Nursing Elites

1. A hemoglobin electrophoresis is done to evaluate for sickle cell disease. The report reveals the person has HbAS, which means the person:

• A. is normal with no sickle cell disease.
• B. is a sickle cell carrier.
• C. has sickle cell anemia.
• D. has thalassemia.

Correct answer: B

Rationale: The correct answer is that the person is a sickle cell carrier. In HbAS, 'Hb' stands for hemoglobin, 'A' indicates normal hemoglobin, and 'S' indicates the sickle cell trait. Individuals with HbAS are carriers of the sickle cell trait but do not have sickle cell disease. Choice A is incorrect because having the sickle cell trait means carrying the gene for sickle cell disease. Choice C is incorrect as sickle cell anemia is a different condition where individuals have two copies of the abnormal hemoglobin gene, resulting in the disease. Choice D is incorrect because thalassemia is a separate genetic disorder affecting the production of hemoglobin, not related to the sickle cell trait.

2. What causes secondary brain injury after head trauma?

• A. Brain injury resulting from the body’s response to tissue damage
• B. Brain injury resulting from initial trauma
• C. Injury as a result of medical therapy
• D. Focal areas of bleeding

Correct answer: A

Rationale: The correct answer is A. Secondary brain injury occurs due to the body's response to the initial trauma, which can worsen the effects of the primary injury. This response includes processes like inflammation, increased intracranial pressure, and reduced oxygen delivery to tissues. Choice B is incorrect because it refers to the primary trauma itself, not the secondary injury. Choice C is incorrect as it relates to injury caused by medical interventions rather than the body's response. Choice D is incorrect as it specifically mentions focal areas of bleeding, which is a consequence of trauma rather than the cause of secondary brain injury.

3. A 30-year-old man has a history of heart transplant and is receiving long-term steroids to prevent rejection. The patient is due for routine vaccines. Attenuated vaccines are contraindicated in this patient because the antigen is:

• A. live and can cause infection.
• B. mutated and infectious.
• C. inactive but still infectious
• D. pathogenic

Correct answer: A

Rationale: The correct answer is A: live and can cause infection. Patients who are immunocompromised, like those receiving long-term steroids after an organ transplant, should not receive live vaccines because the live attenuated organisms in these vaccines can cause infections in individuals with weakened immune systems. Choice B is incorrect because attenuated vaccines are live but weakened, not mutated. Choice C is incorrect because while inactive, attenuated vaccines are not infectious. Choice D is incorrect because attenuated vaccines are not pathogenic; they are attenuated (weakened) forms of the pathogen.

4. When a Tae Kwon Do (TKD) master applies downward pressure just above the elbow joint on an attacker who immediately collapses to the ground, which reflex is applicable to this example?

• A. Golgi tendon reflex
• B. Myotatic reflex
• C. Withdrawal reflex
• D. Crossed-extensor reflex

Correct answer: A

Rationale: The Golgi tendon reflex is the correct answer. This reflex protects the muscle and tendons from excessive force by causing the muscle to relax. In this scenario, the downward pressure applied just above the elbow joint triggers the Golgi tendon reflex, resulting in the attacker's collapse. The other options are incorrect: - The myotatic reflex (also known as the stretch reflex) is responsible for contracting a muscle in response to its stretch, not relaxing it. - The withdrawal reflex is a spinal reflex that moves a body part away from a painful stimulus, not directly related to the scenario described. - The crossed-extensor reflex is a reflex that occurs on the opposite side of the body in response to a withdrawal reflex, which is not the case in this situation.

5. A client has approached the nurse asking for advice on how to deal with his alcohol addiction. The nurse should tell the client that the only effective treatment for alcoholism is:

• A. psychotherapy.
• B. total abstinence.
• C. Alcoholics Anonymous (AA).
• D. aversion therapy.

Correct answer: B

Rationale: The correct answer is B: total abstinence. Total abstinence from alcohol is considered the most effective treatment for alcoholism. This approach eliminates the risk of relapse and helps individuals maintain sobriety. While psychotherapy can be beneficial in addressing underlying issues, total abstinence is crucial in overcoming alcohol addiction. Alcoholics Anonymous (AA) is a supportive group that can complement treatment, but it is not the only effective approach. Aversion therapy aims to create a negative association with alcohol but may not address the underlying causes of addiction, making total abstinence a more comprehensive and recommended approach.

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