Nursing Elites

1. Which of the following chronic inflammatory skin diseases is characterized by angiogenesis, immune cell activation (particularly T cells), and keratinocyte proliferation?

• A. Psoriasis
• B. Melanoma
• C. Atopic dermatitis
• D. Urticaria

Correct answer: A

Rationale: Psoriasis is the correct answer because it is a chronic inflammatory skin condition characterized by features such as angiogenesis (formation of new blood vessels), immune cell activation (especially T cells), and excessive keratinocyte proliferation. This results in the typical symptoms seen in psoriasis, such as red, scaly patches on the skin. Melanoma is a type of skin cancer arising from melanocytes, not characterized by the features mentioned. Atopic dermatitis is a different skin condition involving eczematous changes, not specifically associated with the described characteristics of psoriasis. Urticaria is a skin condition characterized by hives and does not involve the same pathophysiological processes as psoriasis.

2. What important instruction should the nurse provide regarding the application of testosterone gel in a patient with hypogonadism?

• A. Apply the gel to the chest or upper arms and allow it to dry completely before dressing.
• B. Apply the gel to the face and neck for maximum absorption.
• C. Apply the gel to the genitals for improved results.
• D. Apply the gel to the scalp and back for better results.

Correct answer: A

Rationale: The correct instruction for applying testosterone gel in a patient with hypogonadism is to apply it to the chest or upper arms and allow it to dry completely before dressing. This method helps avoid transfer to others. Applying the gel to the face, neck, or genitals is not recommended as it can lead to unintended exposure to others. Additionally, applying the gel to the scalp and back is not a standard or effective route of administration for testosterone gel. Therefore, choice A is the correct answer as it ensures proper application and safety.

3. A patient is starting on alendronate (Fosamax) for osteoporosis. What instructions should the nurse provide to ensure the effectiveness of the medication?

• A. Take the medication with a full glass of water and remain upright for at least 30 minutes.
• B. Take the medication at bedtime to ensure absorption during sleep.
• C. Take the medication with milk to enhance calcium absorption.
• D. Take the medication with food to prevent gastrointestinal upset.

Correct answer: A

Rationale: The correct answer is to take alendronate with a full glass of water and remain upright for at least 30 minutes. This is essential to prevent esophageal irritation and ensure proper absorption. Choice B is incorrect because taking alendronate at bedtime can increase the risk of esophageal irritation due to lying down. Choice C is incorrect as taking alendronate with milk can reduce its absorption. Choice D is incorrect because alendronate should be taken on an empty stomach to enhance its effectiveness.

4. A public health nurse is responsible for the administration of numerous immunizations. Which of the following guidelines regarding anaphylaxis should the nurse adhere to?

• A. The patient should be observed for anaphylaxis for 1 minute after administration.
• B. The patient should be observed for anaphylaxis for 5 minutes after administration.
• C. The patient should be observed for anaphylaxis for 30 minutes after administration.
• D. The patient should be observed for anaphylaxis for 90 minutes after administration.

Correct answer: C

Rationale: The correct answer is C: 'The patient should be observed for anaphylaxis for 30 minutes after administration.' This is because anaphylaxis can occur within minutes of administration of an immunization. By observing the patient for 30 minutes, the nurse can promptly identify and manage any signs of anaphylaxis. Choices A, B, and D are incorrect as they suggest shorter or longer observation periods, which may not be sufficient to detect and respond to anaphylaxis in a timely manner.

5. What causes atherosclerotic plaques to form in the body?

• A. Poor dietary habits
• B. Administration of statin medication
• C. Interruption of blood flow to the brain
• D. Injury to the endothelium of the coronary arteries

Correct answer: D

Rationale: Atherosclerotic plaques form in the body due to injury to the endothelium of the coronary arteries. When the endothelium is damaged, it triggers an inflammatory response that leads to the accumulation of fats, cholesterol, and other substances, forming plaques. These plaques can narrow the arteries, reducing blood flow and potentially leading to serious complications like heart attacks or strokes. Poor dietary habits (choice A) can contribute to the development of atherosclerosis by promoting the buildup of plaque-forming substances in the blood, but the direct cause is the injury to the endothelium. Administration of statin medication (choice B) is actually a treatment for high cholesterol and aims to reduce the risk of plaque formation. Interruption of blood flow to the brain (choice C) is more related to conditions like ischemic stroke rather than the primary cause of atherosclerotic plaque formation.

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