Nursing Elites

1. Hematopoiesis occurs primarily in the bone marrow. What cells are formed during this process?

• A. Pancreatic beta cells
• B. Red blood cells
• C. Gastric parietal cells
• D. Neurons and glial cells

Correct answer: B

Rationale: The correct answer is B: Red blood cells. Hematopoiesis is the process of blood cell formation that primarily occurs in the bone marrow. Red blood cells are one of the main cell types formed during this process. Pancreatic beta cells (Choice A), gastric parietal cells (Choice C), and neurons and glial cells (Choice D) are not formed during hematopoiesis. Pancreatic beta cells are involved in insulin production, gastric parietal cells secrete gastric acid, and neurons and glial cells are part of the nervous system.

2. A woman is being treated with clomiphene citrate for the treatment of infertility. She states to the nurse that she has seen an increase in vaginal discharge. The nurse knows that this effect is related to:

• A. Increased blood flow to the vaginal area.
• B. Increased cervical mucus production.
• C. Increased production of vaginal secretions.
• D. Increased lubrication in the vaginal canal.

Correct answer: C

Rationale: The correct answer is C: 'Increased production of vaginal secretions.' Clomiphene citrate affects cervical mucus production, leading to an increase in vaginal secretions. This effect is beneficial for fertility as it helps create a more hospitable environment for sperm transport. Choice A, 'Increased blood flow to the vaginal area,' is incorrect as the increase in vaginal discharge is primarily due to changes in cervical mucus. Choice B, 'Increased cervical mucus production,' is partially correct but does not fully explain the increase in vaginal secretions. Choice D, 'Increased lubrication in the vaginal canal,' is not directly related to the effect seen with clomiphene citrate treatment for infertility.

3. After teaching the students about B cells, which statement indicates teaching was successful? B cells are originally derived from cells of the:

• A. Bone marrow
• B. Lymph nodes
• C. Gut-associated lymphoid tissue
• D. Thymus

Correct answer: A

Rationale: The correct answer is A: Bone marrow. B cells are originally derived from cells of the bone marrow. Bone marrow is the primary site where B cells develop and mature. Lymph nodes (choice B), gut-associated lymphoid tissue (choice C), and the thymus (choice D) are involved in the immune response but are not the primary site of origin for B cells.

4. A client on an acute medicine unit of a hospital with a diagnosis of small bowel obstruction is reporting intense, diffuse pain in her abdomen. Which physiologic phenomenon is most likely contributing to her complaint?

• A. Somatic pain resulting from pressure on the parietal peritoneum
• B. Referred pain from her small bowel
• C. Visceral pain resulting from distension and ischemia
• D. Neuropathic pain resulting from autonomic dysfunction

Correct answer: C

Rationale: Visceral pain is associated with distension, ischemia, and inflammation of internal organs. In the case of a small bowel obstruction, the intense, diffuse pain reported by the client is likely due to the distension and ischemia of the small bowel. Somatic pain (Choice A) would be more localized and sharp, typically arising from the parietal peritoneum. Referred pain (Choice B) is pain perceived at a site distant from the actual pathology. Neuropathic pain (Choice D) involves dysfunction or damage to the nervous system and is not typically associated with the described physiologic phenomenon of distension and ischemia in the context of a small bowel obstruction.

5. A 37-year-old woman has a 10 pack-year smoking history and has been using oral contraceptives for the past 2 years. The nurse should plan health education interventions knowing that this patient faces an increased risk of

• A. osteoporosis.
• B. dementia.
• C. myocardial infarction.
• D. deep vein thrombosis.

Correct answer: C

Rationale: The correct answer is C: myocardial infarction. Women aged 35 and older who smoke, especially with a history of 10 pack-years like in this case, face an increased risk of cardiovascular disorders, including myocardial infarction, when using oral contraceptives. Choice A, osteoporosis, is incorrect because smoking and oral contraceptives do not significantly increase the risk of osteoporosis. Choice B, dementia, is not directly associated with smoking, oral contraceptives, or their combination. Choice D, deep vein thrombosis, is a risk associated with oral contraceptives, especially in combination with smoking, but the highest increased risk in this case is for myocardial infarction.

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