthcare provider immediately (Choice D) is important but may not address the immediate need to lower blood pressure in a hypertensive crisis.

3. A man with gout has developed large, hard nodules around his toes and elbows. The phase of gout he is in is:

• A. asymptomatic
• B. acute flare
• C. the intercritical period
• D. chronic gout

Correct answer: D

Rationale: The correct answer is 'chronic gout.' Chronic gout is characterized by the presence of tophi, which are large, hard nodules that can develop around joints like toes and elbows. These tophi are a sign of longstanding, untreated gout. Choice A, 'asymptomatic,' is incorrect as the presence of tophi indicates a symptomatic phase. Choice B, 'acute flare,' is incorrect as acute flares are characterized by sudden and severe pain, inflammation, and redness in the joints, not the development of tophi. Choice C, 'the intercritical period,' is also incorrect as this phase occurs between acute attacks and is typically asymptomatic, without the presence of tophi.

4. What aspect of this woman's current health status would contraindicate the use of oral contraceptives?

• A. The woman has a diagnosis of type 2 diabetes.
• B. The woman has asthma and uses inhaled corticosteroids and bronchodilators.
• C. The woman has a family history of breast cancer.
• D. The woman takes an antiplatelet medication for coronary artery disease.

Correct answer: A

Rationale: The correct answer is A. Women with type 2 diabetes are at higher risk of developing cardiovascular complications. Oral contraceptives further increase this risk due to their potential effects on blood pressure, lipid metabolism, and clotting factors. Choice B is incorrect as inhaled corticosteroids and bronchodilators do not contraindicate the use of oral contraceptives. Choice C is incorrect as a family history of breast cancer does not directly contraindicate the use of oral contraceptives. Choice D is also incorrect as taking an antiplatelet medication for coronary artery disease does not necessarily contraindicate the use of oral contraceptives.

5. During an assessment of a male client suspected of having a disorder of motor function, which finding would suggest a possible upper motor neuron (UMN) lesion?

• A. Hypotonia
• B. Hyperreflexia
• C. Muscle atrophy
• D. Fasciculations

Correct answer: B

Rationale: Hyperreflexia, or exaggerated reflexes, is a common sign of an upper motor neuron (UMN) lesion. An UMN lesion indicates damage to the central nervous system pathways that control movement. Hypotonia (choice A) refers to reduced muscle tone, which is more indicative of lower motor neuron lesions. Muscle atrophy (choice C) suggests long-standing denervation or disuse of muscles. Fasciculations (choice D) are involuntary muscle contractions that can be seen in lower motor neuron lesions, like in amyotrophic lateral sclerosis (ALS), rather than UMN lesions.

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