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. A hospital client is at a high risk of developing bacterial endocarditis. Which of the following prophylactic measures is likely to be most effective?

• A. Avoiding exposure to individuals known to carry the streptococcus bacterium
• B. Daily administration of low-dose corticosteroids
• C. Prophylactic antimicrobial therapy before any invasive procedure
• D. Routine vaccinations against meningococcal and pneumococcal infections

Correct answer: C

Rationale: Prophylactic antimicrobial therapy before any invasive procedure is the most effective measure in preventing bacterial endocarditis in at-risk individuals. This measure helps to reduce the risk of bacterial infection during invasive procedures, which can lead to endocarditis. Choice A is incorrect as avoiding exposure to individuals with streptococcus does not address the primary preventive measure needed. Choice B is incorrect as corticosteroids do not prevent bacterial endocarditis, and daily administration is not the recommended prophylactic measure. Choice D is incorrect as routine vaccinations against meningococcal and pneumococcal infections are important for other conditions but not specifically for preventing bacterial endocarditis.

3. An infant is being administered an immunization. Which of the following provides an accurate description of an immunization?

• A. It should be administered to a pregnant woman prior to the infant's birth.
• B. It is the administration of an antigen to stimulate an antibody response.
• C. It produces many adverse reactions, particularly autism, in the infant.
• D. It protects the infant from exposure to infectious antibodies.

Correct answer: B

Rationale: The correct answer is B. Immunization involves administering an antigen, such as a weakened or killed microorganism, to stimulate the immune system to produce an antibody response. This process helps the body recognize and remember specific pathogens, providing immunity against future infections. Choice A is incorrect because immunizations are administered to the infant directly, not to the pregnant woman before birth. Choice C is incorrect as there is no scientific evidence linking immunizations to autism. Choice D is incorrect as immunizations protect against infectious agents, not antibodies.

4. A patient is prescribed sildenafil (Viagra) for erectile dysfunction. What condition would contraindicate the use of this medication?

• A. History of peptic ulcer disease
• B. Use of nitrates
• C. Use of antihypertensive medications
• D. History of hypertension

Correct answer: B

Rationale: The correct answer is B: Use of nitrates. Sildenafil (Viagra) is contraindicated in patients taking nitrates due to the risk of severe hypotension. Nitrates combined with sildenafil can lead to a dangerous drop in blood pressure. Choices A, C, and D are incorrect because a history of peptic ulcer disease, use of antihypertensive medications, or a history of hypertension are not direct contraindications for sildenafil use.

5. A female client with bone metastases secondary to lung cancer is admitted for palliative radiation treatment and pain control. The client is currently experiencing pain that she rates at 9 out of 10. Which of the following nonpharmacologic treatments is most likely to be a useful and appropriate supplement to pharmacologic analgesia at this point?

• A. Teaching the client guided imagery and meditation
• B. Initiating neurostimulation
• C. Heat therapy
• D. Relaxation and distraction

Correct answer: D

Rationale: In the scenario described, the client is experiencing high pain levels, rated at 9 out of 10. Relaxation and distraction techniques are effective nonpharmacologic interventions for managing pain. Teaching the client guided imagery and meditation (Choice A) can also be beneficial; however, in this acute situation of severe pain, relaxation and distraction techniques are more likely to provide immediate relief. Initiating neurostimulation (Choice B) and heat therapy (Choice C) may not be suitable for immediate pain relief in this scenario and are not as commonly used for managing high pain levels in palliative care settings.

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