Nursing Elites

1. How does influenza immunization produce immunity?

• A. The virus from the vaccine remains in the body until the end of the season
• B. An attenuated virus causes immune system suppression and triggers immunity
• C. The body identifies the virus and develops antibodies against the virus
• D. The vaccine remains in the injection site and produces immune cells

Correct answer: C

Rationale: The correct answer is C. Influenza immunization works by introducing a weakened or inactivated form of the virus into the body, allowing the immune system to recognize it as foreign. This recognition triggers the production of antibodies specific to the virus. Choice A is incorrect as the virus in the vaccine does not remain in the body until the end of the season. Choice B is incorrect as an attenuated virus does not cause immune system suppression but rather stimulates an immune response. Choice D is incorrect because the vaccine does not stay at the injection site but rather prompts a systemic immune response throughout the body.

2. What is the distinguishing feature of Hodgkin disease noted on histologic exam?

• A. Reed-Sternberg cells
• B. Red-stained cells
• C. Human Papillomavirus
• D. B-cells and T-cells

Correct answer: A

Rationale: The correct answer is A: Reed-Sternberg cells. Reed-Sternberg cells are large, abnormal B-cells that are characteristic of Hodgkin's lymphoma. These cells are identified on histologic examination of lymph node biopsies from patients with Hodgkin disease. Choice B, 'Red-stained cells,' is vague and does not describe a specific feature of Hodgkin disease. Choice C, 'Human Papillomavirus,' is incorrect as Hodgkin disease is not caused by HPV. Choice D, 'B-cells and T-cells,' is incorrect as Hodgkin disease is characterized by the presence of Reed-Sternberg cells, which are abnormal B-cells.

3. What causes osteoporosis?

• A. Poor nutrition in infancy
• B. Regularly weight-bearing exercise
• C. Bone loss, frequently during aging
• D. Cerebral palsy and associated disorders

Correct answer: C

Rationale: The correct answer is C. Osteoporosis is commonly caused by bone loss that occurs with aging, leading to brittle bones. Choice A, poor nutrition in infancy, is not a direct cause of osteoporosis. Choice B, regularly weight-bearing exercise, actually helps in maintaining bone density and strength, reducing the risk of osteoporosis. Choice D, cerebral palsy and associated disorders, is not a common cause of osteoporosis.

4. A 60-year-old male client with a long history of back pain has had little success with a variety of analgesic regimens that his family physician has prescribed. He has recently been diagnosed with a chronic pain disorder. Which teaching points about chronic pain would his physician most likely emphasize to the client?

• A. Chronic pain is often difficult to treat and requires a multimodal approach.
• B. Chronic pain indicates that an underlying injury has not healed properly.
• C. Chronic pain can be managed with a single long-term medication.
• D. Chronic pain is typically less severe than acute pain but lasts longer.

Correct answer: A

Rationale: The correct answer is A. Chronic pain is often complex and challenging to treat, necessitating a multimodal approach that may include medication, physical therapy, and behavioral therapy. Choice B is incorrect because chronic pain does not always indicate that an underlying injury has not healed properly; it can persist even after the initial injury has healed. Choice C is incorrect as chronic pain management usually involves a combination of treatments rather than relying solely on a single long-term medication. Choice D is incorrect because chronic pain is not necessarily less severe than acute pain; it can vary in intensity and duration depending on the individual and underlying condition.

5. Which patient is most likely to be diagnosed with complex regional pain syndrome II (CRPS II)?

• A. A patient who has experienced a spinal cord injury and reports severe, burning pain in his legs.
• B. A patient who reports severe pain in her hand following a surgery for carpal tunnel syndrome.
• C. A patient who develops pain in his foot following a fracture and immobilization with a cast.
• D. A patient who experiences chronic pain and swelling in his arm following a brachial plexus injury.

Correct answer: D

Rationale: Complex regional pain syndrome II (CRPS II) typically occurs after an injury to a peripheral nerve. In this case, a brachial plexus injury involves damage to the nerves that control muscles in the arm and hand, leading to chronic pain and swelling. Choices A, B, and C describe pain related to other conditions such as spinal cord injury, carpal tunnel surgery, and fracture immobilization, which are not typically associated with CRPS II.

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