Nursing Elites

1. 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.

2. On the advice of his brother, a 53-year-old man has made an appointment to request a prescription for Viagra. The nurse who works at the clinic is reviewing the man's medical history and would recognize what health problem as being prohibitive to this treatment?

• A. Type 2 diabetes, treated with metformin
• B. Hypercholesterolemia, treated with simvastatin
• C. Angina, treated with nitroglycerin
• D. Hypertension, treated with metoprolol

Correct answer: C

Rationale: Nitroglycerin is contraindicated with Viagra due to their combined effects on lowering blood pressure, which can result in a severe drop and potentially life-threatening complications. Using both medications together can lead to hypotension, putting the patient at risk. Therefore, the presence of angina treated with nitroglycerin would make prescribing Viagra unsafe. Choices A, B, and D are not directly contraindicated with Viagra and can be managed concurrently with this treatment.

3. A patient presents with a sudden onset of severe chest pain radiating to his back. His blood pressure is significantly higher in the right arm than in the left arm. Which of the following conditions is most likely?

• A. Acute myocardial infarction
• B. Pulmonary embolism
• C. Aortic dissection
• D. Pericarditis

Correct answer: C

Rationale: The correct answer is C, aortic dissection. Aortic dissection is characterized by sudden, severe chest pain that can radiate to the back. The discrepancy in blood pressure between the arms (higher in the right arm) is known as a 'pulse deficit' and is a classic finding in aortic dissection. This condition involves a tear in the inner layer of the aorta, leading to the abnormal flow of blood within the aortic wall. Acute myocardial infarction (choice A) presents with chest pain but typically does not cause discrepancies in blood pressure between arms. Pulmonary embolism (choice B) usually presents with chest pain and difficulty breathing but does not cause unequal blood pressures in the arms. Pericarditis (choice D) can cause chest pain exacerbated by breathing or lying down, but it does not typically lead to differences in blood pressure between arms.

4. What is the most sensitive indicator of altered brain function?

• A. The ability to perform complex mathematics
• B. Altered level of consciousness
• C. The lack of cerebrospinal fluid production
• D. Intact cranial nerve functions

Correct answer: B

Rationale: The correct answer is B: Altered level of consciousness. Changes in consciousness are the most sensitive indicator of altered brain function as they can signal underlying neurological issues. Option A, the ability to perform complex mathematics, though it involves brain function, is not as sensitive or direct an indicator as altered consciousness. Option C, the lack of cerebrospinal fluid production, is more related to conditions like hydrocephalus rather than a direct indicator of altered brain function. Option D, intact cranial nerve functions, indicate the normal functioning of peripheral nerves and are not as sensitive to changes in brain function as alterations in consciousness.

5. In nephritic syndrome compared to nephrotic syndrome, there is:

• A. higher amounts of albuminuria.
• B. negligible hematuria or absence of hematuria.
• C. presence of red blood cell casts in the urine.
• D. hypoalbuminemia

Correct answer: C

Rationale: In nephritic syndrome, the presence of red blood cell casts in the urine is a characteristic finding, reflecting glomerular inflammation and damage. This differentiates it from nephrotic syndrome, where red blood cell casts are typically absent. Choice A is incorrect because nephritic syndrome usually presents with less albuminuria compared to nephrotic syndrome. Choice B is incorrect as hematuria is a common feature of nephritic syndrome. Choice D is incorrect as hypoalbuminemia is more commonly associated with nephrotic syndrome.

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