Nursing Elites

1. The nurse is closely following a patient who began treatment with testosterone several months earlier. When assessing the patient for potential adverse effects of treatment, the nurse should prioritize which of the following assessments?

• A. Skin inspection for developing lesions
• B. Lung function testing
• C. Assessment of serum calcium levels
• D. Assessment of arterial blood gases

Correct answer: C

Rationale: In patients receiving testosterone therapy, the nurse should prioritize assessing serum calcium levels. Testosterone therapy can lead to hypercalcemia, making the evaluation of serum calcium levels crucial. Skin inspection for developing lesions, lung function testing, and arterial blood gas assessment are not the priority assessments for potential adverse effects of testosterone therapy. Skin inspection may be relevant for dermatological side effects, lung function testing and arterial blood gas assessment are not directly related to the common side effects of testosterone therapy.

2. What is the most common cause of cancer-related deaths in both men and women?

• A. Lung cancer
• B. Breast cancer
• C. Colorectal cancer
• D. Prostate cancer

Correct answer: A

Rationale: Lung cancer is the leading cause of cancer-related deaths in both men and women globally. It is strongly associated with smoking and exposure to environmental toxins. Breast cancer (choice B) primarily affects women, while colorectal cancer (choice C) and prostate cancer (choice D) are more gender-specific. Colorectal cancer is more common in both men and women but not the leading cause of cancer-related deaths.

3. A patient is prescribed zanamivir (Relenza) to treat influenza B. The patient has a history of asthma. For which of the following symptoms should the nurse assess?

• A. Bradycardia
• B. Pneumonia
• C. Bronchospasm
• D. Pulmonary embolism

Correct answer: C

Rationale: The correct answer is C: Bronchospasm. Zanamivir (Relenza) is an inhaled medication used to treat influenza by reducing the severity and duration of symptoms. Patients with a history of asthma are at risk of bronchospasm as a potential side effect of zanamivir. Assessing for bronchospasm is crucial in this case to ensure the patient's safety and well-being. Choices A, B, and D are incorrect. Bradycardia, pneumonia, and pulmonary embolism are not commonly associated with zanamivir use in the treatment of influenza B, especially in a patient with a history of asthma.

4. 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.

5. In emphysema, what features result in impaired oxygenation?

• A. The bronchioles are inflamed and filled with mucus
• B. The alveoli have lost surfactant and collapse
• C. Enlarged, permanently inflated alveoli
• D. The accumulation of purulent fluid in the bronchioles

Correct answer: C

Rationale: The correct answer is C. In emphysema, impaired oxygenation results from enlarged and permanently inflated alveoli, leading to reduced surface area for gas exchange. Choices A, B, and D are incorrect. In emphysema, bronchioles are not typically filled with mucus, alveoli losing surfactant and collapsing is more characteristic of conditions like atelectasis, and purulent fluid accumulation in the bronchioles is commonly seen in conditions like pneumonia, not emphysema.

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