Nursing Elites

1. A patient suffers from an autoimmune disorder. Which of the following represents a potential result of a viral infection in a patient with an autoimmune disorder?

• A. Lymphocytes recognize the host's tissue as foreign.
• B. Erythrocytes destroy the T cells of the host.
• C. The involution of the thymus gland increases the risk of infection.
• D. The differential decreases the sedimentation rate.

Correct answer: A

Rationale: In a patient with an autoimmune disorder, a viral infection can trigger an immune response where lymphocytes mistakenly recognize the host's tissue as foreign. This can lead to an exacerbation of the autoimmune condition. Choice B is incorrect because erythrocytes are not responsible for destroying T cells. Choice C is incorrect as thymus involution weakens the immune response, making the patient more susceptible to infections rather than increasing the infection risk. Choice D is unrelated to the potential effects of a viral infection in a patient with an autoimmune disorder.

2. A patient with a history of venous thromboembolism is being considered for hormone replacement therapy (HRT). What should the nurse discuss with the patient regarding the risks of HRT?

• A. Discuss the potential for increased bone density.
• B. Discuss the potential for an increased risk of cardiovascular events.
• C. Discuss the potential for a reduced risk of breast cancer.
• D. Discuss the potential for improved mood and energy levels.

Correct answer: B

Rationale: The correct answer is B because hormone replacement therapy (HRT) is associated with an increased risk of cardiovascular events, including venous thromboembolism. Patients with a history of venous thromboembolism are at higher risk, so discussing this potential risk is crucial. Choice A, increased bone density, is not a major risk of HRT. Choice C, reduced risk of breast cancer, is not a common discussion point regarding HRT risks. Choice D, improved mood and energy levels, is more related to the benefits of HRT rather than its risks.

3. What is the distinguishing feature of Hodgkin disease noted on histologic exam?

• A. Reed-Sternberg cells
• B. Red-stained cells
• C. Human Papillomavirus
• D. B-cells and T-cells

Correct answer: A

Rationale: The correct answer is A: Reed-Sternberg cells. Reed-Sternberg cells are large, abnormal B-cells that are characteristic of Hodgkin's lymphoma. These cells are identified on histologic examination of lymph node biopsies from patients with Hodgkin disease. Choice B, 'Red-stained cells,' is vague and does not describe a specific feature of Hodgkin disease. Choice C, 'Human Papillomavirus,' is incorrect as Hodgkin disease is not caused by HPV. Choice D, 'B-cells and T-cells,' is incorrect as Hodgkin disease is characterized by the presence of Reed-Sternberg cells, which are abnormal B-cells.

4. Which scenario would be an example of a child born with congenital insensitivity to pain?

• A. A child who does not cry when injured and fails to respond to painful stimuli.
• B. A child who cries excessively and has a heightened response to pain.
• C. A child who experiences pain but has difficulty expressing it.
• D. A child who is sensitive to minor stimuli but has a delayed response to severe pain.

Correct answer: A

Rationale: The correct scenario depicting a child with congenital insensitivity to pain is when the child does not cry when injured and fails to respond to painful stimuli. This condition is characterized by the inability to feel and react to pain, resulting in a lack of typical responses such as crying or withdrawal when hurt. Choice B is incorrect as it describes a child with heightened pain sensitivity, opposite to the insensitivity seen in the condition. Choice C is incorrect as it suggests the child feels pain but struggles to communicate it, which is not the case with congenital insensitivity to pain. Choice D is incorrect as it describes a child who is sensitive to minor stimuli and has delayed responses to severe pain, which is not indicative of congenital insensitivity to pain.

5. A 60-year-old male patient is receiving androgen therapy for the treatment of hypogonadism. Which of the following adverse effects should the nurse monitor for?

• A. Hepatotoxicity
• B. Nephrotoxicity
• C. Cardiotoxicity
• D. Pulmonary toxicity

Correct answer: A

Rationale: The correct answer is A: Hepatotoxicity. Androgen therapy, such as testosterone, can lead to hepatotoxicity, which is toxic to the liver. Therefore, the nurse should monitor the patient's liver function. Choices B, C, and D are incorrect because androgen therapy is not typically associated with nephrotoxicity, cardiotoxicity, or pulmonary toxicity.

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