Nursing Elites

1. Which of the following is a key symptom of myocardial infarction (MI)?

• A. Chest pain.
• B. Shortness of breath.
• C. Nausea.
• D. Fatigue.

Correct answer: A

Rationale: The correct answer is A: Chest pain. Chest pain is a hallmark symptom of myocardial infarction (MI) due to inadequate blood flow to the heart muscle. This pain can be severe, crushing, or squeezing, and may radiate to the left arm, jaw, or back. Shortness of breath (choice B), nausea (choice C), and fatigue (choice D) can accompany MI but are not as specific or characteristic as chest pain in diagnosing this condition. Therefore, chest pain is the primary symptom to recognize for suspected MI.

2. What most likely led to the 67-year-old woman who lives alone tripping on a rug in her home and fracturing her hip?

• A. Failing eyesight causing an unsafe environment.
• B. Renal osteodystrophy due to chronic renal failure.
• C. Osteoporosis due to hormonal changes.
• D. Cardiovascular changes leading to small strokes impairing mental acuity.

Correct answer: C

Rationale: The correct answer is C. Osteoporosis, caused by hormonal changes in later life, is the most likely predisposing factor for the fracture in the proximal end of her femur. Osteoporosis leads to reduced bone density, making bones more fragile and susceptible to fractures, especially in the elderly. Choices A, B, and D are less likely to directly lead to a hip fracture in this scenario. Failing eyesight (choice A) could contribute to the fall but is not the main predisposing factor for the fracture. Renal osteodystrophy (choice B) and cardiovascular changes (choice D) are less commonly associated with hip fractures compared to osteoporosis in elderly women.

3. What do crackles heard on lung auscultation indicate?

• A. Cyanosis.
• B. Bronchospasm.
• C. Airway narrowing.
• D. Fluid-filled alveoli.

Correct answer: D

Rationale: Crackles heard on lung auscultation are caused by the popping open of small airways that are filled with fluid. This is commonly associated with conditions such as pulmonary edema, pneumonia, or heart failure. Cyanosis (Choice A) is a bluish discoloration of the skin and mucous membranes due to low oxygen levels in the blood, not directly related to crackles. Bronchospasm (Choice B) refers to the constriction of the airway smooth muscle, causing difficulty in breathing but does not typically produce crackles. Airway narrowing (Choice C) can lead to wheezing but is not directly linked to crackles heard on auscultation.

4. The client with deep vein thrombosis (DVT) in the left lower leg is receiving heparin therapy. Which of the following assessments is the most important for the nurse to perform?

• A. Measure the circumference of the left leg.
• B. Assess for signs of bleeding, such as bruising or hematuria.
• C. Monitor the client's vital signs.
• D. Monitor the client's respiratory status.

Correct answer: B

Rationale: The most important assessment for a client with DVT on heparin therapy is to monitor for signs of bleeding, such as bruising or hematuria. Heparin is an anticoagulant medication that can increase the risk of bleeding. Assessing for bleeding is crucial to prevent complications like hemorrhage. Measuring the circumference of the leg may be relevant for assessing for edema but is not as critical as monitoring for bleeding. Monitoring vital signs and respiratory status are important aspects of care but are not the priority when the client is on heparin therapy for DVT.

5. A male client expresses concern about how a hypophysectomy will affect his sexual function. Which of the following statements provides the most accurate information about the physiologic effects of hypophysectomy?

• A. Removing the source of excess hormone should restore the client's libido, erectile function, and fertility.
• B. Potency will be restored, but the client will remain infertile.
• C. Fertility will be restored, but impotence and decreased libido will persist.
• D. Exogenous hormones will be needed to restore erectile function after the adenoma is removed.

Correct answer: A

Rationale: Choice A is the most accurate statement regarding the physiologic effects of hypophysectomy on sexual function. The client's sexual problems are directly related to excessive hormone levels. Removing the source of excess hormone secretion through hypophysectomy should allow the client to return to a normal physiologic pattern, which includes restoring libido, erectile function, and fertility. Choices B, C, and D are incorrect. Choice B incorrectly states that the client will remain infertile, which is not necessarily true after a hypophysectomy. Choice C inaccurately suggests that fertility will be restored while impotence and decreased libido will persist, which is not aligned with the expected outcomes of hypophysectomy. Choice D is incorrect because exogenous hormones are typically not needed to restore erectile function after the adenoma is removed; rather, the removal of the source of excessive hormone secretion should address the sexual function concerns.

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