Nursing Elites

1. Muscular dystrophy is a result of an abnormality of the muscle protein:

• A. glycoprotein
• B. dystrophin
• C. troponin
• D. actinomyosin

Correct answer: B

Rationale: Muscular dystrophy is primarily caused by mutations in the gene that provides instructions for making the protein dystrophin. Dystrophin plays a crucial role in maintaining the structure of muscle fibers. Glycoprotein is a general term for proteins with sugar molecules attached, not specifically related to muscular dystrophy. Troponin is a protein involved in muscle contraction regulation, and actinomyosin is not a specific muscle protein but a complex formed during muscle contraction. Therefore, the correct answer is dystrophin.

2. Nurse Isabelle enters the room of a client with a cognitive impairment disorder and asks what day of the week it is, what the date, month, and year are, and where the client is. The nurse is attempting to assess:

• A. confabulation.
• B. delirium.
• C. orientation.
• D. perseveration.

Correct answer: C

Rationale: The correct answer is C: "orientation." Nurse Isabelle is assessing the client's orientation by asking questions about time (day, date, month, year), place, and person. This assessment helps determine the client's awareness of their surroundings and situation. Confabulation (choice A) is the unintentional fabrication of details or events to fill in memory gaps and is not being assessed in this scenario. Delirium (choice B) is a state of acute confusion and disorientation, usually with a rapid onset, which is different from assessing orientation. Perseveration (choice D) refers to the persistent repetition of a response, statement, or behavior and is not the focus of the assessment being conducted by Nurse Isabelle in this situation.

3. A male patient is being treated with testosterone gel for hypogonadism. What important instruction should the nurse provide regarding the application of this medication?

• A. Apply the gel to the chest or upper arms.
• B. Apply the gel to the lower abdomen or thighs.
• C. Apply the gel to the face and neck.
• D. Apply the gel to the scalp and back.

Correct answer: A

Rationale: The correct answer is to apply the testosterone gel to the chest or upper arms. This is important to minimize the risk of transfer to others. Applying the gel to the lower abdomen, thighs, face, or neck can increase the risk of transfer to others, especially women and children who should avoid contact with testosterone gel. Applying it to the scalp and back is not recommended as these areas are not suitable for absorption of the medication.

4. A patient is receiving intravenous amphotericin. Which of the following assessments warrants the discontinuation of the antifungal agent?

• A. Sodium level of 138 mEq/L
• B. Hematocrit of 39%
• C. Blood urea nitrogen of 60 mg/dL
• D. AST level of 10 Unit/L

Correct answer: C

Rationale: Intravenous amphotericin can cause nephrotoxicity, leading to increased blood urea nitrogen levels. Elevated blood urea nitrogen (BUN) indicates impaired renal function, which is a known adverse effect of amphotericin. Therefore, a BUN level of 60 mg/dL warrants the discontinuation of the antifungal agent. The other options, such as a sodium level of 138 mEq/L, hematocrit of 39%, and AST level of 10 Unit/L, are within normal ranges and not indicative of the need to discontinue amphotericin therapy.

5. A client with atrial fibrillation is at risk for which of the following complications?

• A. Deep vein thrombosis (DVT)
• B. Pulmonary embolism
• C. Hypertensive crisis
• D. Myocardial infarction

Correct answer: B

Rationale: Corrected Rationale: A client with atrial fibrillation is at increased risk of thromboembolism due to blood stasis in the atria. This can lead to the formation of blood clots, which may travel to the lungs and cause a pulmonary embolism. Pulmonary embolism is a serious complication of atrial fibrillation. Choices A, C, and D are incorrect because while atrial fibrillation can lead to complications such as stroke or heart failure, it is specifically associated with an increased risk of pulmonary embolism due to the clot formation associated with the condition.

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