Nursing Elites

1. Which hormone is responsible for amenorrhea in the pregnant woman?

• A. Progesterone
• B. Estrogen
• C. Follicle-stimulating hormone (FSH)
• D. Human chorionic gonadotropin (hCG)

Correct answer: A

Rationale: Correct! Progesterone is the hormone responsible for amenorrhea in pregnant women. Progesterone plays a crucial role in maintaining the uterine lining for implantation and supporting early pregnancy. High levels of progesterone during pregnancy suppress the normal menstrual cycle, leading to amenorrhea. Estrogen, FSH, and hCG do not directly cause amenorrhea in pregnant women. Estrogen is involved in the development of female secondary sexual characteristics, FSH is involved in the growth and maturation of ovarian follicles, and hCG is produced by the placenta to support the production of progesterone during pregnancy.

2. A physician orders a serum creatinine for a hospitalized client. The nurse should explain to the client and his family that this test:

• A. is normal if the level is 4.0 to 5.5 mg/dl.
• B. can be elevated with increased protein intake.
• C. is a better indicator of renal function than the BUN.
• D. reflects the fluid volume status of a person

Correct answer: C

Rationale: A serum creatinine level should be 0.7 to 1.5 mg/dl, and it does not vary with increased protein intake, so it is a better indicator of renal function than the BUN. Choice A is incorrect as a serum creatinine level of 4.0 to 5.5 mg/dl is not normal. Choice B is incorrect as serum creatinine is not affected by increased protein intake. Choice D is incorrect as serum creatinine primarily reflects renal function, not fluid volume status.

3. One of the major functions of the kidneys in maintaining normal fluid balance is:

• A. the manufacture of antidiuretic hormone.
• B. the regulation of calcium and phosphate balance.
• C. the regulation of the pH of the extracellular fluid.
• D. the control of aldosterone levels.

Correct answer: C

Rationale: The correct answer is 'the regulation of the pH of the extracellular fluid.' The kidneys play a crucial role in maintaining normal fluid balance by regulating extracellular fluid and osmolarity through selective retention and excretion of fluids. Additionally, they regulate the pH of the extracellular fluid by retaining hydrogen ions and excreting metabolic wastes and toxic substances. Choice A is incorrect because antidiuretic hormone (ADH) is manufactured by the pituitary gland, not the kidneys. Choice B is incorrect as the regulation of calcium and phosphate balance is primarily controlled by the parathyroid gland. Choice D is incorrect as aldosterone levels are controlled by the adrenal glands, not the kidneys.

4. A nurse is caring for a patient in the step-down unit. The patient has signs of increased intracranial pressure. Which of the following is not a sign of increased intracranial pressure?

• A. Bradycardia
• B. Increased pupil size bilaterally
• C. Change in LOC
• D. Vomiting

Correct answer: B

Rationale: The correct answer is 'Increased pupil size bilaterally.' When assessing for signs of increased intracranial pressure, bilateral pupil dilation is not typically associated with this condition. Instead, unilateral pupil changes, especially one pupil becoming dilated or non-reactive while the other remains normal, are indicative of increased ICP. Bradycardia, a change in level of consciousness (LOC), and vomiting are commonly seen in patients with increased intracranial pressure due to the brain's response to the rising pressure. Therefore, the presence of bilateral pupil dilation goes against the typical pattern observed in patients with increased intracranial pressure.

5. A 55-year-old female asks a nurse the following, “Which mineral/vitamin is the most important to prevent the progression of osteoporosis?” The nurse should state:

• A. Potassium
• B. Magnesium
• C. Calcium
• D. Vitamin B12

Correct answer: C

Rationale: The correct answer is C: Calcium. Calcium is essential for maintaining bone health and is crucial in preventing osteoporosis. Adequate calcium intake, along with vitamin D, is vital for bone strength. While other minerals and vitamins are also important for overall health, in the context of preventing osteoporosis, calcium plays a primary role. Potassium (Choice A), Magnesium (Choice B), and Vitamin B12 (Choice D) are important for various bodily functions but are not as directly linked to preventing osteoporosis as calcium.

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