Nursing Elites

1. What occurs in a client with polycythemia?

• A. Deficient plasma in the blood
• B. Increased lymphatic fluid being produced
• C. Increased red blood cells being produced
• D. Deficient number of red blood cells

Correct answer: C

Rationale: The correct answer is C: Increased red blood cells being produced. Polycythemia is a condition characterized by an elevated number of red blood cells in the blood. This increased concentration of red blood cells can lead to blood thickening and potentially result in complications such as blood clots. Choices A, B, and D are incorrect because polycythemia does not involve deficient plasma, increased lymphatic fluid production, or a deficient number of red blood cells.

2. A 5-month-old child is admitted to the hospital with recurring respiratory infections. A possible cause of this condition is:

• A. Hypergammaglobulinemia
• B. Increased maternal IgG
• C. Immune insufficiency
• D. Decreased maternal antibody breakdown, resulting in hyposensitivity

Correct answer: C

Rationale: Immune insufficiency is a possible cause of recurring respiratory infections in a 5-month-old child. In this scenario, the child's immune system may not be functioning optimally, leading to a susceptibility to infections. Choices A, B, and D are incorrect. Hypergammaglobulinemia refers to high levels of gamma globulins in the blood and is not typically associated with recurring respiratory infections in this context. Increased maternal IgG would provide passive immunity to the child, offering some protection against infections. Decreased maternal antibody breakdown leading to hyposensitivity is not a common cause of recurring respiratory infections in a 5-month-old child.

3. A female patient has been diagnosed with tuberculosis and begun multiple-drug therapy. The woman has asked the nurse why it is necessary for her to take several different drugs instead of one single drug. How should the nurse best respond to the patient's question?

• A. “Multiple drugs are used because doctors need to combat the TB bacteria from different angles to effectively treat the infection.”
• B. “The use of multiple drugs prevents the development of drug-resistant TB.”
• C. “Multiple drugs are prescribed because the final testing results for TB can take up to 3 weeks to confirm the most effective treatment.”
• D. “Multiple drugs are used in order to speed up the course of treatment.”

Correct answer: B

Rationale: The correct answer is B. Using multiple drugs in tuberculosis treatment helps prevent the development of drug-resistant TB. This approach is crucial because if the infection is not completely eradicated, the remaining bacteria may become resistant to the single drug used, making future treatments less effective. Choice A is incorrect because the use of multiple drugs is not due to uncertainty about which drug will work, but rather to address the bacteria from different angles. Choice C is incorrect as it misleads the patient about the reason for using multiple drugs. Choice D is also incorrect because the primary purpose of using multiple drugs is not to speed up treatment but to ensure effectiveness and prevent resistance.

4. A 23-year-old pregnant female visits her primary care provider for her final prenatal checkup. The primary care provider determines that the fetus has developed an infection in utero. Which of the following would be increased in the fetus at birth?

• A. IgG
• B. IgA
• C. IgM
• D. IgD

Correct answer: C

Rationale: The correct answer is IgM. IgM is the first antibody produced in response to an infection and is elevated in a fetus with an in utero infection. IgG is the primary antibody responsible for providing immunity to the fetus and is transferred across the placenta during the third trimester. IgA is mainly found in mucosal areas and colostrum but not significantly elevated in fetal infections. IgD is involved in the development and maturation of B cells but not typically increased in fetal infections.

5. Which of the following accurately describes the pathophysiology of asthma?

• A. Chronic inflammation of the bronchial lining
• B. Narrowing of the airway due to bronchoconstriction
• C. Damage to alveoli reducing lung elasticity
• D. Overproduction of mucus by the goblet cells

Correct answer: B

Rationale: The correct answer is B: "Narrowing of the airway due to bronchoconstriction." In asthma, there is an inflammatory response that leads to bronchoconstriction, causing the airways to narrow and making it difficult to breathe. Choice A is incorrect as chronic inflammation is a feature of asthma but not the primary pathophysiological mechanism. Choice C is incorrect as damage to alveoli is more characteristic of conditions like emphysema. Choice D is incorrect as overproduction of mucus is a feature of chronic bronchitis, not asthma.

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