Nursing Elites

1. A secondary immune response differs from the primary immune response in that:

• A. It is more rapid than the primary response and results in higher antibody levels
• B. It is slower than the primary response and doesn't change the antibody levels
• C. It occurs at the same time as the primary response but results in a decrease in antibodies
• D. It only occurs in hyperallergic reactions and results in a decrease in antibodies

Correct answer: A

Rationale: The correct answer is A. A secondary immune response is characterized by being more rapid than the primary response and results in higher antibody levels. This is because memory B cells are already present and can quickly differentiate into plasma cells upon re-exposure to the antigen. Choice B is incorrect because a secondary immune response is faster, not slower, than the primary response, and it does lead to higher antibody levels. Choice C is incorrect because a secondary response does not result in a decrease in antibodies; instead, it leads to an increase. Choice D is incorrect because a secondary immune response is not limited to hyperallergic reactions, and it results in an increase, not a decrease, in antibodies.

2. Which of the following types of vitamin or mineral deficiency can cause megaloblastic anemia and is associated with lower extremity paresthesias?

• A. Vitamin B12
• B. Folate
• C. Iron
• D. Vitamin K

Correct answer: A

Rationale: The correct answer is Vitamin B12. Vitamin B12 deficiency can lead to megaloblastic anemia and neurological symptoms, including lower extremity paresthesias. Folate deficiency can also cause megaloblastic anemia but typically does not present with neurological symptoms. Iron deficiency leads to microcytic anemia, not megaloblastic anemia. Vitamin K deficiency is associated with coagulation abnormalities, not megaloblastic anemia.

3. A 67-year-old man is receiving androgen therapy for osteoporosis. What laboratory test should the nurse monitor during this therapy?

• A. Liver function tests
• B. Blood glucose levels
• C. Prostate-specific antigen (PSA)
• D. Cholesterol levels

Correct answer: A

Rationale: During androgen therapy, monitoring liver function tests is crucial to detect any signs of liver dysfunction. Androgens can potentially impact liver function, making it essential to monitor enzymes such as ALT and AST. While blood glucose levels and cholesterol levels are important parameters to monitor in certain situations, they are not the primary focus during androgen therapy for osteoporosis. Prostate-specific antigen (PSA) monitoring is more relevant in the context of prostate health and cancer screening, not specifically during androgen therapy for osteoporosis.

4. When assessing a patient experiencing breakthrough bleeding while taking oral contraceptives, what should the nurse consider?

• A. The possibility of pregnancy
• B. The patient's adherence to the medication schedule
• C. The need for an increased dosage
• D. The effectiveness of the current oral contraceptive

Correct answer: B

Rationale: When a patient on oral contraceptives experiences breakthrough bleeding, it is crucial for the nurse to consider the patient's adherence to the medication schedule. Breakthrough bleeding is often a sign of missed doses or inconsistent use, which can decrease the effectiveness of the oral contraceptive. Considering the possibility of pregnancy (Choice A) is important but secondary to assessing adherence. The need for an increased dosage (Choice C) is not typically the first consideration for breakthrough bleeding. Evaluating the effectiveness of the current oral contraceptive (Choice D) is relevant but should come after assessing adherence to the medication schedule.

5. A woman of childbearing age is diagnosed with breast cancer. She is currently taking hormonal contraceptives. What information should the woman be given regarding the hormonal contraceptives?

• A. The hormonal contraceptives do not affect the course of the disease.
• B. The hormonal contraceptives will stimulate uterine bleeding.
• C. The hormonal contraceptives will impair uterine bleeding.
• D. The hormonal contraceptives will stimulate tumor growth.

Correct answer: A

Rationale: The correct answer is A. Hormonal contraceptives should be discontinued in women diagnosed with breast cancer because they can potentially stimulate cancer growth. Choice B is incorrect as hormonal contraceptives do not stimulate uterine bleeding. Choice C is also incorrect as hormonal contraceptives typically do not impair uterine bleeding. Choice D is incorrect because hormonal contraceptives are not meant to stimulate tumor growth.

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