Nursing Elites

1. If the client's dorsal columns are not functioning, the nurse will observe which response during neuro testing, where the nurse asks the client to close his eyes and then proceeds to touch corresponding parts of the body on each side simultaneously with two sharp points?

• A. The client will not be able to distinguish between the two points.
• B. The client will feel only one point of contact.
• C. The client will accurately identify both points.
• D. The client will report no sensation in the touched areas.

Correct answer: A

Rationale: If the client's dorsal columns are not functioning, the ability to distinguish between two closely spaced points is impaired. This results in the client not being able to differentiate between the two points when touched simultaneously. Choice B is incorrect because the client feeling only one point suggests an intact dorsal column function. Choice C is incorrect as accurately identifying both points indicates normal discrimination ability. Choice D is incorrect as reporting no sensation does not correspond to the specific impairment related to dorsal column dysfunction.

2. Women who have breast cancer due to a BRCA1 gene mutation are usually:

• A. positive for human epidermal growth factor receptor 1 and 2.
• B. negative for estrogen receptor.
• C. positive for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2.
• D. negative for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2.

Correct answer: D

Rationale: Women with breast cancer due to a BRCA1 gene mutation commonly have a triple-negative breast cancer subtype, which means they are negative for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 (HER2). This subtype tends to be more aggressive and harder to treat. Choice A is incorrect as they are typically negative for HER2. Choice B is incorrect because they are usually negative for estrogen receptor. Choice C is incorrect as they are usually negative for progesterone receptor and HER2.

3. A client asks a nurse about the cause of Parkinson's disease. How should the nurse respond?

• A. Parkinson's disease is caused by a lack of dopamine in the brain, which affects movement.
• B. Parkinson's disease is caused by an excess of acetylcholine in the brain, leading to tremors and rigidity.
• C. Parkinson's disease is caused by an autoimmune response that attacks the nervous system.
• D. Parkinson's disease is caused by a bacterial infection that needs to be treated with antibiotics.

Correct answer: A

Rationale: The correct answer is A. Parkinson's disease is caused by a deficiency of dopamine in the brain, which results in the characteristic motor symptoms such as tremors, rigidity, and bradykinesia. Choice B is incorrect because Parkinson's disease is not caused by an excess of acetylcholine. Choice C is incorrect because Parkinson's disease is not an autoimmune disorder. Choice D is incorrect because Parkinson's disease is not caused by a bacterial infection and cannot be treated with antibiotics.

4. A newborn is diagnosed with congenital intrinsic factor deficiency. Which of the following types of anemia will the nurse see documented on the chart?

• A. Iron deficiency anemia
• B. Sideroblastic anemia
• C. Pernicious anemia
• D. Hemolytic anemia

Correct answer: C

Rationale: The correct answer is C, Pernicious anemia. Pernicious anemia is associated with a congenital intrinsic factor deficiency, leading to the impaired absorption of vitamin B12. Iron deficiency anemia (Choice A) is not directly related to intrinsic factor deficiency. Sideroblastic anemia (Choice B) is characterized by defective iron uptake by developing erythrocytes and is not linked to intrinsic factor deficiency. Hemolytic anemia (Choice D) involves the premature destruction of red blood cells and is not specifically associated with intrinsic factor deficiency.

5. How can a colony-stimulating factor affect the patient's erythrocyte count?

• A. It stimulates the growth of red blood cells.
• B. It suppresses T-cell production.
• C. It inhibits protein synthesis.
• D. It stimulates antibody production.

Correct answer: A

Rationale: Colony-stimulating factors are substances that stimulate the production of blood cells in the bone marrow. Erythrocytes are red blood cells, so a colony-stimulating factor would specifically stimulate the growth of red blood cells, leading to an increase in the patient's erythrocyte count. Choice B is incorrect because colony-stimulating factors do not suppress T-cell production. Choice C is incorrect because colony-stimulating factors do not inhibit protein synthesis. Choice D is incorrect because colony-stimulating factors do not stimulate antibody production; they primarily affect the production of blood cells.

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