Nursing Elites

1. When a Tae Kwon Do (TKD) master applies downward pressure just above the elbow joint on an attacker who immediately collapses to the ground, which reflex is applicable to this example?

• A. Golgi tendon reflex
• B. Myotatic reflex
• C. Withdrawal reflex
• D. Crossed-extensor reflex

Correct answer: A

Rationale: The Golgi tendon reflex is the correct answer. This reflex protects the muscle and tendons from excessive force by causing the muscle to relax. In this scenario, the downward pressure applied just above the elbow joint triggers the Golgi tendon reflex, resulting in the attacker's collapse. The other options are incorrect: - The myotatic reflex (also known as the stretch reflex) is responsible for contracting a muscle in response to its stretch, not relaxing it. - The withdrawal reflex is a spinal reflex that moves a body part away from a painful stimulus, not directly related to the scenario described. - The crossed-extensor reflex is a reflex that occurs on the opposite side of the body in response to a withdrawal reflex, which is not the case in this situation.

2. Which of the following outcome criteria is appropriate for a client with dementia?

• A. The client will return to an established schedule for activities of daily living.
• B. The client will learn new coping mechanisms to handle anxiety.
• C. The client will seek out resources in the community for support.
• D. The client will follow an established schedule for activities of daily living.

Correct answer: D

Rationale: The correct answer is D. For clients with dementia, following an established schedule for activities of daily living is appropriate as it helps maintain routine and structure, which can be beneficial for their condition. Choice A has been rephrased to align better with the context of dementia care. Choice A is incorrect as expecting a return to a previous level of self-functioning may not be realistic for clients with dementia. Choice B is not the most appropriate outcome criteria as handling anxiety, while important, may not be the primary focus when working with clients with dementia. Choice C, seeking out resources in the community for support, is also important but may not be as directly related to the day-to-day care and management of activities for a client with dementia.

3. A male patient receiving androgen therapy is concerned about side effects. What adverse effect should the nurse monitor for during this therapy?

• A. Increased risk of liver dysfunction
• B. Increased risk of cardiovascular events
• C. Increased risk of prostate cancer
• D. Increased risk of bone fractures

Correct answer: B

Rationale: The correct answer is B: Increased risk of cardiovascular events. Androgen therapy can lead to an increased risk of cardiovascular events such as heart attack and stroke, especially in older patients. Choice A is incorrect because androgen therapy usually does not significantly increase the risk of liver dysfunction. Choice C is incorrect as androgen therapy does not increase the risk of prostate cancer; in fact, it is sometimes used in the treatment of prostate cancer. Choice D is also incorrect as androgen therapy is more likely to improve bone density and reduce the risk of fractures.

4. What is the cause of swelling during acute inflammation?

• A. Collagenase
• B. Fluid exudate
• C. Lymphocytic margination
• D. Anaerobic glycolysis

Correct answer: B

Rationale: Swelling during acute inflammation is primarily caused by the accumulation of fluid exudate in the affected tissues. This fluid exudate contains proteins and cells that leak from blood vessels due to increased vascular permeability. Collagenase (Choice A) is an enzyme that breaks down collagen and is not directly responsible for swelling. Lymphocytic margination (Choice C) is the process where white blood cells line up along the blood vessel walls, which does not directly cause swelling. Anaerobic glycolysis (Choice D) is a metabolic process that occurs in the absence of oxygen and is not related to the mechanism of swelling in acute inflammation.

5. A homeless man was screened for tuberculosis (TB) during a health consultation at a shelter, and the results indicate latent TB. The community health nurse who is liaising with the providers of the shelter would anticipate what component of this man's plan of care?

• A. The man will undergo conservative treatment for TB using adjuvant medications.
• B. The man will be treated for TB using first-line antitubercular drugs.
• C. The man will be monitored closely to determine if treatment is necessary.
• D. The man will be screened again in 10 to 12 weeks to determine if he has developed active TB.

Correct answer: B

Rationale: The correct answer is B. When a patient is diagnosed with latent TB infection, the standard approach involves treating them with first-line antitubercular drugs to prevent the progression to active TB. Adjuvant medications are not typically used for latent TB. Close monitoring without initiating treatment can lead to the development of active TB, so immediate treatment is crucial. Screening the individual again in 10 to 12 weeks does not address the immediate need for treatment of latent TB, which is essential to prevent the progression of the disease.

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