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. What best describes sepsis?

• A. An overwhelming allergic reaction
• B. Severe inflammatory response to a pathogen's endotoxins
• C. Unknown causes resulting in hypertension
• D. Poor nursing and health care provider interventions

Correct answer: B

Rationale: The correct answer is B. Sepsis is a severe inflammatory response to a pathogen's endotoxins, leading to widespread infection and organ dysfunction. Choice A is incorrect as sepsis is not primarily an allergic reaction. Choice C is incorrect as sepsis is not characterized by unknown causes resulting in hypertension. Choice D is incorrect as sepsis is a medical condition and not solely caused by poor nursing or healthcare provider interventions.

3. Following cardiothoracic surgery where controlled therapeutic hypothermia was utilized to decrease metabolic demands, the nurse responsible for monitoring this client postoperatively should be assessing for which potential complication related to cold cardioplegia?

• A. Thrombocytopenia
• B. Hypokalemia
• C. Hyperglycemia
• D. Coagulopathy

Correct answer: D

Rationale: Coagulopathy is the correct answer. During therapeutic hypothermia, which lowers the body's temperature to reduce metabolic demands post-surgery, coagulopathy, or impaired blood clotting, is a potential complication due to the effects of cold cardioplegia. Thrombocytopenia (choice A) refers to a low platelet count and is not directly related to cold cardioplegia. Hypokalemia (choice B) is a condition of low potassium levels, and hyperglycemia (choice C) is high blood sugar levels, neither of which are primary complications of cold cardioplegia.

4. Which symptoms are typical of asthma?

• A. Chest pain; cough
• B. Diarrhea; wheezing
• C. Wheezing; dyspnea
• D. Tachypnea; constipation

Correct answer: C

Rationale: The correct answer is C: Wheezing and dyspnea are typical symptoms of asthma. Wheezing refers to a high-pitched whistling sound while breathing, and dyspnea is shortness of breath. These symptoms are classic signs of airway obstruction and inflammation seen in asthma. Choice A is incorrect as chest pain is not a typical symptom of asthma, though coughing can occur. Choice B is incorrect as diarrhea is not associated with asthma, while wheezing is a common symptom. Choice D is incorrect as tachypnea (rapid breathing) can occur in asthma, but constipation is not a typical symptom.

5. A patient with a history of osteoporosis is prescribed raloxifene (Evista). What is the primary therapeutic action of this medication?

• A. It stimulates the formation of new bone.
• B. It decreases bone resorption and increases bone density.
• C. It increases calcium absorption in the intestines.
• D. It increases the excretion of calcium through the kidneys.

Correct answer: B

Rationale: The correct answer is B: 'It decreases bone resorption and increases bone density.' Raloxifene, as a selective estrogen receptor modulator (SERM), works by reducing bone resorption (breakdown) and maintaining or increasing bone density. This mechanism helps in preventing further bone loss and can even increase bone mass. Choices A, C, and D are incorrect. Raloxifene does not stimulate the formation of new bone (choice A), increase calcium absorption in the intestines (choice C), or increase the excretion of calcium through the kidneys (choice D).

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