Nursing Elites

1. The neurotransmitter GABA mainly functions to trigger inhibitory postsynaptic potentials (IPSPs). Therefore, when explaining this to a group of nursing students, the nurse will state:

• A. It takes at least three chemical substances (amino acids, neuropeptides, and monoamines) to stimulate any activity between the cells.
• B. There is a symbiotic relationship; therefore, the end result will be depolarization of the postsynaptic membrane.
• C. The combination of GABA with a receptor site is inhibitory since it causes the local nerve membrane to become hyperpolarized and less excitable.
• D. The neurotransmitters will interact with cholinergic receptors to bind to acetylcholine in order to produce hypopolarization within the cell.

Correct answer: C

Rationale: When GABA binds with a receptor site, it causes hyperpolarization of the local nerve membrane, making it less excitable. This hyperpolarization leads to inhibition of nerve cell activity. Choice A is incorrect because GABA is a neurotransmitter itself and does not require three chemical substances to stimulate activity between cells. Choice B is incorrect as GABA triggers inhibitory postsynaptic potentials (IPSPs), leading to hyperpolarization, not depolarization, of the postsynaptic membrane. Choice D is also incorrect as it describes a process involving cholinergic receptors and acetylcholine, which is unrelated to GABA's mechanism of action.

2. In osteoporosis, what is the expected therapeutic action of raloxifene (Evista)?

• A. It decreases bone resorption and increases bone density.
• B. It stimulates the formation of new bone.
• C. It increases calcium absorption in the intestines.
• D. It decreases the excretion of calcium through the kidneys.

Correct answer: A

Rationale: The correct answer is A. Raloxifene works by decreasing bone resorption and increasing bone density. This helps in strengthening bones, reducing the risk of fractures, and improving bone health in patients with osteoporosis. Choice B is incorrect because raloxifene does not directly stimulate the formation of new bone but rather prevents bone loss. Choice C is incorrect as raloxifene does not primarily affect calcium absorption in the intestines. Choice D is also incorrect as raloxifene does not primarily decrease the excretion of calcium through the kidneys.

3. Although stress exposure initiates integrated responses by multiple systems, which system first activates the most important changes?

• A. Pulmonary
• B. Gastrointestinal
• C. Neuroendocrine
• D. Cardiovascular

Correct answer: C

Rationale: The correct answer is C, the Neuroendocrine system. When the body is exposed to stress, the neuroendocrine system plays a crucial role in initiating the body's response. This system, particularly through the hypothalamic-pituitary-adrenal axis, triggers a cascade of physiological responses to stress. Choices A, B, and D are incorrect because while other systems like the cardiovascular and gastrointestinal systems also respond to stress, the neuroendocrine system is primarily responsible for the initial and significant changes in the body's stress response.

4. A 20-year-old college student has presented to her campus medical clinic for a scheduled Pap smear. The clinician who will interpret the smear will examine cell samples for evidence of:

• A. Changes in cell shape, size, and organization
• B. Presence of unexpected cell types
• C. Ischemic changes in cell sample
• D. Abnormally high numbers of cells

Correct answer: A

Rationale: The correct answer is changes in cell shape, size, and organization (Choice A). Pap smears are performed to detect potential precancerous or cancerous conditions by examining the cells for any abnormalities in their shape, size, or organization. This helps in identifying early signs of cervical cancer. Choices B, C, and D are incorrect because Pap smears primarily focus on detecting cellular changes associated with cancer, not unexpected cell types, ischemic changes, or abnormally high numbers of cells.

5. After a patient is exposed to a specific antigen, B cells will differentiate into:

• A. B cytotoxic cells
• B. Plasma cells
• C. Bursal cells
• D. Clonal equivalents

Correct answer: B

Rationale: After exposure to a specific antigen, B cells undergo differentiation into plasma cells. Plasma cells are responsible for producing antibodies in response to the antigen. Choice A ('B cytotoxic cells') is incorrect because B cells do not differentiate into cytotoxic cells; cytotoxic cells are typically associated with T cells. Choice C ('Bursal cells') is incorrect as bursal cells are specific to birds and not relevant to human immune responses. Choice D ('Clonal equivalents') is incorrect as it does not describe the differentiation process of B cells exposed to antigens.

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