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. Following a knee injury, a football player is taking ibuprofen, a nonsteroidal anti-inflammatory drug, for the control of pain. Which drug action is most likely to result in diminished sensation of pain for the player?

• A. Inhibition of cyclooxygenase (COX) enzymes
• B. Activation of opioid receptors
• C. Blocking of NMDA receptors
• D. Stimulation of serotonin receptors

Correct answer: A

Rationale: The correct answer is A: Inhibition of cyclooxygenase (COX) enzymes. Ibuprofen works by inhibiting these enzymes, which are involved in the production of prostaglandins that mediate pain and inflammation. This inhibition leads to decreased prostaglandin production, resulting in a decrease in pain and inflammation. Choices B, C, and D are incorrect because ibuprofen does not act on opioid receptors, NMDA receptors, or serotonin receptors to control pain. It primarily exerts its analgesic and anti-inflammatory effects through COX enzyme inhibition.

3. A client with chronic bronchitis is receiving education from a healthcare provider about the condition. Which statement made by the client indicates a need for further teaching?

• A. I should avoid being around people who smoke.
• B. I should try to avoid any exposure to pollutants and irritants.
• C. I should limit my fluid intake to avoid worsening my cough.
• D. I should use my inhaler regularly, even when I don't have symptoms.

Correct answer: C

Rationale: The correct answer is C because limiting fluid intake is not recommended for chronic bronchitis. Hydration is essential as it helps thin mucus, making it easier to clear from the airways. Choices A, B, and D are all correct statements for managing chronic bronchitis. Avoiding exposure to smoke, pollutants, and irritants can help reduce respiratory symptoms and exacerbations. Using the inhaler regularly, even in the absence of symptoms, is crucial for controlling inflammation and maintaining airway function.

4. The parents of a 4-year-old girl have sought care because their daughter has admitted to chewing and swallowing imported toy figurines that have been determined to be made of lead. Which of the following blood tests should the care team prioritize?

• A. White blood cell levels with differential
• B. Red blood cell levels and morphology
• C. Urea and creatinine levels
• D. Liver function panel

Correct answer: B

Rationale: The correct answer is B: Red blood cell levels and morphology. Lead poisoning primarily affects red blood cells, causing anemia. Therefore, the priority test would be to assess red blood cell levels and morphology. Choice A (White blood cell levels with differential) is incorrect as lead poisoning does not primarily affect white blood cells. Choice C (Urea and creatinine levels) is unrelated to lead poisoning and not a priority in this scenario. Choice D (Liver function panel) is also not the priority as lead poisoning's primary impact is on the red blood cells, not the liver.

5. A client presents to the emergency department with complaints of chest pain and shortness of breath. The client's ECG shows ST-segment elevation. What is the priority nursing intervention?

• A. Administer aspirin as prescribed.
• B. Prepare the client for emergent coronary angiography.
• C. Administer oxygen therapy.
• D. Initiate CPR.

Correct answer: B

Rationale: In a client presenting with chest pain, shortness of breath, and ST-segment elevation on ECG, the priority nursing intervention is to prepare the client for emergent coronary angiography. This procedure is crucial in diagnosing and treating acute myocardial infarction promptly. Administering aspirin (Choice A) is important but not the priority over emergent coronary angiography. Administering oxygen therapy (Choice C) is supportive but does not address the underlying cause of the ST-segment elevation. Initiating CPR (Choice D) is not the priority in this scenario as the client is stable and conscious.

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