Nursing Elites

1. Right-sided heart failure is characterized by:

• A. Immunosuppression
• B. Pulmonary edema
• C. Peripheral edema
• D. Coughing

Correct answer: C

Rationale: Right-sided heart failure is characterized by peripheral edema, which results from the buildup of fluid in the body. This fluid accumulates in the extremities due to the heart's inability to effectively pump blood forward. Choices A, B, and D are incorrect. Immunosuppression is not a typical feature of right-sided heart failure. Pulmonary edema is more commonly associated with left-sided heart failure, where fluid accumulates in the lungs. Coughing is a symptom that can be present in various conditions but is not a defining characteristic of right-sided heart failure.

2. A male patient with benign prostatic hyperplasia (BPH) is being treated with tamsulosin (Flomax). What should the nurse include in the teaching plan for this patient?

• A. Avoid lying down after taking the medication.
• B. Take the medication with meals.
• C. Report any side effects such as dizziness or fainting.
• D. Take the medication at bedtime.

Correct answer: C

Rationale: The correct answer is C: 'Report any side effects such as dizziness or fainting.' Patients taking tamsulosin should be advised to report any side effects, such as dizziness or fainting, which can occur due to orthostatic hypotension. Choices A, B, and D are incorrect because avoiding lying down after taking the medication, taking it with meals, or at bedtime are not specific teaching points related to the potential side effects of tamsulosin.

3. A nurse is educating a client with peripheral artery disease (PAD). Which statement made by the client indicates a need for further teaching?

• A. I should avoid walking for long periods to prevent leg pain.
• B. I should inspect my feet daily for any sores or wounds.
• C. I should wear compression stockings to improve circulation.
• D. I should avoid smoking to prevent further damage to my arteries.

Correct answer: A

Rationale: The correct answer is A. Walking is crucial in improving circulation in peripheral artery disease; therefore, the client should not avoid walking for long periods. Choices B, C, and D are correct statements for a client with PAD. Inspecting feet daily helps in early detection of sores or wounds, wearing compression stockings improves circulation, and avoiding smoking helps prevent further damage to arteries in PAD.

4. A patient is prescribed clomiphene citrate (Clomid) for the treatment of infertility. Which of the following statements should be included in the nurse's teaching?

• A. This drug induces ovulation by stimulating gonadotropins.
• B. This drug induces ovulation by inhibiting gonadotropins.
• C. This drug suppresses ovulation by inhibiting gonadotropins.
• D. This drug increases progesterone levels, which maintains pregnancy.

Correct answer: A

Rationale: The correct statement to include in the nurse's teaching is that clomiphene induces ovulation by stimulating the release of gonadotropins, which in turn stimulate the ovaries. Choice B is incorrect because clomiphene does not induce ovulation by inhibiting gonadotropins. Choice C is also incorrect as clomiphene does not suppress ovulation by inhibiting gonadotropins. Choice D is inaccurate as clomiphene does not directly increase progesterone levels to maintain pregnancy.

5. A 45-year-old woman presents with fatigue, weight gain, and cold intolerance. Her thyroid function tests reveal low T3 and T4 levels and elevated TSH levels. Which of the following is the most likely diagnosis?

• A. Hyperthyroidism
• B. Hypothyroidism
• C. Euthyroid sick syndrome
• D. Subclinical hyperthyroidism

Correct answer: B

Rationale: The scenario describes a 45-year-old woman with fatigue, weight gain, cold intolerance, low T3 and T4 levels, and elevated TSH levels, which are indicative of hypothyroidism. In hypothyroidism, there is decreased production of thyroid hormones (T3 and T4) leading to elevated TSH levels as the pituitary gland tries to stimulate the thyroid gland to produce more hormones. Therefore, the correct answer is hypothyroidism (Choice B). Choice A, Hyperthyroidism, is incorrect as the patient's symptoms and thyroid function tests point towards decreased thyroid hormone levels, which is characteristic of hypothyroidism, not hyperthyroidism. Choice C, Euthyroid sick syndrome, is incorrect because this condition typically presents with normal to low T3 and T4 levels in the setting of non-thyroid illness, unlike the elevated TSH levels observed in this case. Choice D, Subclinical hyperthyroidism, is also incorrect as the patient has low T3 and T4 levels, which is not consistent with hyperthyroidism, whether clinical or subclinical.

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