Nokea
A 70-year-old client presents with weakness and sensory loss in the right hand and foot. The client also exhibits speech difficulties. Which condition is the client most likely experiencing?
- A. Transient ischemic attack (TIA)
- B. Brain tumor
- C. Cerebral infarction
- D. Multiple sclerosis
Correct Answer: C
Rationale: The correct answer is C: Cerebral infarction (stroke). In this case, the client's symptoms of weakness and sensory loss in the right hand and foot, along with speech difficulties, are indicative of a stroke. These symptoms are commonly seen in individuals experiencing a cerebral infarction, where a blockage in blood flow to the brain leads to neurological deficits. Choices A, B, and D are less likely as transient ischemic attacks (TIAs) typically have temporary symptoms with no permanent damage, brain tumors may present with a different set of symptoms depending on their location, and multiple sclerosis usually presents with a relapsing-remitting pattern of neurological symptoms rather than sudden onset unilateral deficits.
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What should the nurse emphasize regarding the risks associated with hormone replacement therapy (HRT) in a patient with a history of cardiovascular disease?
- A. HRT is associated with an increased risk of cardiovascular events, including heart attack and stroke.
- B. HRT may decrease the risk of osteoporosis.
- C. HRT may improve mood and energy levels.
- D. HRT may increase the risk of venous thromboembolism.
Correct Answer: A
Rationale: The correct answer is A because hormone replacement therapy (HRT) is associated with an increased risk of cardiovascular events, including heart attack and stroke, particularly in patients with a history of cardiovascular disease. Choice B is incorrect because HRT does not decrease the risk of osteoporosis; instead, it may have adverse effects on bone health. Choice C is incorrect as the improvement in mood and energy levels is not a significant risk associated with HRT. Choice D is incorrect because while HRT may increase the risk of venous thromboembolism, the question specifically focuses on patients with a history of cardiovascular disease, where the emphasis should be on cardiovascular risks.
In a 41-year-old male patient with a complex medical history diagnosed with secondary hypogonadism, which of the following health problems is the most likely etiology of his diagnosis?
- A. Type 1 diabetes
- B. Mumps
- C. An inflammatory process in the testicles
- D. Testicular trauma
Correct Answer: C
Rationale: The correct answer is C: An inflammatory process in the testicles. Secondary hypogonadism in males can be caused by various factors, including an inflammatory process in the testicles. Mumps (choice B) can lead to orchitis but is less common in adults. Type 1 diabetes (choice A) is not a common cause of secondary hypogonadism. Testicular trauma (choice D) can cause primary hypogonadism but is less likely to cause secondary hypogonadism.
A patient is prescribed clomiphene citrate (Clomid) for the treatment of infertility. Which of the following statements should be included in the nurse's teaching?
- A. This drug induces ovulation by stimulating gonadotropins.
- B. This drug induces ovulation by inhibiting gonadotropins.
- C. This drug suppresses ovulation by inhibiting gonadotropins.
- D. This drug increases progesterone levels, which maintains pregnancy.
Correct Answer: A
Rationale: The correct statement to include in the nurse's teaching is that clomiphene induces ovulation by stimulating the release of gonadotropins, which in turn stimulate the ovaries. Choice B is incorrect because clomiphene does not induce ovulation by inhibiting gonadotropins. Choice C is also incorrect as clomiphene does not suppress ovulation by inhibiting gonadotropins. Choice D is inaccurate as clomiphene does not directly increase progesterone levels to maintain pregnancy.
A patient is receiving intravenous amphotericin. Which of the following assessments warrants the discontinuation of the antifungal agent?
- A. Sodium level of 138 mEq/L
- B. Hematocrit of 39%
- C. Blood urea nitrogen of 60 mg/dL
- D. AST level of 10 Unit/L
Correct Answer: C
Rationale: Intravenous amphotericin can cause nephrotoxicity, leading to increased blood urea nitrogen levels. Elevated blood urea nitrogen (BUN) indicates impaired renal function, which is a known adverse effect of amphotericin. Therefore, a BUN level of 60 mg/dL warrants the discontinuation of the antifungal agent. The other options, such as a sodium level of 138 mEq/L, hematocrit of 39%, and AST level of 10 Unit/L, are within normal ranges and not indicative of the need to discontinue amphotericin therapy.
In Guillain-Barre syndrome, what pathophysiologic process underlies the deficits that accompany the degeneration of myelin in the peripheral nervous system (PNS)?
- A. The destruction of myelin results in a reduction in Schwann cell production in the client's PNS.
- B. The lack of myelin surrounding nerve cells compromises the axonal transport system.
- C. Without remyelination, the axon will eventually die.
- D. A deficit of myelin makes the client more susceptible to infection by potential pathogens.
Correct Answer: C
Rationale: In Guillain-Barre syndrome, the destruction of myelin leads to axonal damage. If remyelination does not occur, the axon will eventually degenerate and die, impacting nerve function. Choice A is incorrect because the destruction of myelin does not affect Schwann cell production. Choice B is incorrect as the lack of myelin directly affects the conduction of nerve impulses, not the axonal transport system. Choice D is incorrect as a deficit of myelin does not predispose the client to infections by potential pathogens.