Nursing Elites

1. Which of the following tests is recommended for lung cancer screening?

• A. Chest X-ray
• B. Pulmonary function test
• C. Computed tomography (CT) scan
• D. Magnetic resonance imaging

Correct answer: C

Rationale: The correct answer is Computed tomography (CT) scan. When screening for lung cancer, CT scans are recommended over chest X-rays due to their higher sensitivity in detecting lung nodules and early-stage cancers. Pulmonary function tests are not used for screening lung cancer but rather to assess lung function. Magnetic resonance imaging is not the preferred imaging modality for routine lung cancer screening, as CT scans are more commonly used.

2. A male patient is receiving testosterone therapy for hypogonadism. What adverse effect should the nurse be most concerned about?

• A. Increased risk of breast cancer
• B. Increased risk of liver dysfunction
• C. Increased risk of cardiovascular events
• D. Increased risk of prostate cancer

Correct answer: C

Rationale: The correct answer is C: Increased risk of cardiovascular events. Cardiovascular events such as stroke and myocardial infarction are the most concerning adverse effects of testosterone therapy, especially in older patients. Choice A, increased risk of breast cancer, is not a common adverse effect of testosterone therapy in males. Choice B, increased risk of liver dysfunction, is a potential adverse effect but is not the most concerning. Choice D, increased risk of prostate cancer, is a consideration in patients with a history of prostate cancer or those with prostate carcinoma, not typically in patients receiving testosterone therapy for hypogonadism.

3. A nurse working in a busy orthopedic clinic is asked to perform the Tinel sign on a client having problems in her hand/wrist. In order to test Tinel sign, the nurse should give the client which direction?

• A. Stand tall, arms at your side, shut your eyes; place the tip of your index finger to your nose.
• B. Hold your wrist in complete flexion, keep it in this position for 60 seconds. How does your hand feel after placing it in a neutral position?
• C. I'm going to tap (percuss) over the median nerve in your wrist; tell me what sensation you feel while I am doing this. Does the sensation stay in the wrist or go anywhere else?
• D. I'm going to tap this tuning fork; place it on the side of your thumb, then tell me what you are feeling in your hand and wrist.

Correct answer: C

Rationale: The correct answer is C. The Tinel sign involves percussing over the median nerve in the wrist to test for carpal tunnel syndrome. Choice A is incorrect as it describes a different action unrelated to the Tinel sign. Choice B is also incorrect as it involves holding the wrist in flexion, which is not part of the Tinel sign assessment. Choice D is incorrect as it mentions using a tuning fork on the thumb, which is not the correct technique for assessing the Tinel sign.

4. Mrs. Jordan is an elderly client diagnosed with Alzheimer’s disease. She becomes agitated and combative when a nurse approaches to help with morning care. The most appropriate nursing intervention in this situation would be to:

• A. tell the client firmly that it is time to get dressed.
• B. obtain assistance to restrain the client for safety.
• C. remain calm and talk quietly to the client.
• D. call the doctor and request an order for sedation.

Correct answer: C

Rationale: When dealing with an elderly client with Alzheimer’s disease who is agitated and combative, the most appropriate nursing intervention is to remain calm and talk quietly to the client. This approach can help soothe the client and prevent escalating the situation. Choice A is incorrect as being firm may further agitate the client. Choice B is inappropriate as restraining should only be used as a last resort for safety reasons and after other de-escalation techniques have been attempted. Choice D is not the best initial intervention and should only be considered after other non-pharmacological interventions have failed.

5. A patient is prescribed medroxyprogesterone acetate (Provera) for endometriosis. What should the nurse teach the patient about the proper use of this medication?

• A. Take the medication at the same time each day to maintain consistent hormone levels.
• B. Avoid prolonged sun exposure while taking this medication.
• C. Discontinue the medication if side effects occur.
• D. Apply the medication once a week.

Correct answer: A

Rationale: The correct answer is to take the medication at the same time each day to maintain consistent hormone levels and effectiveness. Consistency in timing helps regulate the hormone levels in the body, ensuring the medication's optimal benefit. Choice B is incorrect as there is no specific need to avoid sun exposure with this medication. Choice C is incorrect because discontinuing the medication without consulting the healthcare provider may not be safe. Choice D is incorrect as medroxyprogesterone acetate is typically taken orally and not applied topically once a week.

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