Nursing Elites

1. Manifestations of Cushing syndrome include:

• A. truncal obesity with thin extremities.
• B. enlargement of face, hands, and feet.
• C. cachexia.
• D. thick scalp hair.

Correct answer: A

Rationale: The correct manifestation of Cushing syndrome is truncal obesity with thin extremities. This occurs due to the redistribution of fat to the face, neck, and abdomen, while the arms and legs remain thin. Choice B, enlargement of face, hands, and feet, is more indicative of acromegaly. Choice C, cachexia, refers to extreme weight loss and muscle wasting, which is typically not seen in Cushing syndrome. Choice D, thick scalp hair, is not a typical manifestation of Cushing syndrome.

2. In chronic obstructive pulmonary disease, the inflammatory response predominantly involves:

• A. eosinophils
• B. neutrophils
• C. monocytes
• D. cells

Correct answer: B

Rationale: In chronic obstructive pulmonary disease, the inflammatory response predominantly involves neutrophils. Neutrophils play a key role in COPD due to their involvement in initiating and sustaining the inflammatory process. Eosinophils are more commonly associated with asthma rather than COPD. Monocytes are less involved in the inflammatory response in COPD compared to neutrophils. The choice 'cells' is too broad and vague to be a specific answer in this context.

3. The parents of a 4-year-old girl have sought care because their daughter has admitted to chewing and swallowing imported toy figurines that have been determined to be made of lead. Which of the following blood tests should the care team prioritize?

• A. White blood cell levels with differential
• B. Red blood cell levels and morphology
• C. Urea and creatinine levels
• D. Liver function panel

Correct answer: B

Rationale: The correct answer is B: Red blood cell levels and morphology. Lead poisoning primarily affects red blood cells, causing anemia. Therefore, the priority test would be to assess red blood cell levels and morphology. Choice A (White blood cell levels with differential) is incorrect as lead poisoning does not primarily affect white blood cells. Choice C (Urea and creatinine levels) is unrelated to lead poisoning and not a priority in this scenario. Choice D (Liver function panel) is also not the priority as lead poisoning's primary impact is on the red blood cells, not the liver.

4. A male patient is receiving androgen therapy for hypogonadism. What laboratory tests should the nurse monitor during this therapy?

• A. Liver function tests
• B. Kidney function tests
• C. Prostate-specific antigen (PSA)
• D. Complete blood count (CBC)

Correct answer: A

Rationale: During androgen therapy for hypogonadism, it is important to monitor liver function tests. Androgens can affect the liver, potentially leading to liver dysfunction. Monitoring liver function tests helps in early detection of any liver abnormalities. Kidney function tests (Choice B) are not typically affected by androgen therapy. Prostate-specific antigen (PSA) levels (Choice C) may be monitored for conditions like prostate cancer, but it is not directly related to androgen therapy for hypogonadism. A complete blood count (CBC) (Choice D) may not show specific changes related to androgen therapy for hypogonadism.

5. A patient is starting on alendronate (Fosamax) for osteoporosis. What instructions should the nurse provide to ensure the effectiveness of the medication?

• A. Take the medication with a full glass of water and remain upright for at least 30 minutes.
• B. Take the medication at bedtime to ensure absorption during sleep.
• C. Take the medication with milk to enhance calcium absorption.
• D. Take the medication with food to prevent gastrointestinal upset.

Correct answer: A

Rationale: The correct answer is to take alendronate with a full glass of water and remain upright for at least 30 minutes. This is essential to prevent esophageal irritation and ensure proper absorption. Choice B is incorrect because taking alendronate at bedtime can increase the risk of esophageal irritation due to lying down. Choice C is incorrect as taking alendronate with milk can reduce its absorption. Choice D is incorrect because alendronate should be taken on an empty stomach to enhance its effectiveness.

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