Nursing Elites

1. A public health nurse is responsible for the administration of numerous immunizations. Which of the following guidelines regarding anaphylaxis should the nurse adhere to?

• A. The patient should be observed for anaphylaxis for 1 minute after administration.
• B. The patient should be observed for anaphylaxis for 5 minutes after administration.
• C. The patient should be observed for anaphylaxis for 30 minutes after administration.
• D. The patient should be observed for anaphylaxis for 90 minutes after administration.

Correct answer: C

Rationale: The correct answer is C: 'The patient should be observed for anaphylaxis for 30 minutes after administration.' This is because anaphylaxis can occur within minutes of administration of an immunization. By observing the patient for 30 minutes, the nurse can promptly identify and manage any signs of anaphylaxis. Choices A, B, and D are incorrect as they suggest shorter or longer observation periods, which may not be sufficient to detect and respond to anaphylaxis in a timely manner.

2. What should the nurse emphasize regarding the risks associated with hormone replacement therapy (HRT) in a patient with a history of cardiovascular disease?

• A. HRT is associated with an increased risk of cardiovascular events, including heart attack and stroke.
• B. HRT may decrease the risk of osteoporosis.
• C. HRT may improve mood and energy levels.
• D. HRT may increase the risk of venous thromboembolism.

Correct answer: A

Rationale: The correct answer is A because hormone replacement therapy (HRT) is associated with an increased risk of cardiovascular events, including heart attack and stroke, particularly in patients with a history of cardiovascular disease. Choice B is incorrect because HRT does not decrease the risk of osteoporosis; instead, it may have adverse effects on bone health. Choice C is incorrect as the improvement in mood and energy levels is not a significant risk associated with HRT. Choice D is incorrect because while HRT may increase the risk of venous thromboembolism, the question specifically focuses on patients with a history of cardiovascular disease, where the emphasis should be on cardiovascular risks.

3. During a flu shot clinic, one of the questions the student nurse asks relates to whether the client has a history of Guillain-Barré syndrome. The client asks, 'What is that?' How should the nursing student reply?

• A. A type of paralysis that affects movement on both sides of the body. It may even involve the respiratory muscles.
• B. Swelling of your arm where you got your flu shot and maybe your eyes and lips had some swelling as well.
• C. A degenerative disease where you have trouble walking without the help of a cane or walker.
• D. Influenza-like illness where you had fever and chills for 2 to 3 days after your last flu shot.

Correct answer: A

Rationale: The correct answer is A because Guillain-Barré syndrome is an acute immune-mediated polyneuropathy that can lead to paralysis affecting movement on both sides of the body, and in severe cases, involving the respiratory muscles. Choice B is incorrect as it describes local swelling, not the systemic effects of Guillain-Barré syndrome. Choice C is incorrect as it describes a degenerative disease affecting mobility, not an acute immune-mediated condition like Guillain-Barré syndrome. Choice D is incorrect as it describes flu-like symptoms following a flu shot, which is not the same as Guillain-Barré syndrome.

4. A person is given an attenuated antigen as a vaccine. When the person asks what was given in the vaccine, how should the nurse respond? The antigen is:

• A. Alive, but less infectious
• B. Mutated, but highly infectious
• C. Normal, but not infectious
• D. Inactive, but infectious

Correct answer: A

Rationale: An attenuated antigen used in a vaccine is alive but less infectious, aiming to stimulate an immune response. Choice B is incorrect because an attenuated antigen is not highly infectious. Choice C is incorrect as the antigen is intentionally altered to be less infectious. Choice D is incorrect as an attenuated antigen is not infectious.

5. During a late-night study session, a pathophysiology student reaches out to turn the page of her textbook. Which component of her nervous system contains the highest level of control of her arm and hand action?

• A. Cerebral cortex
• B. Basal ganglia
• C. Brainstem
• D. Cerebellum

Correct answer: A

Rationale: The correct answer is A: Cerebral cortex. The cerebral cortex, particularly the motor cortex, is responsible for the voluntary control of precise movements such as turning a page. The cerebral cortex plays a crucial role in the highest level of control of motor functions, including those of the arm and hand. Choice B, Basal ganglia, is more involved in motor planning and coordination, while choice C, Brainstem, is responsible for basic life functions and reflexes. Choice D, Cerebellum, is primarily involved in coordination, precision, and accurate timing of movements, rather than the highest level of control for specific actions like page-turning.

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