Nursing Elites

1. Which term should the nurse use to document a situation in which cells increase in size and function?

• A. Atrophy
• B. Hypertrophy
• C. Metaplasia
• D. Hyperplasia

Correct answer: B

Rationale: Hypertrophy is the correct term used to describe the situation in which cells increase in size and function. Atrophy (Choice A) is the opposite, indicating a decrease in cell size. Metaplasia (Choice C) refers to the reversible replacement of one mature cell type by another. Hyperplasia (Choice D) involves an increase in the number of cells, not just an increase in size and function as in hypertrophy.

2. 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.

3. The nurse is planning care for a client with damage to the vestibular area of the vestibulocochlear nerve. What should the nurse include in the plan of care? Select all that apply.

• A. Assistance with ambulation
• B. Regular hearing tests
• C. Monitoring for nausea
• D. Vision assessments

Correct answer: A

Rationale: Damage to the vestibular area affects balance and may cause nausea. Therefore, the nurse should include assistance with ambulation in the care plan to help the client maintain stability while walking. Regular hearing tests (choice B) are not directly related to damage in the vestibular area of the vestibulocochlear nerve. While nausea (choice C) may occur due to vestibular damage, monitoring for it alone is not as essential as providing assistance with ambulation. Vision assessments (choice D) are important for assessing visual function but are not the priority when dealing with vestibular issues.

4. Which of the following mediators of inflammation causes increased capillary permeability and pain?

• A. Serotonin
• B. Histamine
• C. Bradykinin
• D. Nitric oxide

Correct answer: C

Rationale: Bradykinin is the correct answer. It is a potent mediator of inflammation that causes increased capillary permeability and is responsible for the pain associated with inflammation. Serotonin and histamine are also mediators of inflammation, but they are not primarily known for increasing capillary permeability or inducing pain. Nitric oxide is involved in various physiological processes but is not a primary mediator of inflammation that causes increased capillary permeability and pain.

5. A patient underwent an open cholecystectomy 4 days ago, and her incision is now in the proliferative phase of healing. The nurse knows that the next step in the process of wound healing is:

• A. Inflammation
• B. Maturation
• C. Remodeling
• D. Coagulation

Correct answer: C

Rationale: In the context of wound healing, after the proliferative phase comes the remodeling phase. During the remodeling phase, the wound gains strength as collagen fibers reorganize, and the scar matures. Inflammation is the initial phase of healing, where the body responds to injury with redness, swelling, and warmth. Maturation is the final stage where the scar tissue continues to undergo changes but is not the immediate next step after the proliferative phase. Coagulation is the process of blood clot formation and is not a phase in wound healing.

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