Nursing Elites

1. A child's thymus gland is fully formed and proportionately larger than an adult's. Which of the following processes that contribute to immunity takes place in the thymus gland?

• A. Differentiation of B cells
• B. Production of natural killer (NK) cells
• C. Proliferation of T cells
• D. Filtration of antigens from the blood

Correct answer: C

Rationale: The correct answer is C: Proliferation of T cells. The thymus gland is responsible for the maturation and proliferation of T cells, which play a crucial role in adaptive immunity. Option A, differentiation of B cells, is incorrect because B cell maturation primarily occurs in the bone marrow. Option B, production of natural killer (NK) cells, is incorrect as NK cells are mainly produced in the bone marrow and lymph nodes. Option D, filtration of antigens from the blood, is incorrect as antigen filtration is not a primary function of the thymus gland.

2. What nursing diagnosis is suggested by the patient's statement regarding taking extra griseofulvin when she thinks her infection is getting worse?

• A. Deficient knowledge related to correct use of griseofulvin
• B. Effective therapeutic regimen management related to symptom identification
• C. Disturbed thought processes related to appropriate use of griseofulvin
• D. Ineffective coping related to self-medication

Correct answer: C

Rationale: The correct answer is C: 'Disturbed thought processes related to appropriate use of griseofulvin.' The patient's statement shows a misunderstanding of the correct use of griseofulvin by taking extra medication when she believes her infection is worsening. This behavior indicates a disturbance in her thought process regarding the appropriate use of the medication. Choice A is incorrect because the issue is not lack of knowledge but rather a misunderstanding leading to inappropriate actions. Choice B is incorrect as the patient's actions do not demonstrate effective management of her therapeutic regimen. Choice D is incorrect as the patient is not engaged in self-medication but rather misinterpreting signals and self-adjusting the prescribed medication.

3. What is the etiology and most likely treatment for myasthenia gravis in a 22-year-old female college student?

• A. Autoimmune destruction of skeletal muscle cells; treatment with intensive physical therapy and anabolic steroids.
• B. A decline in functioning acetylcholine receptors; treatment with corticosteroids and intravenous immunoglobulins.
• C. Cerebellar lesions; surgical and immunosuppressive treatment.
• D. Excess acetylcholinesterase production; treatment with thymectomy.

Correct answer: B

Rationale: Myasthenia gravis is characterized by a decline in functioning acetylcholine receptors rather than autoimmune destruction of skeletal muscle cells (Choice A), cerebellar lesions (Choice C), or excess acetylcholinesterase production (Choice D). The most likely treatment for myasthenia gravis involves corticosteroids to reduce inflammation and intravenous immunoglobulins to block the antibodies attacking acetylcholine receptors. Intensive physical therapy and anabolic steroids are not primary treatments for myasthenia gravis.

4. During a home visit to a family of three: a mother, father, and their child, the mother tells the community nurse that the father (who is not present) had hit the child on several occasions when he was drinking. The mother further explains that she has talked her husband into going to Alcoholics Anonymous and asks the nurse not to interfere so her husband won’t get angry and refuse treatment. Which of the following is the best response of the nurse?

• A. The nurse agrees not to interfere if the husband attends an Alcoholics Anonymous meeting that evening.
• B. The nurse commends the mother’s efforts and agrees to let her handle things.
• C. The nurse commends the mother’s efforts and also contacts protective services.
• D. The nurse confronts the mother’s failure to protect the child.

Correct answer: C

Rationale: In this situation, the best response for the nurse is to commend the mother's efforts in seeking help for her husband by encouraging him to attend Alcoholics Anonymous. However, it is crucial for the nurse to also contact protective services to ensure the safety and well-being of the child. Option A is incorrect as it is not appropriate to condition non-interference on the husband attending a meeting that evening. Option B is incorrect because solely letting the mother handle things might put the child at risk. Option D is incorrect as it does not address the immediate need to ensure the child's safety through involving protective services.

5. A client asks a nurse about the cause of Parkinson's disease. How should the nurse respond?

• A. Parkinson's disease is caused by a lack of dopamine in the brain, which affects movement.
• B. Parkinson's disease is caused by an excess of acetylcholine in the brain, leading to tremors and rigidity.
• C. Parkinson's disease is caused by an autoimmune response that attacks the nervous system.
• D. Parkinson's disease is caused by a bacterial infection that needs to be treated with antibiotics.

Correct answer: A

Rationale: The correct answer is A. Parkinson's disease is caused by a deficiency of dopamine in the brain, which results in the characteristic motor symptoms such as tremors, rigidity, and bradykinesia. Choice B is incorrect because Parkinson's disease is not caused by an excess of acetylcholine. Choice C is incorrect because Parkinson's disease is not an autoimmune disorder. Choice D is incorrect because Parkinson's disease is not caused by a bacterial infection and cannot be treated with antibiotics.

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