Nursing Elites

1. A child is experiencing difficulty with chewing and swallowing. The nurse knows that which cells may be innervating specialized gut-related receptors that provide taste and smell?

• A. Special somatic afferent fibers
• B. General somatic afferents
• C. Special visceral afferent cells
• D. General visceral afferent neurons

Correct answer: C

Rationale: The correct answer is C: Special visceral afferent cells. These cells are responsible for innervating taste and smell receptors related to the gut. Special somatic afferent fibers (choice A) are involved in sensations like touch and proprioception, not taste and smell. General somatic afferents (choice B) carry sensory information from the skin and musculoskeletal system, not taste and smell. General visceral afferent neurons (choice D) transmit sensory information from internal organs, but not specifically related to taste and smell sensations.

2. The nurse is caring for a client with an astrocytoma. The client asks, 'What do astrocytes do in the brain?' What is the nurse's best response?

• A. Astrocytes help to nourish and support neurons in the brain.
• B. Astrocytes are a type of neuron that transmit electrical signals.
• C. Astrocytes are involved in immune responses in the brain.
• D. Astrocytes help regulate blood flow in the brain.

Correct answer: A

Rationale: Astrocytes play a crucial role in supporting and nourishing neurons by providing metabolic support, maintaining the blood-brain barrier, and regulating the chemical environment of the brain. While astrocytes are essential for brain function, they are not neurons and do not transmit electrical signals (Choice B). Astrocytes are not primarily involved in immune responses in the brain (Choice C) or in regulating blood flow in the brain (Choice D), although they indirectly influence blood flow through their support functions.

3. Which manifestation of stress reflects the non-specific fight or flight response?

• A. Decreased pupillary light response
• B. Increased GI motility
• C. Decreased short-term memory
• D. Increased cardiopulmonary rates

Correct answer: D

Rationale: The correct answer is D, 'Increased cardiopulmonary rates.' The fight or flight response, activated by stress, is a non-specific physiological reaction that prepares the body to deal with perceived threats. In this response, the heart rate and breathing rate increase to supply more oxygen to muscles and vital organs, enabling a rapid response in dangerous situations. Choices A, B, and C are incorrect because decreased pupillary light response, increased GI motility, and decreased short-term memory are not typical manifestations of the fight or flight response.

4. What specific instructions should the nurse provide for proper administration of alendronate (Fosamax) in a patient with osteoporosis?

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

Correct answer: B

Rationale: The correct answer is to take alendronate with a full glass of water and remain upright for at least 30 minutes. This is essential to prevent esophageal irritation and ensure proper drug absorption. Choice A is incorrect as alendronate should not be taken with milk due to potential interactions. Choice C is incorrect as there is no need to take the medication at bedtime specifically. Choice D is incorrect as taking alendronate with food can decrease its absorption.

5. A client with a history of tuberculosis (TB) is experiencing a recurrence of symptoms. Which diagnostic test should the nurse anticipate being ordered?

• A. Sputum culture
• B. Bronchoscopy
• C. Chest x-ray
• D. CT scan of the chest

Correct answer: C

Rationale: A chest x-ray is the most appropriate diagnostic test for a client with a history of tuberculosis experiencing a recurrence of symptoms. A chest x-ray is commonly used to visualize the lungs and check for signs of active tuberculosis, such as abnormal shadows or nodules. While a sputum culture (Choice A) can confirm the presence of TB bacteria, it may not be the initial test ordered for a recurrence. Bronchoscopy (Choice B) and CT scan of the chest (Choice D) are more invasive and usually reserved for cases where the chest x-ray is inconclusive or to further assess complications, rather than as the initial diagnostic test for a recurrence of tuberculosis.

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