Nursing Elites

1. When caring for a patient with systemic lupus erythematosus (SLE), the disease the nurse is dealing with is an example of:

• A. Autoimmunity
• B. Alloimmunity
• C. Homoimmunity
• D. Alleimmunity

Correct answer: A

Rationale: When a nurse cares for a patient with systemic lupus erythematosus (SLE), the nurse is dealing with an autoimmune disease. In autoimmune diseases like SLE, the immune system mistakenly attacks the body's own tissues. Choice A, 'Autoimmunity,' is the correct answer because SLE is an example of the immune system attacking self-antigens, leading to tissue damage and inflammation. Choices B, C, and D are incorrect. Alloimmunity refers to the immune response against foreign antigens from members of the same species, homoimmunity is not a recognized term in immunology, and alleimmunity is not a valid term in this context.

2. Which of the following is found in clients with Parkinson’s disease?

• A. Mobility and functioning
• B. The liver and kidneys
• C. Too much dopamine in the brain
• D. Skeletal muscle flaccidity

Correct answer: C

Rationale: The correct answer is C: Too much dopamine in the brain. Parkinson's disease is characterized by a deficiency of dopamine in the brain, not an excess. This deficiency leads to the motor symptoms associated with the disease. Choices A, B, and D are incorrect. Mobility and functioning are affected in Parkinson's disease due to the lack of dopamine, not an excess. The liver and kidneys are not directly related to Parkinson's disease. Skeletal muscle flaccidity is not typically a primary symptom of Parkinson's disease, which is more characterized by rigidity and tremors.

3. When the body produces antibodies against its own tissue, the condition is called:

• A. Alloimmunity
• B. Opsonization
• C. Autoimmunity
• D. Hypersensitivity

Correct answer: C

Rationale: Autoimmunity is the correct term for a condition where the body's immune system mistakenly targets its own tissues. Alloimmunity (Choice A) refers to an immune response against foreign tissue. Opsonization (Choice B) is a process where pathogens are marked for destruction by immune cells. Hypersensitivity (Choice D) involves an exaggerated immune response against antigens.

4. A nurse is teaching a patient about the use of raloxifene (Evista) for the prevention of osteoporosis. What is the primary therapeutic action of this medication?

• A. It decreases the absorption of calcium from the intestines.
• B. It decreases bone resorption and increases bone density.
• C. It increases the excretion of calcium through the kidneys.
• D. It stimulates the formation of new bone.

Correct answer: B

Rationale: The correct answer is B. Raloxifene, a selective estrogen receptor modulator (SERM), works by decreasing bone resorption and increasing bone density. This action helps in preventing osteoporosis by maintaining bone strength. Choice A is incorrect as raloxifene does not affect the absorption of calcium from the intestines. Choice C is incorrect as raloxifene does not increase the excretion of calcium through the kidneys. Choice D is incorrect as raloxifene does not directly stimulate the formation of new bone; instead, it primarily works by reducing bone loss.

5. A 30-year-old male has been brought to the emergency department by his wife because of a severe headache, nausea, vomiting, and fever. A lumbar puncture is performed, and cerebrospinal fluid (CSF) analysis reveals a high protein count, low glucose, and numerous polymorphonuclear leukocytes (PMNs). Which organism is the most likely cause of these findings?

• A. Streptococcus pneumoniae
• B. Neisseria meningitidis
• C. Escherichia coli
• D. Listeria monocytogenes

Correct answer: A

Rationale: The cerebrospinal fluid (CSF) analysis findings of high protein count, low glucose, and numerous polymorphonuclear leukocytes (PMNs) are classic for bacterial meningitis. Among the choices, Streptococcus pneumoniae is the most likely cause in this case. Streptococcus pneumoniae is a common cause of bacterial meningitis in adults, especially presenting with symptoms such as severe headache, nausea, vomiting, and fever. Neisseria meningitidis is another common cause of bacterial meningitis but is more frequently associated with a different CSF profile. Escherichia coli is a common cause of neonatal meningitis, not typically seen in a 30-year-old male. Listeria monocytogenes is more commonly associated with meningitis in immunocompromised individuals and neonates, and typically presents differently in CSF analysis.

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