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. A 70-year-old patient is seen in the family practice clinic. Which of the following vaccines should be administered to prevent shingles?

• A. Zoster vaccine
• B. Haemophilus influenzae Type b (Hib) vaccine
• C. Human papillomavirus (HPV) vaccine
• D. Pneumococcal polyvalent vaccine

Correct answer: A

Rationale: The correct answer is A: Zoster vaccine. The Zoster vaccine is recommended for the prevention of shingles in individuals aged 50 years and older. Shingles is caused by the reactivation of the varicella-zoster virus, the same virus that causes chickenpox. The vaccine helps reduce the risk of developing shingles and decreases the severity and duration of the illness if it occurs. Choices B, C, and D are incorrect: Haemophilus influenzae Type b (Hib) vaccine is used to prevent infections caused by Haemophilus influenzae type b, Human papillomavirus (HPV) vaccine is used to prevent HPV infections that can lead to cervical cancer and other cancers, and Pneumococcal polyvalent vaccine is used to protect against infections caused by the bacterium Streptococcus pneumoniae.

3. A patient is being educated about sildenafil (Viagra). Which of the following statements by the patient indicates that further teaching is necessary?

• A. I can take this medication with nitroglycerin.
• B. This medication can cause an erection lasting more than 4 hours.
• C. I should not take this medication if I am taking medications containing nitrates.
• D. This medication is safe to take with any over-the-counter medication.

Correct answer: A

Rationale: The correct answer is A because sildenafil should not be taken with medications containing nitrates, such as nitroglycerin, due to the risk of severe hypotension. Choice B is incorrect because priapism (prolonged erection) is a serious side effect but does not require immediate intervention like severe hypotension. Choice C is incorrect as it correctly identifies a contraindication for sildenafil use. Choice D is incorrect because not all over-the-counter medications are safe to take with sildenafil, and interactions can occur.

4. A 55-year-old man presents with a history of fatigue, weight loss, and night sweats. He reports recent onset of a productive cough and hemoptysis. Which condition should the nurse suspect?

• A. Lung cancer
• B. Pneumonia
• C. Tuberculosis
• D. Pulmonary embolism

Correct answer: C

Rationale: The correct answer is C: Tuberculosis. The symptoms described - fatigue, weight loss, night sweats, productive cough, and hemoptysis - are classic manifestations of tuberculosis. Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis, commonly affecting the lungs but can also involve other organs. **Choice A: Lung cancer** typically presents with symptoms like persistent cough, chest pain, and shortness of breath, but it is less likely in this case due to the presence of hemoptysis. **Choice B: Pneumonia** can present with productive cough, fever, and chest pain, but it is less likely given the chronicity of symptoms and the presence of hemoptysis. **Choice D: Pulmonary embolism** usually presents with sudden onset shortness of breath, chest pain, and can be associated with risk factors like recent surgery or immobility.

5. Which of the following is a common cause of mechanical small intestine obstruction?

• A. Infection
• B. Postoperative adhesions
• C. Tumors
• D. Foreign body

Correct answer: B

Rationale: Postoperative adhesions are a common cause of mechanical small intestine obstruction. Adhesions can form after abdominal surgery, causing bands of scar tissue that may twist or pull the intestines, leading to obstruction. This is a more common cause compared to infection, tumors, or foreign bodies. Infection may lead to inflammation but is not a typical cause of mechanical obstruction. Tumors and foreign bodies can cause blockages but are less common than postoperative adhesions.

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