Nursing Elites

1. A 20-year-old male shoots his hand with a nail gun while replacing roofing shingles. Which of the following cell types would be the first to aid in killing bacteria to prevent infection in his hand?

• A. Eosinophils
• B. Neutrophils
• C. Leukotrienes
• D. Monocytes

Correct answer: B

Rationale: Neutrophils are the first responders to bacterial infections. When there is a breach in the skin like in this scenario, neutrophils are quickly recruited to the site of injury to phagocytize and kill bacteria. Eosinophils are primarily involved in parasitic infections and allergic reactions, making choice A incorrect. Leukotrienes are lipid mediators involved in inflammation but are not cells, so choice C is incorrect. Monocytes are precursors to macrophages and play a role in immune response, but they are not the first cells to arrive at the site of a bacterial infection, making choice D incorrect.

2. After experiencing several months of worsening nocturia, a patient has been assessed for benign prostatic hypertrophy (BPH) and has begun drug treatment. In addition to nocturia, what other sign or symptom is most likely to accompany BPH?

• A. Hematuria
• B. Erectile dysfunction
• C. Urinary frequency
• D. Flank pain

Correct answer: A

Rationale: The correct answer is hematuria. Hematuria, which is the presence of blood in the urine, is a common sign associated with benign prostatic hypertrophy (BPH). It can occur due to irritation or damage to the prostate tissue. While urinary frequency and erectile dysfunction can also be seen in BPH patients, hematuria is more specifically linked to prostate issues. Flank pain is not typically a direct symptom of BPH.

3. 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.

4. A patient has a heart attack that leads to progressive cell injury resulting in cell death with severe cell swelling and breakdown of organelles. What term would the nurse use to define this process?

• A. Adaptation
• B. Pathologic calcification
• C. Apoptosis
• D. Necrosis

Correct answer: D

Rationale: The correct answer is D: Necrosis. Necrosis is the process of cell death characterized by cell swelling, breakdown of organelles, and eventual rupture, often following ischemic injury like a heart attack. Choices A, B, and C are incorrect. Adaptation refers to the ability of cells to adjust to changes in their environment. Pathologic calcification is the abnormal deposition of calcium salts in tissues. Apoptosis is a programmed cell death that occurs in a controlled, orderly manner.

5. What specific instructions should the nurse provide for a patient starting on alendronate (Fosamax) for osteoporosis to ensure proper administration?

• A. Take the medication with a full glass of water and remain upright for at least 30 minutes.
• B. Take the medication with milk to enhance calcium absorption.
• C. Take the medication at bedtime to ensure absorption during sleep.
• D. Take the medication with food to prevent nausea.

Correct answer: A

Rationale: The correct answer is A. Alendronate should be taken with a full glass of water, and patients should remain upright for at least 30 minutes to prevent esophageal irritation and ensure proper absorption. Choice B is incorrect because alendronate should not be taken with milk, as it can interfere with its absorption. Choice C is incorrect as there is no specific instruction to take alendronate at bedtime. Choice D is incorrect because alendronate should be taken on an empty stomach, not with food, to enhance absorption.

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