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. How are antibodies produced?

• A. B cells
• B. T cells
• C. Helper cells
• D. Memory cells

Correct answer: A

Rationale: Antibodies are produced by B cells. B cells are specialized white blood cells that generate antibodies as part of the immune response. B cells differentiate into plasma cells that secrete antibodies. T cells play a role in cell-mediated immunity, not antibody production. Helper cells, or helper T cells, assist in activating B cells but do not directly produce antibodies. Memory cells store information about previous infections but do not actively produce antibodies.

3. The unique clinical presentation of a 3-month-old infant in the emergency department leads the care team to suspect botulism. Which assessment question posed to the parents is likely to be most useful in the differential diagnosis?

• A. Has your child received all recommended vaccinations?
• B. Has your child been feeding poorly or showing signs of constipation?
• C. Has your child been exposed to any sick individuals?
• D. Has your child been displaying signs of respiratory distress?

Correct answer: B

Rationale: The correct answer is B. Poor feeding and constipation are common early symptoms of infant botulism, which is caused by a neurotoxin that impairs muscle function. Option A is unrelated to the presentation of botulism. Option C does not directly relate to the symptoms of botulism. Option D is more indicative of respiratory issues rather than the constellation of symptoms seen in botulism.

4. In a patient with chronic kidney disease and a hemoglobin level of 9 g/dL, which of the following treatments is most appropriate?

• A. Iron supplementation
• B. Erythropoiesis-stimulating agents
• C. Blood transfusion
• D. Vitamin B12 supplementation

Correct answer: B

Rationale: In chronic kidney disease, anemia commonly occurs due to decreased erythropoietin production. Erythropoiesis-stimulating agents, such as erythropoietin or darbepoetin, are the mainstay of treatment to stimulate red blood cell production. Iron supplementation is more appropriate for iron-deficiency anemia, not the anemia of chronic kidney disease. Blood transfusion is reserved for severe cases or acute blood loss. Vitamin B12 supplementation is indicated for megaloblastic anemia caused by vitamin B12 deficiency, not specifically in chronic kidney disease-related anemia.

5. A patient with benign prostatic hyperplasia (BPH) is prescribed finasteride (Proscar). What outcome should the nurse expect if the medication is effective?

• A. Decreased urinary frequency and urgency
• B. Increased prostate size
• C. Increased blood pressure
• D. Decreased blood pressure

Correct answer: A

Rationale: The correct answer is A: Decreased urinary frequency and urgency. Finasteride is used to reduce the size of the prostate gland in patients with BPH. As a result, when the medication is effective, the patient should experience a decrease in urinary frequency and urgency. Choices B, C, and D are incorrect. Choice B is inaccurate because finasteride aims to reduce prostate size, not increase it. Choices C and D are unrelated to the action of finasteride in treating BPH.

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