Nursing Elites

1. A patient is to be administered an immunization. The serum contains aluminum phosphate. What route is most appropriate to administer this immunization?

• A. Intramuscularly
• B. Subcutaneously
• C. Intravenously
• D. Orally

Correct answer: A

Rationale: The most appropriate route to administer an immunization containing aluminum phosphate is intramuscularly. Aluminum phosphate is commonly used as an adjuvant in vaccines to enhance the immune response. Intramuscular administration allows for the vaccine to be delivered into the muscle tissue, where it can be effectively absorbed by the body's immune cells. Subcutaneous administration is not ideal for vaccines containing aluminum phosphate, as it may not elicit the desired immune response. Intravenous administration is typically reserved for specific medications or situations that require rapid absorption into the bloodstream. Oral administration is not suitable for vaccines containing aluminum phosphate as they would be degraded in the gastrointestinal tract.

2. What is the primary cause of angina?

• A. Increased oxygen demand by the heart
• B. Obstruction of the coronary arteries
• C. Lack of oxygen in the lungs
• D. Decreased blood supply to the liver

Correct answer: B

Rationale: The correct answer is B: Obstruction of the coronary arteries. Angina is primarily caused by a reduced blood flow to the heart due to blockages or narrowing in the coronary arteries. Choice A is incorrect because while increased oxygen demand can contribute to angina symptoms, it is not the primary cause. Choice C is incorrect as angina is not caused by a lack of oxygen in the lungs. Choice D is also incorrect as angina is not related to decreased blood supply to the liver.

3. While in an induced coma for 3 weeks, a badly burned firefighter awakens and thanks his son for singing Happy Birthday to him a week earlier. Which part of the brain is responsible for allowing him to hear and comprehend while comatose?

• A. Cerebellum
• B. Thalamus
• C. Temporal lobe
• D. Occipital lobe

Correct answer: C

Rationale: The temporal lobe is responsible for processing auditory information, allowing the patient to hear and comprehend while in a coma. The cerebellum is primarily associated with coordination and balance, not auditory processing. The thalamus serves as a relay station for sensory information but is not specifically responsible for auditory processing. The occipital lobe is mainly involved in processing visual information, not auditory functions.

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 women are at highest risk for the development of endometrial cancer?

• A. A 50-year-old postmenopausal woman with a history of high-risk human papillomavirus
• B. A 45-year-old woman who is obese and has menstrual irregularities with periods of amenorrhea and infrequent periods.
• C. A 40-year-old woman who is overweight and has hypertension.
• D. A 55-year-old woman who smokes.

Correct answer: B

Rationale: The correct answer is B. Obesity and irregular menstrual cycles, including periods of amenorrhea and infrequent periods, are significant risk factors for the development of endometrial cancer. Choice A is less likely as postmenopausal status reduces the risk. Choice C is not directly associated with a high risk of endometrial cancer. Choice D, smoking, is more strongly linked to other types of cancers like lung cancer rather than endometrial cancer.

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