Nursing Elites

1. A patient has a heart attack that leads to progressive cell injury resulting in cell death with severe cell swelling and breakdown of organelles. What term would the nurse use to define this process?

• A. Adaptation
• B. Pathologic calcification
• C. Apoptosis
• D. Necrosis

Correct answer: D

Rationale: The correct answer is D: Necrosis. Necrosis is the process of cell death characterized by cell swelling, breakdown of organelles, and eventual rupture, often following ischemic injury like a heart attack. Choices A, B, and C are incorrect. Adaptation refers to the ability of cells to adjust to changes in their environment. Pathologic calcification is the abnormal deposition of calcium salts in tissues. Apoptosis is a programmed cell death that occurs in a controlled, orderly manner.

2. When a child jumps out of the tub, crying and stating her feet are 'burning,' what pathophysiologic principle is responsible for this response?

• A. Pain receptors (nociceptors) have been activated in response to a thermal stimulus.
• B. The child's skin thermal receptors have undergone adaptation.
• C. The child is exhibiting a psychogenic pain response due to anxiety.
• D. The child is experiencing a conditioned pain response based on previous experiences.

Correct answer: A

Rationale: The child's reaction is due to the activation of nociceptors, which are pain receptors that respond to thermal stimuli. This response is an immediate protective mechanism to prevent tissue damage caused by extreme temperatures. Option B is incorrect because adaptation does not explain the child's immediate and intense response. Option C is incorrect as there is a clear physical stimulus present, ruling out a psychogenic response. Option D is incorrect as the child's response is not based on previous experiences but rather on the current thermal stimulus.

3. In the ED, a homeless client is brought in with severe hypothermia. The police officers also state that they found a 'bottle of booze' on the sidewalk next to him. This puts the nurse on high alert since alcohol contributes to hypothermia by:

• A. interfering with the appetite center in the brain, causing the person to not respond to hunger cues.
• B. causing the person to have less insulation from body fat.
• C. dulling mental awareness, impairing judgment to seek shelter.
• D. increasing the basal metabolic rate, leading to faster depletion of ATP.

Correct answer: C

Rationale: Alcohol impairs judgment and dulls mental awareness, making a person less likely to seek shelter when experiencing hypothermia. This impaired judgment can lead to risky behaviors that exacerbate the effects of cold exposure. Choice A is incorrect because alcohol does not directly interfere with the appetite center in the brain to the extent described. Choice B is incorrect as alcohol consumption does not directly impact the amount of body fat present. Choice D is incorrect because alcohol does not increase the basal metabolic rate but rather slows it down.

4. In menopausal women, what is the primary goal of estrogen therapy?

• A. To relieve menopausal symptoms
• B. To prevent osteoporosis
• C. To increase calcium absorption
• D. To maintain bone strength

Correct answer: B

Rationale: The primary goal of estrogen therapy in menopausal women is to prevent osteoporosis by maintaining bone density. Estrogen helps in preserving bone mass and reducing the risk of fractures. While estrogen therapy may alleviate some menopausal symptoms, such as hot flashes, its primary focus is on bone health rather than symptom management. Increasing calcium absorption and maintaining bone strength are outcomes of preventing osteoporosis rather than the primary goal of estrogen therapy.

5. 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.

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