Nursing Elites

1. Which of the following is an example of a Type 1 hypersensitivity reaction?

• A. Anaphylaxis
• B. Indigestion
• C. Beta cell destruction
• D. ABO transfusion reaction

Correct answer: A

Rationale: Anaphylaxis is a classic example of a Type 1 hypersensitivity reaction. In Type 1 hypersensitivity, allergens trigger an immediate immune response mediated by IgE antibodies, leading to the release of histamine and other mediators. This reaction can result in symptoms ranging from mild itching and hives to severe conditions like anaphylaxis, which is a life-threatening emergency. The other options, such as indigestion (choice B), beta cell destruction (choice C), and ABO transfusion reaction (choice D), are not classified as Type 1 hypersensitivity reactions. Indigestion is typically related to gastrointestinal disturbances, beta cell destruction is associated with autoimmune conditions like type 1 diabetes, and ABO transfusion reaction involves antibodies targeting incompatible blood groups, which is a different immune mechanism compared to Type 1 hypersensitivity.

2. Nurse Isabelle enters the room of a client with a cognitive impairment disorder and asks what day of the week it is, what the date, month, and year are, and where the client is. The nurse is attempting to assess:

• A. confabulation.
• B. delirium.
• C. orientation.
• D. perseveration.

Correct answer: C

Rationale: The correct answer is C: "orientation." Nurse Isabelle is assessing the client's orientation by asking questions about time (day, date, month, year), place, and person. This assessment helps determine the client's awareness of their surroundings and situation. Confabulation (choice A) is the unintentional fabrication of details or events to fill in memory gaps and is not being assessed in this scenario. Delirium (choice B) is a state of acute confusion and disorientation, usually with a rapid onset, which is different from assessing orientation. Perseveration (choice D) refers to the persistent repetition of a response, statement, or behavior and is not the focus of the assessment being conducted by Nurse Isabelle in this situation.

3. What is a potential implication of multiple dark bands on the nails?

• A. They are considered a normal variant.
• B. They can be associated with malignant melanoma.
• C. They are indicative of a nail fungus.
• D. They are associated with aging.

Correct answer: B

Rationale: Multiple dark bands on the nails can be a concerning sign of malignant melanoma, a type of skin cancer that can affect the nails. While some nail changes are considered normal variants, dark bands should not be dismissed lightly as they can indicate a serious condition like melanoma. Nail fungus typically presents differently, causing discoloration, thickening, or distortion of the nail without distinct dark bands. Additionally, aging can lead to various nail changes, but dark bands alone are not a common feature of normal aging.

4. A 58-year-old woman comes to the clinic for evaluation of a sharp, intermittent, severe, stabbing facial pain that she describes as 'like an electric shock.' The pain occurs only on one side of her face; it seems to be triggered when she chews, brushes her teeth, or sometimes when she merely touches her face. There is no numbness associated with the pain. What is most likely causing her pain?

• A. Temporal arteritis
• B. Trigeminal neuralgia
• C. Migraine headache
• D. Cluster headache

Correct answer: B

Rationale: The correct answer is B: Trigeminal neuralgia. Trigeminal neuralgia is characterized by severe, stabbing pain in the distribution of the trigeminal nerve, often triggered by light touch, chewing, or brushing teeth. In this case, the patient's symptoms of sharp, intermittent facial pain triggered by activities like chewing and touching her face are classic for trigeminal neuralgia. Choices A, C, and D are incorrect. Temporal arteritis typically presents with unilateral headache, jaw claudication, and visual symptoms. Migraine headaches are usually throbbing in nature and often associated with nausea, vomiting, and sensitivity to light and sound. Cluster headaches are characterized by severe unilateral pain around the eye with autonomic symptoms like lacrimation and nasal congestion.

5. What causes osteoporosis?

• A. Poor nutrition in infancy
• B. Regularly weight-bearing exercise
• C. Bone loss, frequently during aging
• D. Cerebral palsy and associated disorders

Correct answer: C

Rationale: The correct answer is C. Osteoporosis is commonly caused by bone loss that occurs with aging, leading to brittle bones. Choice A, poor nutrition in infancy, is not a direct cause of osteoporosis. Choice B, regularly weight-bearing exercise, actually helps in maintaining bone density and strength, reducing the risk of osteoporosis. Choice D, cerebral palsy and associated disorders, is not a common cause of osteoporosis.

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