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. Which of the following is a common cause of mechanical small intestine obstruction?

• A. Infection
• B. Postoperative adhesions
• C. Tumors
• D. Foreign body

Correct answer: B

Rationale: Postoperative adhesions are a common cause of mechanical small intestine obstruction. Adhesions can form after abdominal surgery, causing bands of scar tissue that may twist or pull the intestines, leading to obstruction. This is a more common cause compared to infection, tumors, or foreign bodies. Infection may lead to inflammation but is not a typical cause of mechanical obstruction. Tumors and foreign bodies can cause blockages but are less common than postoperative adhesions.

3. A 74-year-old woman states that many of her peers underwent hormone replacement therapy (HRT) in years past. The woman asks the nurse why her primary care provider has not yet proposed this treatment for her. What fact should underlie the nurse's response to the woman?

• A. The risks of stroke and breast cancer are unacceptably high in women taking HRT.
• B. HRT was found to cause mood disturbances in many women who used it long term.
• C. HRT was found to be a significant risk factor for bone fractures and osteoporosis.
• D. The risks of chronic obstructive pulmonary disease were found to be significantly higher in women using HRT.

Correct answer: A

Rationale: The correct answer is A because the main reason HRT is not recommended for all women is due to the increased risks of stroke and breast cancer associated with its use. Hormone replacement therapy (HRT) has been linked to an elevated risk of stroke and breast cancer, which outweigh its potential benefits for many individuals. Choices B, C, and D are incorrect as they do not address the primary concerns regarding HRT use. While HRT can indeed cause mood disturbances and may affect bone health, the significant risks of stroke and breast cancer are the primary reasons why healthcare providers may choose not to recommend HRT for some women.

4. What is the cause of swelling during acute inflammation?

• A. Collagenase
• B. Fluid exudate
• C. Lymphocytic margination
• D. Anaerobic glycolysis

Correct answer: B

Rationale: Swelling during acute inflammation is primarily caused by the accumulation of fluid exudate in the affected tissues. This fluid exudate contains proteins and cells that leak from blood vessels due to increased vascular permeability. Collagenase (Choice A) is an enzyme that breaks down collagen and is not directly responsible for swelling. Lymphocytic margination (Choice C) is the process where white blood cells line up along the blood vessel walls, which does not directly cause swelling. Anaerobic glycolysis (Choice D) is a metabolic process that occurs in the absence of oxygen and is not related to the mechanism of swelling in acute inflammation.

5. A patient with a diagnosis of renal failure is being treated with epoetin alfa (Epogen). Frequent assessment of which of the following laboratory values should be prioritized before and during treatment?

• A. AST
• B. C-reactive protein
• C. CBC
• D. ALT

Correct answer: A

Rationale: The correct answer is AST. Epoetin alfa is a medication used to treat anemia associated with chronic renal failure. During treatment with epoetin alfa, it is crucial to monitor AST levels as this medication can potentially lead to liver toxicity. Assessing AST levels before and throughout treatment helps in early detection of any liver abnormalities. C-reactive protein is not specifically related to the use of epoetin alfa in renal failure. While CBC (Complete Blood Count) monitoring is essential during treatment with epoetin alfa to evaluate the response to therapy, prioritizing AST assessment is more critical due to the potential for liver toxicity. ALT monitoring is also important but AST is prioritized in this scenario.

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