Nursing Elites

1. When educating a client about to undergo a pacemaker insertion, the nurse explains the normal phases of cardiac muscle tissue. During the repolarization phase, the nurse will stress that membranes must be repolarized before they can be re-excited. Within the cell, the nurse understands that:

• A. Potassium channels open while sodium channels close, causing repolarization to the resting state.
• B. The influx of calcium is the primary stimulus for the repolarization of cardiac tissue.
• C. Only the electrical activity within the heart will determine when repolarization occurs.
• D. The cell membranes need to stay calm, resulting in muscle tissue becoming refractory.

Correct answer: A

Rationale: During the repolarization phase of cardiac muscle tissue, potassium channels open while sodium channels close. This process is crucial for the cardiac muscle to return to its resting state after depolarization. Potassium moving out of the cell and sodium staying out helps reset the membrane potential and prepare the cell for the next depolarization phase. The influx of calcium is not the primary stimulus for repolarization in cardiac tissue; it is mainly involved in the depolarization phase. While electrical activity within the heart influences repolarization, the specific ion movements described in choice A are what physiologically drive repolarization. Cell membranes need to be in an active state during repolarization, not calm, to facilitate the necessary ion movements for muscle tissue to properly function.

2. A nurse is teaching a class about immune deficiencies, and a person from the audience asks which cells are affected by severe combined immune deficiency (SCID) syndrome, and the nurse answers:

• A. B cell deficits
• B. T cell deficits
• C. Complement deficits
• D. B and T cell deficits

Correct answer: D

Rationale: The correct answer is D: B and T cell deficits. Severe combined immune deficiency (SCID) syndrome affects both B and T cells, leading to a severe impairment in the immune system's ability to fight infections. Choice A (B cell deficits) is incorrect because SCID affects not only B cells but also T cells. Choice B (T cell deficits) is incorrect as SCID is characterized by deficits in both B and T cells. Choice C (Complement deficits) is incorrect as SCID primarily involves B and T cell deficiencies rather than complement deficiencies.

3. The registered nurse is teaching a class on inflammation and explains that which cell is the predominant phagocyte arriving early at inflammatory and infection sites?

• A. Macrophages
• B. Mast cells
• C. Monocytes
• D. Neutrophils

Correct answer: D

Rationale: Neutrophils are the correct answer as they are the predominant phagocytes arriving early at inflammatory and infection sites. Neutrophils are part of the body's innate immune system and are among the first responders to sites of inflammation or infection. They play a crucial role in engulfing and destroying pathogens. Macrophages, although important phagocytes, usually arrive later at the site. Mast cells are involved in allergic reactions and not primarily phagocytes. Monocytes are precursors to macrophages and are not the predominant phagocytes arriving early at inflammatory sites.

4. A woman with severe visual and auditory deficits is able to identify individuals by running her fingers lightly over her face. Which source is most likely to provide the input that allows for the woman's unique ability?

• A. Special somatic afferent fibers
• B. General somatic afferents
• C. Special visceral afferent cells
• D. General visceral afferent neurons

Correct answer: C

Rationale: The correct answer is C, special visceral afferent cells. These cells are responsible for functions like taste and smell. In individuals with severe visual and auditory deficits, their other sensory abilities, such as touch, can be heightened. Special somatic afferent fibers (choice A) are involved in sensations like touch and vibration from the skin and muscles, but they are not specific to the face. General somatic afferents (choice B) transmit sensory information from the skin, muscles, and joints, but they are not specialized for the unique ability described. General visceral afferent neurons (choice D) are responsible for transmitting sensory information from internal organs, not relevant to the woman's ability to identify individuals through touch on her face.

5. During childhood, the thymus decreases in size, and this is referred to as ______ atrophy.

• A. Physiologic
• B. Pathologic
• C. Disuse
• D. Neurogenic

Correct answer: A

Rationale: The correct answer is A, 'Physiologic.' Physiologic atrophy is a normal part of development, like the reduction in thymus size during childhood. Pathologic atrophy (choice B) refers to tissue wasting due to disease, not a normal process like the reduction in thymus size. Disuse atrophy (choice C) results from a lack of physical activity or stimulation, which is not the case with thymus size reduction. Neurogenic atrophy (choice D) is caused by damage to or diseases of the nerves supplying the muscles, not related to the thymus size reduction seen in childhood.

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