Nursing Elites

1. Which of the following hormones do the kidneys secrete to increase red blood cell production?

• A. Erythropoietin
• B. Insulin and glycogen
• C. Testosterone
• D. Thyroid stimulating hormone

Correct answer: A

Rationale: The correct answer is A: Erythropoietin. The kidneys produce erythropoietin to stimulate the production of red blood cells. Insulin and glycogen are not hormones secreted by the kidneys; insulin is produced by the pancreas, and glycogen is a stored form of glucose. Testosterone is a hormone primarily produced by the testes in males and to a lesser extent in females. Thyroid stimulating hormone is produced by the pituitary gland to regulate thyroid function, not red blood cell production.

2. What important information should the nurse provide about the risks associated with tamoxifen (Nolvadex) for a patient with a history of breast cancer?

• A. Tamoxifen may increase the risk of venous thromboembolism.
• B. Tamoxifen may decrease the risk of osteoporosis.
• C. Tamoxifen may cause hot flashes and other menopausal symptoms.
• D. Tamoxifen may cause weight gain and fluid retention.

Correct answer: A

Rationale: The correct answer is A: Tamoxifen may increase the risk of venous thromboembolism. Patients on tamoxifen should be educated about the signs and symptoms of blood clots. Choices B, C, and D are incorrect. Tamoxifen does not decrease the risk of osteoporosis; it may cause hot flashes and other menopausal symptoms, and it may cause weight gain and fluid retention.

3. Canola oil produced from genetically modified canola plants altered to be herbicide-resistant is an example of a:

• A. pesticide-free food.
• B. saturated fat food.
• C. genetically modified food.
• D. product that is pure.

Correct answer: C

Rationale: The correct answer is 'genetically modified food.' Canola oil derived from genetically modified canola plants falls into this category because the plant's genome has been altered to exhibit herbicide resistance. This genetic modification makes it a genetically modified food. Choice A, 'pesticide-free food,' is incorrect as the genetic modification is to resist herbicides, not pesticides. Choice B, 'saturated fat food,' is incorrect as it does not accurately describe the genetic modification of the canola plants. Choice D, 'product that is pure,' is too vague and does not address the genetic modification aspect of the canola plants.

4. Which of the following are normal arterial blood gas values?

• A. PH 7.25, PaCO2 52 mm Hg, PaO2 75 mm Hg, HCO3 18 mEq/L
• B. PH 7.50, PaCO2 30 mm Hg, PaO2 80 mm Hg, HCO3 28 mEq/L
• C. PH 7.40, PaCO2 40 mm Hg, PaO2 90 mm Hg, HCO3 24 mEq/L
• D. PH 7.15, PaCO2 30 mm Hg, PaO2 50 mm Hg, HCO3 24 mEq/L

Correct answer: C

Rationale: The correct answer is C: PH 7.40, PaCO2 40 mm Hg, PaO2 90 mm Hg, HCO3 24 mEq/L. These values represent a balanced state for arterial blood gas. Choice A has lower than normal PH and HCO3 levels and higher PaCO2 and lower PaO2 levels. Choice B has higher than normal PH and HCO3 levels, lower PaCO2, and a normal PaO2 level. Choice D has a significantly lower PH and PaO2 level, normal HCO3 level, and low PaCO2 level, indicating an acidic state with impaired oxygenation.

5. A patient has a heart attack that leads to progressive cell injury resulting in cell death with severe cell swelling and breakdown of organelles. What term would the nurse use to define this process?

• A. Adaptation
• B. Pathologic calcification
• C. Apoptosis
• D. Necrosis

Correct answer: D

Rationale: The correct answer is D: Necrosis. Necrosis is the process of cell death characterized by cell swelling, breakdown of organelles, and eventual rupture, often following ischemic injury like a heart attack. Choices A, B, and C are incorrect. Adaptation refers to the ability of cells to adjust to changes in their environment. Pathologic calcification is the abnormal deposition of calcium salts in tissues. Apoptosis is a programmed cell death that occurs in a controlled, orderly manner.

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