Nursing Elites

1. Multiple sclerosis manifests as asymmetrical and in different parts of the body because:

• A. Autoreactive lymphocytes are causing diffuse patchy damage to the myelin sheath in the central nervous system.
• B. Acetylcholine receptors are destroyed by immunoglobulin G.
• C. Autoreactive T lymphocytes cause progressive loss of neurons in the substantia nigra.
• D. Cortical motor cells degenerate.

Correct answer: A

Rationale: The correct answer is A. Multiple sclerosis is characterized by the immune system attacking the myelin sheath in the central nervous system. This attack leads to patchy damage on the myelin sheath, resulting in asymmetrical neurological symptoms. Choices B, C, and D are incorrect because they do not accurately describe the pathophysiology of multiple sclerosis. In multiple sclerosis, it is the autoreactive lymphocytes that target and damage the myelin sheath, not acetylcholine receptors, T lymphocytes, or cortical motor cells.

2. A patient is being treated with finasteride (Proscar) for benign prostatic hyperplasia (BPH). What expected outcome should the nurse include in the patient teaching?

• A. The medication will cure BPH after treatment is complete.
• B. The effects of the medication may take several weeks or months to become noticeable.
• C. The medication may cause increased hair growth.
• D. The medication may decrease libido.

Correct answer: B

Rationale: The correct answer is B. Finasteride is used to reduce the size of the prostate gland in patients with BPH, leading to decreased urinary frequency and urgency over several weeks or months. Choice A is incorrect because finasteride does not cure BPH but helps manage symptoms. Choice C is incorrect as increased hair growth is associated with another medication called minoxidil, not finasteride. Choice D is incorrect since finasteride may cause a decrease in libido as a side effect.

3. A patient is receiving finasteride (Proscar) for the treatment of benign prostatic hyperplasia. Which of the following is an expected outcome of the medication?

• A. Decrease in the size of the prostate gland.
• B. Improved urinary flow and decreased symptoms of urinary retention.
• C. Increased production of prostate-specific antigen (PSA).
• D. Reduction in the number of nocturnal awakenings.

Correct answer: B

Rationale: The correct answer is B. Finasteride (Proscar) is used in the treatment of benign prostatic hyperplasia to improve urinary flow and decrease symptoms of urinary retention by reducing the size of the prostate gland. Choice A is incorrect because although finasteride may reduce the size of the prostate gland, the expected outcome relevant to the patient's symptoms is improved urinary flow rather than a specific change in gland size. Choice C is incorrect because finasteride actually decreases the production of prostate-specific antigen (PSA) due to its mechanism of action. Choice D is incorrect because although improved urinary flow may lead to a reduction in nocturnal awakenings, the main expected outcome of finasteride treatment is related to urinary symptoms.

4. A 35-year-old male has enlarged lymph nodes in the neck and a mediastinal mass. He was diagnosed with Hodgkin lymphoma. Which of the following abnormal cells would the nurse expect to find with this disease?

• A. Merkel cell
• B. Schwann cell
• C. Reed-Sternberg cell
• D. Kupffer cell

Correct answer: C

Rationale: Reed-Sternberg cells are characteristic of Hodgkin lymphoma. These large abnormal cells have a bi-lobed or multi-lobed nucleus and are essential for diagnosing Hodgkin lymphoma through histological examination. Merkel cells are associated with Merkel cell carcinoma, Schwann cells are related to nerve sheaths, and Kupffer cells are liver macrophages. Therefore, choices A, B, and D are incorrect for Hodgkin lymphoma.

5. What important instruction should the nurse provide regarding the application of testosterone gel in a patient with hypogonadism?

• A. Apply the gel to the chest or upper arms and allow it to dry completely before dressing.
• B. Apply the gel to the face and neck for maximum absorption.
• C. Apply the gel to the genitals for improved results.
• D. Apply the gel to the scalp and back for better results.

Correct answer: A

Rationale: The correct instruction for applying testosterone gel in a patient with hypogonadism is to apply it to the chest or upper arms and allow it to dry completely before dressing. This method helps avoid transfer to others. Applying the gel to the face, neck, or genitals is not recommended as it can lead to unintended exposure to others. Additionally, applying the gel to the scalp and back is not a standard or effective route of administration for testosterone gel. Therefore, choice A is the correct answer as it ensures proper application and safety.

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