Nursing Elites

1. What is the pathophysiologic process responsible for the decreased glomerular filtration rate in a patient with acute glomerulonephritis?

• A. Decreased renal-induced constriction of the renal arteries
• B. Immune complex deposition, increased capillary permeability, and cellular proliferation
• C. Necrosis of 70% or more of the nephrons secondary to increased kidney interstitial hydrostatic pressure
• D. Scar tissue formation throughout the proximal convoluted tubule secondary to toxin-induced collagen synthesis

Correct answer: B

Rationale: The correct answer is B: Immune complex deposition, increased capillary permeability, and cellular proliferation. Acute glomerulonephritis is characterized by inflammation of the glomeruli in the kidneys. This inflammation leads to the deposition of immune complexes, increased capillary permeability, and cellular proliferation, which collectively contribute to a decreased glomerular filtration rate. Choice A is incorrect as decreased renal-induced constriction of the renal arteries would not directly result in decreased glomerular filtration rate. Choice C is incorrect as necrosis of nephrons due to increased kidney interstitial hydrostatic pressure would affect kidney function differently. Choice D is incorrect as scar tissue formation in the proximal convoluted tubule due to toxin-induced collagen synthesis is not a typical feature of acute glomerulonephritis.

2. After studying about fungi, which information indicates a correct understanding of fungi? Fungi causing deep or systemic infections:

• A. Are easily treated with penicillin
• B. Are extremely rare
• C. Never occur with other infections
• D. Are commonly opportunistic

Correct answer: D

Rationale: The correct answer is D: 'Are commonly opportunistic.' Fungi causing deep or systemic infections are commonly opportunistic, particularly in individuals with compromised immune systems. Choice A is incorrect because fungi infections are not easily treated with penicillin. Choice B is incorrect as deep or systemic fungal infections are not extremely rare. Choice C is incorrect as fungal infections can co-occur with other infections.

3. A female patient is concerned about the side effects of hormone replacement therapy (HRT). What common side effect should the nurse explain?

• A. Weight gain
• B. Hair loss
• C. Increased libido
• D. Decreased energy levels

Correct answer: A

Rationale: The correct answer is A: Weight gain. Weight gain is a common side effect of hormone replacement therapy (HRT) due to hormonal changes. Patients should be informed about this possibility as part of their treatment plan. Hair loss (Choice B) is not a common side effect of HRT. Increased libido (Choice C) and decreased energy levels (Choice D) are not typically associated with HRT side effects. Therefore, the nurse should focus on discussing weight gain with the patient.

4. A patient is prescribed estradiol (Estrace) for hormone replacement therapy (HRT). What should the nurse monitor during this therapy?

• A. Blood glucose levels
• B. Liver function tests
• C. Kidney function tests
• D. Blood pressure

Correct answer: B

Rationale: During estradiol therapy, monitoring liver function tests is essential due to the potential for liver dysfunction. Estradiol can affect liver function, making it crucial to monitor enzyme levels. Choice A, blood glucose levels, is not directly impacted by estradiol therapy, making it an incorrect choice. Choice C, kidney function tests, is not typically affected by estradiol therapy, so it is not the priority for monitoring. Choice D, blood pressure, is also not the primary parameter to monitor during estradiol therapy unless there are pre-existing conditions that warrant such monitoring.

5. When a child jumps out of the tub, crying and stating her feet are 'burning,' what pathophysiologic principle is responsible for this response?

• A. Pain receptors (nociceptors) have been activated in response to a thermal stimulus.
• B. The child's skin thermal receptors have undergone adaptation.
• C. The child is exhibiting a psychogenic pain response due to anxiety.
• D. The child is experiencing a conditioned pain response based on previous experiences.

Correct answer: A

Rationale: The child's reaction is due to the activation of nociceptors, which are pain receptors that respond to thermal stimuli. This response is an immediate protective mechanism to prevent tissue damage caused by extreme temperatures. Option B is incorrect because adaptation does not explain the child's immediate and intense response. Option C is incorrect as there is a clear physical stimulus present, ruling out a psychogenic response. Option D is incorrect as the child's response is not based on previous experiences but rather on the current thermal stimulus.

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