Nursing Elites

1. An oncology nurse is providing care for an adult patient who is currently immunocompromised. The nurse is aware of the physiology involved in hematopoiesis and immune function, including the salient role of cytokines. What is the primary role of cytokines in maintaining homeostasis?

• A. Cytokines perform phagocytosis in response to bacterial and protozoal infections.
• B. Cytokines perform a regulatory role in the development of diverse blood cells.
• C. Cytokines play a significant role in the formation of all blood cells.
• D. Cytokines are produced in response to the presence of antibodies.

Correct answer: B

Rationale: The primary role of cytokines in maintaining homeostasis is to perform a regulatory function in the development of diverse blood cells. Cytokines act as signaling molecules that regulate the immune response and hematopoiesis. Choice A is incorrect because cytokines do not perform phagocytosis; they regulate immune responses. Choice C is incorrect because while cytokines are involved in the formation of some blood cells, they are not considered the basic 'building blocks' of all blood cells. Choice D is incorrect because cytokines are not formed in response to antibodies, but rather play a role in the immune response to various stimuli.

2. A patient with a history of cardiovascular disease is being prescribed hormone replacement therapy (HRT). What should the nurse include in the patient education regarding the risks associated with HRT?

• A. HRT may increase the risk of cardiovascular events, including heart attack and stroke.
• B. HRT may decrease the risk of osteoporosis.
• C. HRT may increase the risk of venous thromboembolism.
• D. HRT may decrease the risk of breast cancer.

Correct answer: A

Rationale: The correct answer is A. Hormone replacement therapy (HRT) is associated with an increased risk of cardiovascular events, including heart attack and stroke, especially in patients with a history of cardiovascular disease. Choice B is incorrect because HRT does not decrease the risk of osteoporosis; in fact, it may increase the risk of certain conditions like venous thromboembolism, as mentioned in choice C. Choice D is also incorrect as HRT has been associated with a slight increase in the risk of breast cancer.

3. What should a nurse include in patient teaching for a patient prescribed medroxyprogesterone acetate (Provera) for endometriosis?

• A. Medroxyprogesterone should be taken at the same time each day to maintain consistent hormone levels and effectiveness in treating endometriosis.
• B. Medroxyprogesterone can be taken with food to reduce gastrointestinal upset.
• C. Medroxyprogesterone should be discontinued if side effects occur.
• D. Medroxyprogesterone should be taken once a week to maintain effectiveness.

Correct answer: A

Rationale: When teaching a patient prescribed medroxyprogesterone acetate (Provera) for endometriosis, the nurse should emphasize the importance of taking the medication at the same time each day. This helps maintain consistent hormone levels and ensures the effectiveness of the treatment. Option A is correct because it addresses this key point. Option B is incorrect because medroxyprogesterone should be taken consistently but not necessarily with food. Option C is incorrect because discontinuing the medication without consulting a healthcare provider is not advisable. Option D is incorrect as medroxyprogesterone is usually taken daily, not weekly, for the treatment of endometriosis.

4. The nurse is planning care for a client with damage to the vestibular area of the vestibulocochlear nerve. What should the nurse include in the plan of care? Select all that apply.

• A. Assistance with ambulation
• B. Regular hearing tests
• C. Monitoring for nausea
• D. Vision assessments

Correct answer: A

Rationale: Damage to the vestibular area affects balance and may cause nausea. Therefore, the nurse should include assistance with ambulation in the care plan to help the client maintain stability while walking. Regular hearing tests (choice B) are not directly related to damage in the vestibular area of the vestibulocochlear nerve. While nausea (choice C) may occur due to vestibular damage, monitoring for it alone is not as essential as providing assistance with ambulation. Vision assessments (choice D) are important for assessing visual function but are not the priority when dealing with vestibular issues.

5. During childhood, the thymus decreases in size, and this is referred to as ______ atrophy.

• A. Physiologic
• B. Pathologic
• C. Disuse
• D. Neurogenic

Correct answer: A

Rationale: The correct answer is A, 'Physiologic.' Physiologic atrophy is a normal part of development, like the reduction in thymus size during childhood. Pathologic atrophy (choice B) refers to tissue wasting due to disease, not a normal process like the reduction in thymus size. Disuse atrophy (choice C) results from a lack of physical activity or stimulation, which is not the case with thymus size reduction. Neurogenic atrophy (choice D) is caused by damage to or diseases of the nerves supplying the muscles, not related to the thymus size reduction seen in childhood.

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