Nursing Elites

1. Which of the following describes the pathophysiology of exercise-induced asthma?

• A. Bronchospasm after exercise
• B. IgE-mediated inflammatory response to antigen
• C. Bronchoconstriction after ingesting high-allergen foods
• D. Increased mucus production due to a genetic mutation

Correct answer: A

Rationale: The correct answer is A: 'Bronchospasm after exercise.' Exercise-induced asthma involves the narrowing of the airways (bronchospasm) triggered by physical activity. This bronchospasm leads to symptoms such as coughing, wheezing, and shortness of breath. Choices B, C, and D are incorrect because exercise-induced asthma is not primarily caused by an IgE-mediated inflammatory response to an antigen, bronchoconstriction after ingesting high-allergen foods, or increased mucus production due to a genetic mutation.

2. Stress-induced cortisol hormone secretion is associated with:

• A. Increased growth hormone level
• B. Regulation of the stress response
• C. Increased thyroid-stimulating hormone
• D. Depressed adrenal gland function

Correct answer: B

Rationale: The correct answer is B: Regulation of the stress response. Cortisol plays a crucial role in regulating the body's response to stress by modulating various physiological processes. Choices A, C, and D are incorrect because stress-induced cortisol hormone secretion is not directly associated with increased growth hormone levels, increased thyroid-stimulating hormone, or depressed adrenal gland function.

3. Which of the following types of vitamin or mineral deficiency can cause megaloblastic anemia and is associated with lower extremity paresthesias?

• A. Vitamin B12
• B. Folate
• C. Iron
• D. Vitamin K

Correct answer: A

Rationale: The correct answer is Vitamin B12. Vitamin B12 deficiency can lead to megaloblastic anemia, a condition characterized by the production of abnormally large and immature red blood cells. Lower extremity paresthesias, such as tingling or numbness, are common neurological symptoms associated with vitamin B12 deficiency. Folate deficiency can also cause megaloblastic anemia but is not typically linked to lower extremity paresthesias. Iron deficiency leads to microcytic anemia, not megaloblastic anemia. Vitamin K deficiency is associated with bleeding tendencies, not megaloblastic anemia or paresthesias.

4. A 25-year-old woman who works as an air traffic controller presents with facial pain and severe headache. She reports that she sometimes feels the pain in her neck or ear and that it is particularly bad during very busy times at the airport. What is the most likely diagnosis?

• A. Migraine headache
• B. Cluster headache
• C. Temporomandibular joint syndrome
• D. Sinus headache

Correct answer: C

Rationale: The most likely diagnosis for the 25-year-old woman who works as an air traffic controller and presents with facial pain and severe headache that sometimes radiates to her neck or ear, aggravated by stress, is Temporomandibular joint syndrome. This syndrome involves pain in the jaw joint and the muscles controlling jaw movement, which can radiate to the surrounding areas like the neck and ear. Stress and clenching of the jaw commonly exacerbate the symptoms. Migraine headache (choice A) typically presents with other symptoms like nausea, sensitivity to light or sound, and can be triggered by various factors, not just stress. Cluster headache (choice B) is characterized by severe, unilateral pain around the eye with associated autonomic symptoms. Sinus headache (choice D) is usually associated with sinus congestion or infection, presenting with facial pressure or pain, often worsened by bending forward.

5. A client with a history of smoking presents with a chronic cough and shortness of breath. The nurse should suspect which condition?

• A. Pulmonary fibrosis
• B. Chronic obstructive pulmonary disease (COPD)
• C. Lung cancer
• D. Pulmonary edema

Correct answer: B

Rationale: The correct answer is B: Chronic obstructive pulmonary disease (COPD). COPD is often associated with a chronic cough and shortness of breath, especially in individuals with a history of smoking. Pulmonary fibrosis (choice A) typically presents with progressive dyspnea and dry cough. Lung cancer (choice C) may present with a chronic cough, shortness of breath, and other symptoms like weight loss and hemoptysis. Pulmonary edema (choice D) presents with symptoms such as acute shortness of breath, orthopnea, and pink, frothy sputum.

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