Nursing Elites

1. Which of the following would the nurse expect to see in a client experiencing hypoventilation?

• A. Increased oxygenation in the alveoli
• B. Increased carbon dioxide in the bloodstream
• C. Decreased hemoglobin in the bloodstream
• D. Decreased carbon dioxide in the alveoli

Correct answer: B

Rationale: In hypoventilation, there is inadequate ventilation leading to decreased removal of carbon dioxide. This results in increased carbon dioxide in the bloodstream. The other choices are incorrect because hypoventilation does not improve oxygenation in the alveoli (Choice A), decrease hemoglobin in the bloodstream (Choice C), or decrease carbon dioxide in the alveoli (Choice D).

2. A nurse practitioner is assessing a 7-year-old boy who has been brought to the clinic by his mother, who is concerned about her son's increasingly frequent, severe headaches. Which of the nurse's questions is least likely to yield data that will confirm or rule out migraines as the cause of his problem?

• A. Does your son experience nausea or vomiting when he has a headache?
• B. Does your son have a history of recent head injury?
• C. Does your son become sensitive to light when he has a headache?
• D. Does anyone in your family have a history of migraines?

Correct answer: B

Rationale: Asking about a history of recent head injury is less likely to yield data relevant to confirming or ruling out migraines. Migraines are often associated with symptoms like nausea, vomiting, sensitivity to light, and a family history of migraines. While head injuries can cause headaches, the focus of the assessment in this case should be on symptoms more specific to migraines to guide the diagnosis and management.

3. An older adult man has moved to a long-term care facility, and the nurse is performing medication reconciliation. The resident's current medication regimen includes alfuzosin (Uroxatral). After considering the most likely indication for this drug, what potential problem should the nurse include in the resident's interdisciplinary plan of care?

• A. Impaired urinary elimination
• B. Ineffective sexual pattern
• C. Sexual dysfunction
• D. Functional urinary incontinence

Correct answer: C

Rationale: The correct answer is C, 'Sexual dysfunction.' Alfuzosin is commonly prescribed for benign prostatic hyperplasia (BPH), a condition that can lead to sexual dysfunction in older men. It is important to include this potential problem in the interdisciplinary plan of care to address the impact of the medication on the resident's sexual health. Choices A, B, and D are incorrect because while alfuzosin can affect urinary function, the primary concern related to this medication in this scenario is sexual dysfunction due to its indication for BPH.

4. A client with a history of smoking presents with a chronic cough and shortness of breath. The nurse should suspect which condition?

• A. Pulmonary fibrosis
• B. Chronic obstructive pulmonary disease (COPD)
• C. Lung cancer
• D. Pulmonary edema

Correct answer: B

Rationale: The correct answer is B: Chronic obstructive pulmonary disease (COPD). COPD is often associated with a chronic cough and shortness of breath, especially in individuals with a history of smoking. Pulmonary fibrosis (choice A) typically presents with progressive dyspnea and dry cough. Lung cancer (choice C) may present with a chronic cough, shortness of breath, and other symptoms like weight loss and hemoptysis. Pulmonary edema (choice D) presents with symptoms such as acute shortness of breath, orthopnea, and pink, frothy sputum.

5. During an assessment of a male client suspected of having a disorder of motor function, which finding would suggest a possible upper motor neuron (UMN) lesion?

• A. Hypotonia
• B. Hyperreflexia
• C. Muscle atrophy
• D. Fasciculations

Correct answer: B

Rationale: Hyperreflexia, or exaggerated reflexes, is a common sign of an upper motor neuron (UMN) lesion. An UMN lesion indicates damage to the central nervous system pathways that control movement. Hypotonia (choice A) refers to reduced muscle tone, which is more indicative of lower motor neuron lesions. Muscle atrophy (choice C) suggests long-standing denervation or disuse of muscles. Fasciculations (choice D) are involuntary muscle contractions that can be seen in lower motor neuron lesions, like in amyotrophic lateral sclerosis (ALS), rather than UMN lesions.

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