Nursing Elites

1. What is the most sensitive indicator of altered brain function?

• A. The ability to perform complex mathematics
• B. Altered level of consciousness
• C. The lack of cerebrospinal fluid production
• D. Intact cranial nerve functions

Correct answer: B

Rationale: The correct answer is B: Altered level of consciousness. Changes in consciousness are the most sensitive indicator of altered brain function as they can signal underlying neurological issues. Option A, the ability to perform complex mathematics, though it involves brain function, is not as sensitive or direct an indicator as altered consciousness. Option C, the lack of cerebrospinal fluid production, is more related to conditions like hydrocephalus rather than a direct indicator of altered brain function. Option D, intact cranial nerve functions, indicate the normal functioning of peripheral nerves and are not as sensitive to changes in brain function as alterations in consciousness.

2. A patient taking oral contraceptives reports breakthrough bleeding. What should the nurse assess in this patient?

• A. Adherence to the medication schedule
• B. The possibility of pregnancy
• C. The need for an increased dosage
• D. The effectiveness of the current oral contraceptive

Correct answer: A

Rationale: When a patient on oral contraceptives experiences breakthrough bleeding, the nurse should assess the patient's adherence to the medication schedule. Breakthrough bleeding can be a sign of missed doses or inconsistent timing, which can decrease the effectiveness of oral contraceptives. Assessing the patient's adherence helps in ensuring proper use of the medication. Choices B, C, and D are incorrect because breakthrough bleeding is more likely related to adherence issues rather than pregnancy, the need for increased dosage, or the effectiveness of the current oral contraceptive.

3. What are direct effects of antibodies? (Select ONE that does not apply):

• A. Neutralization
• B. Agglutination
• C. Precipitation
• D. Phagocytosis

Correct answer: D

Rationale: The direct effects of antibodies include neutralization, agglutination, and precipitation. Antibodies neutralize pathogens by binding to them and preventing their harmful effects. Agglutination involves the clumping together of pathogens, making it easier for phagocytes to engulf them. Precipitation refers to the process where antibodies bind to soluble antigens, forming large complexes that are easily removed from the body. Phagocytosis, on the other hand, is an indirect effect of antibodies where phagocytes engulf and destroy pathogens opsonized by antibodies, not a direct effect.

4. What is the distinguishing feature of Hodgkin disease noted on histologic exam?

• A. Reed-Sternberg cells
• B. Red-stained cells
• C. Human Papillomavirus
• D. B-cells and T-cells

Correct answer: A

Rationale: The correct answer is A: Reed-Sternberg cells. Reed-Sternberg cells are large, abnormal B-cells that are characteristic of Hodgkin's lymphoma. These cells are identified on histologic examination of lymph node biopsies from patients with Hodgkin disease. Choice B, 'Red-stained cells,' is vague and does not describe a specific feature of Hodgkin disease. Choice C, 'Human Papillomavirus,' is incorrect as Hodgkin disease is not caused by HPV. Choice D, 'B-cells and T-cells,' is incorrect as Hodgkin disease is characterized by the presence of Reed-Sternberg cells, which are abnormal B-cells.

5. What typically causes contact dermatitis?

• A. Fungal infection
• B. Long-term disorder from gout
• C. Contact with a skin allergen
• D. Staphylococcal infection

Correct answer: C

Rationale: Contact dermatitis is typically caused by contact with a skin allergen that triggers an allergic reaction. Choice A, fungal infection, is incorrect as contact dermatitis is not caused by fungi. Choice B, long-term disorder from gout, is also incorrect as gout is not typically associated with contact dermatitis. Choice D, Staphylococcal infection, is incorrect as contact dermatitis is primarily an allergic reaction rather than a bacterial infection.

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