Nursing Elites

1. Which of the following describes the condition in the body of clients experiencing hypovolemia?

• A. Increased urine retention
• B. Insufficient circulating blood volume
• C. Bounding peripheral pulses
• D. Crackles auscultated in the lungs

Correct answer: B

Rationale: The correct answer is B: Insufficient circulating blood volume. Hypovolemia is a condition characterized by a decrease in the volume of blood plasma. This reduction in circulating blood volume can lead to inadequate perfusion of tissues and organs, potentially resulting in shock if left untreated. Choices A, C, and D are incorrect because increased urine retention, bounding peripheral pulses, and crackles auscultated in the lungs are not typical manifestations of hypovolemia.

2. Which clients are at highest risk for pneumonia?

• A. Those in their 20s and 30s and generally healthy
• B. Those who exercise regularly and are not exposed to pathogens
• C. Those who are hospitalized and immunocompromised
• D. Those who have adequate respiratory function

Correct answer: C

Rationale: Clients who are hospitalized and immunocompromised are at the highest risk for pneumonia due to their weakened immune systems. Choice A is incorrect as young and healthy individuals typically have stronger immune systems. Choice B is incorrect because regular exercise can actually boost the immune system and reduce the risk of infections. Choice D is incorrect as having adequate respiratory function does not necessarily correlate with the risk of developing pneumonia.

3. Staff at the care facility note that a woman has started complaining of back pain in recent weeks and occasionally groans in pain. She has many comorbidities that require several prescription medications. The nurse knows that which factor is likely to complicate the clinician's assessment and treatment of the client's pain?

• A. Her advanced age may influence the expression and perception of pain.
• B. Her polypharmacy may complicate the pain management process.
• C. Her underlying conditions may mask or exacerbate the pain.
• D. Her cognitive function may decline, making pain assessment difficult.

Correct answer: B

Rationale: Polypharmacy, or the use of multiple medications, can complicate pain management due to drug interactions and side effects. While advanced age can influence pain perception, it is not the most likely factor to complicate assessment and treatment in this scenario. Underlying conditions may affect pain perception but do not directly complicate the management process. Cognitive decline can hinder pain assessment, but in this case, the focus is on factors directly impacting the treatment process, making option B the most appropriate choice.

4. Which of the following is a characteristic of osteosarcoma?

• A. Slow-growing tumor that begins in the bone marrow
• B. Solitary tumor that most often affects the metaphyseal region of the femur or tibia
• C. An aggressive tumor most often found in the bone marrow of long bones
• D. A tumor that infiltrates the trabeculae in spongy bone and implants in surrounding tissue

Correct answer: C

Rationale: Osteosarcoma is an aggressive bone tumor that most commonly arises in the bone marrow of long bones, such as the femur or tibia. Choice A is incorrect as osteosarcoma is not a slow-growing tumor but rather a fast-growing one. Choice B is incorrect as osteosarcoma is not typically solitary but can involve multiple lesions. Choice D is incorrect as osteosarcoma primarily affects the medullary (marrow) cavity of bones, rather than infiltrating the trabeculae in spongy bone and surrounding tissue.

5. A 35-year-old female is diagnosed with vitamin B12 deficiency anemia (pernicious anemia). How should the nurse respond when the patient asks what causes pernicious anemia? A decrease in ______ is the most likely cause.

• A. Ferritin
• B. Gastric enzymes
• C. Intrinsic factor
• D. Erythropoietin

Correct answer: C

Rationale: Pernicious anemia is primarily caused by a decrease in intrinsic factor. Intrinsic factor is a protein produced by the stomach that is necessary for the absorption of vitamin B12 in the intestines. Without intrinsic factor, vitamin B12 cannot be absorbed properly, leading to anemia. Ferritin is a protein that stores iron in the body and is not directly related to pernicious anemia. Gastric enzymes play a role in digestion but are not the primary cause of pernicious anemia. Erythropoietin is a hormone produced by the kidneys to stimulate red blood cell production and is not linked to pernicious anemia.

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