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 is the best way to prevent transmission of infectious agents?

• A. Take antibiotics daily
• B. Call the practitioner for herbal supplements
• C. Wash hands
• D. Avoid public areas as much as possible

Correct answer: C

Rationale: The correct answer is C: Wash hands. Washing hands is the most effective way to prevent the transmission of infectious agents. Antibiotics are not effective in preventing infections, and their overuse can lead to antibiotic resistance. Calling a practitioner for herbal supplements is not a primary method for preventing the transmission of infectious agents. Avoiding public areas entirely is impractical and not as effective as proper hand hygiene.

3. Which of the following might result from severe diarrhea?

• A. Respiratory acidosis
• B. Metabolic alkalosis
• C. Respiratory alkalosis
• D. Metabolic acidosis

Correct answer: D

Rationale: The correct answer is D: Metabolic acidosis. Severe diarrhea can lead to metabolic acidosis because the loss of bicarbonate ions in the stool results in an overall decrease in the body's bicarbonate levels. Respiratory acidosis (choice A) is caused by retention of carbon dioxide, usually due to inadequate alveolar ventilation. Metabolic alkalosis (choice B) is characterized by elevated pH and bicarbonate levels, usually caused by conditions like vomiting. Respiratory alkalosis (choice C) is a condition of low blood carbon dioxide levels and high pH, often due to hyperventilation.

4. In a 70-year-old man with a history of chronic obstructive pulmonary disease (COPD) reporting increasing shortness of breath, wheezing, and cough, which finding would indicate a potential exacerbation of his COPD?

• A. Increased wheezing
• B. Decreased respiratory rate
• C. Improved exercise tolerance
• D. Decreased sputum production

Correct answer: A

Rationale: The correct answer is A: Increased wheezing. In COPD exacerbations, there is a worsening of symptoms such as increased wheezing due to airway inflammation and narrowing. Choices B, C, and D are incorrect. Decreased respiratory rate would not be expected in COPD exacerbation as it is usually a compensatory mechanism to maintain oxygenation. Improved exercise tolerance is not a typical finding in exacerbations but rather a sign of improvement. Decreased sputum production is also not indicative of exacerbation, as exacerbations are often associated with increased sputum production.

5. Pain in the lower extremities due to peripheral artery disease usually worsens:

• A. with rest because blood flow increases.
• B. with elevation of the extremity because blood is diverted away.
• C. when the leg is in a dependent position because blood pools.
• D. when the leg is touched or massaged because cytokines are released.

Correct answer: B

Rationale: In peripheral artery disease, pain in the lower extremities worsens with the elevation of the extremity because it diverts blood flow away from the affected area, exacerbating the pain. Choices A, C, and D are incorrect. Resting doesn't increase blood flow, a dependent position doesn't lead to blood pooling in this context, and pain worsening due to touch or massage is not a typical feature of peripheral artery disease.

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