Nursing Elites

1. Mrs. Mendoza is a 75-year-old client who has dementia of the Alzheimer’s type and confabulates. The nurse understands that this client:

• A. Denies confusion by being jovial.
• B. Pretends to be someone else.
• C. Rationalizes various behaviors.
• D. Fills in memory gaps with fantasy.

Correct answer: D

Rationale: Confabulation, a common symptom in dementia, involves filling in memory gaps with fabricated stories rather than intentionally pretending to be someone else (Choice B), denying confusion by being jovial (Choice A), or rationalizing various behaviors (Choice C). Confabulation is not a deliberate act but a memory error that results in the creation of false memories.

2. What is the characteristic of the condition of leukemia?

• A. A benign growth of skin cells
• B. A malignant growth of skin cells
• C. A malignant growth of white blood cells
• D. A benign growth of white blood cells

Correct answer: C

Rationale: The correct answer is C: 'A malignant growth of white blood cells.' Leukemia is a type of cancer that affects the blood and bone marrow, leading to an overproduction of abnormal white blood cells. These cells are malignant and impair the normal function of healthy blood cells. Choices A, B, and D are incorrect because leukemia does not involve skin cells or benign growths; instead, it specifically refers to the abnormal proliferation of white blood cells.

3. Which manifestation of stress reflects the non-specific fight or flight response?

• A. Decreased pupillary light response
• B. Increased GI motility
• C. Decreased short-term memory
• D. Increased cardiopulmonary rates

Correct answer: D

Rationale: The correct answer is D, 'Increased cardiopulmonary rates.' The fight or flight response, activated by stress, is a non-specific physiological reaction that prepares the body to deal with perceived threats. In this response, the heart rate and breathing rate increase to supply more oxygen to muscles and vital organs, enabling a rapid response in dangerous situations. Choices A, B, and C are incorrect because decreased pupillary light response, increased GI motility, and decreased short-term memory are not typical manifestations of the fight or flight response.

4. During childhood, the thymus decreases in size, and this is referred to as ______ atrophy.

• A. Physiologic
• B. Pathologic
• C. Disuse
• D. Neurogenic

Correct answer: A

Rationale: The correct answer is A, 'Physiologic.' Physiologic atrophy is a normal part of development, like the reduction in thymus size during childhood. Pathologic atrophy (choice B) refers to tissue wasting due to disease, not a normal process like the reduction in thymus size. Disuse atrophy (choice C) results from a lack of physical activity or stimulation, which is not the case with thymus size reduction. Neurogenic atrophy (choice D) is caused by damage to or diseases of the nerves supplying the muscles, not related to the thymus size reduction seen in childhood.

5. A patient is prescribed sildenafil (Viagra) for erectile dysfunction. What important contraindication should the nurse emphasize during patient education?

• A. Use of nitrates
• B. History of hypertension
• C. History of peptic ulcer disease
• D. Use of antihypertensive medications

Correct answer: A

Rationale: The correct answer is A: 'Use of nitrates.' Sildenafil (Viagra) is contraindicated in patients using nitrates due to the risk of severe hypotension. Nitrates and sildenafil both cause vasodilation, leading to a synergistic effect that can result in a dangerous drop in blood pressure. Choices B, C, and D are incorrect because they are not direct contraindications for sildenafil use. While a history of hypertension or peptic ulcer disease may require caution, they are not absolute contraindications like the concomitant use of nitrates.

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