Nursing Elites

1. What causes hepatic encephalopathy?

• A. A brain infection
• B. Increased ammonia levels in the bloodstream
• C. Decreased albumin blood levels
• D. Untreated chronic bronchitis

Correct answer: B

Rationale: Hepatic encephalopathy is caused by increased ammonia levels in the bloodstream. Ammonia, a byproduct of protein metabolism normally processed by the liver, accumulates in the bloodstream when the liver is unable to function properly. This excess ammonia affects brain function, leading to symptoms of hepatic encephalopathy. Choices A, C, and D are incorrect because they do not directly relate to the pathophysiology of hepatic encephalopathy.

2. A patient is prescribed 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 face and neck.
• C. Apply the gel to the genitals for maximum absorption.
• 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 recommended to minimize the risk of unintentional transfer of the medication to others, especially women and children, through skin contact. Applying the gel to the face, neck, or genitals is not advised as it can lead to unintended exposure to others. Additionally, applying the gel to the scalp or back is not appropriate as these areas are not indicated for absorption of testosterone.

3. What critical point should the nurse include in patient education regarding tamoxifen (Nolvadex) for a patient with breast cancer?

• A. Tamoxifen may increase the risk of venous thromboembolism.
• B. Tamoxifen may cause hot flashes and other menopausal symptoms.
• C. Tamoxifen may cause weight gain and fluid retention.
• D. Tamoxifen may decrease the risk of osteoporosis.

Correct answer: A

Rationale: The correct answer is A. Tamoxifen increases the risk of venous thromboembolism. Patients should be educated about the signs and symptoms of blood clots, such as swelling, redness, and pain in the legs. Choices B, C, and D are incorrect because tamoxifen is not associated with causing hot flashes, weight gain, fluid retention, or decreasing the risk of osteoporosis.

4. Following a spinal cord injury suffered in a motor vehicle accident, a 22-year-old male has lost fine motor function of his finger and thumb, but is still able to perform gross motor movements of his hand and arm. Which component of his 'white matter' has most likely been damaged?

• A. The inner layer (archilayer)
• B. The middle layer (paleolayer)
• C. The outer layer (neolayer)
• D. The reticular formation

Correct answer: C

Rationale: The correct answer is C: The outer layer (neolayer). The white matter of the spinal cord consists of three layers: the outer layer (neolayer), the middle layer (paleolayer), and the inner layer (archilayer). Damage to the outer layer (neolayer) is likely to affect fine motor skills, explaining the loss of fine motor function in the finger and thumb while gross motor movements remain intact. Choices A, B, and D are incorrect as they do not correspond to the specific layer of the white matter that is typically associated with fine motor control.

5. 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.

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