Nursing Elites

1. Which of the following wounds is most likely to heal by secondary intention?

• A. A finger laceration received while cutting onions
• B. A stage IV pressure ulcer that developed in a nursing home
• C. A needlestick injury received while administering parenteral medication
• D. An incision from an open appendectomy

Correct answer: B

Rationale: A stage IV pressure ulcer is a deep wound involving tissue loss that typically heals by secondary intention. This process involves the wound healing from the bottom up with granulation tissue and often results in significant scarring. Choice A, a finger laceration, would generally heal by primary intention due to its clean edges and minimal tissue loss. Choice C, a needlestick injury, is likely to be sutured and heal by primary intention since it is a small, clean wound. Choice D, an incision from an open appendectomy, is usually closed with sutures and heals by primary intention as well.

2. A patient develops itching and burning of the vaginal vault while taking an anti-infective to treat strep throat. What fungal agent has most likely caused the burning and itching?

• A. Cryptococcus neoformans
• B. Candida albicans
• C. Aspergillus
• D. Dermatophytes

Correct answer: B

Rationale: The correct answer is B: Candida albicans. Candida albicans is a common fungal agent responsible for causing vaginal yeast infections characterized by itching and burning. It is known to overgrow in the vagina, especially when the normal vaginal flora is disrupted, such as during antibiotic use. Cryptococcus neoformans is more associated with causing meningitis in immunocompromised individuals, not vaginal symptoms. Aspergillus is more commonly associated with lung infections and allergic reactions, not vaginal infections. Dermatophytes typically cause skin infections like ringworm, not vaginal symptoms.

3. What causes osteoporosis?

• A. Poor nutrition in infancy
• B. Regularly weight-bearing exercise
• C. Bone loss, frequently during aging
• D. Cerebral palsy and associated disorders

Correct answer: C

Rationale: The correct answer is C. Osteoporosis is commonly caused by bone loss that occurs with aging, leading to brittle bones. Choice A, poor nutrition in infancy, is not a direct cause of osteoporosis. Choice B, regularly weight-bearing exercise, actually helps in maintaining bone density and strength, reducing the risk of osteoporosis. Choice D, cerebral palsy and associated disorders, is not a common cause of osteoporosis.

4. What is the purpose of the inflammatory response?

• A. Prevents blood from entering the injured tissue
• B. Elevates body temperature to prevent spread of infection
• C. Prevents formation of abscess
• D. Minimizes injury and promotes healing

Correct answer: D

Rationale: The inflammatory response is a protective mechanism triggered by tissue damage or infection. It aims to minimize injury by removing harmful stimuli and initiating the healing process. Choice A is incorrect because blood flow to the injured tissue is actually increased to deliver immune cells and nutrients. Choice B is incorrect because while fever is a response to infection, it is not the primary purpose of the inflammatory response. Choice C is incorrect because abscess formation can occur as part of the inflammatory response in an attempt to contain an infection.

5. An oncology nurse is providing care for an adult patient who is currently immunocompromised. The nurse is aware of the physiology involved in hematopoiesis and immune function, including the salient role of cytokines. What is the primary role of cytokines in maintaining homeostasis?

• A. Cytokines perform phagocytosis in response to bacterial and protozoal infections.
• B. Cytokines perform a regulatory role in the development of diverse blood cells.
• C. Cytokines play a significant role in the formation of all blood cells.
• D. Cytokines are produced in response to the presence of antibodies.

Correct answer: B

Rationale: The primary role of cytokines in maintaining homeostasis is to perform a regulatory function in the development of diverse blood cells. Cytokines act as signaling molecules that regulate the immune response and hematopoiesis. Choice A is incorrect because cytokines do not perform phagocytosis; they regulate immune responses. Choice C is incorrect because while cytokines are involved in the formation of some blood cells, they are not considered the basic 'building blocks' of all blood cells. Choice D is incorrect because cytokines are not formed in response to antibodies, but rather play a role in the immune response to various stimuli.

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