Nursing Elites

1. In which of the following cases is dehydration more likely to occur?

• A. A 50-year-old woman who is a bodybuilder
• B. A 50-year-old man who is morbidly obese
• C. A 10-year-old child who is thin
• D. A 30-year-old with multiple sclerosis

Correct answer: B

Rationale: Dehydration is more likely to occur in a 50-year-old man who is morbidly obese due to the increased risk of conditions like diabetes and heart disease that can lead to fluid imbalances. Being morbidly obese can also strain the body's systems, increasing the need for water. The other choices are less likely to experience dehydration as a primary concern. While being a bodybuilder may require strict hydration practices, dehydration is more prevalent in individuals with conditions like obesity.

2. DiGeorge syndrome is a primary immune deficiency caused by:

• A. Failure of B cells to mature
• B. Congenital lack of thymic tissue
• C. Failure of formed elements of blood to develop
• D. Selective IgG deficiency

Correct answer: B

Rationale: DiGeorge syndrome is caused by a congenital lack of thymic tissue, which plays a crucial role in T cell development and maturation, leading to immune deficiency. Choice A is incorrect because DiGeorge syndrome primarily affects T cells, not B cells. Choice C is incorrect as it is too broad and not specific to the thymus. Choice D is incorrect as selective IgG deficiency is a different condition unrelated to DiGeorge syndrome.

3. Which of the following disorders is more likely associated with blood in stool?

• A. Gastroesophageal reflux
• B. Crohn's disease
• C. Irritable bowel syndrome
• D. Colon cancer

Correct answer: D

Rationale: Colon cancer is more likely associated with blood in stool due to the presence of bleeding from the tumor in the colon. Gastroesophageal reflux (Choice A) typically presents with heartburn and regurgitation but not blood in stool. Crohn's disease (Choice B) can cause gastrointestinal symptoms, but bloody stools are more commonly associated with ulcerative colitis. Irritable bowel syndrome (Choice C) is characterized by abdominal pain, bloating, and changes in bowel habits, but it does not typically cause blood in stool. Therefore, the correct answer is D, Colon cancer.

4. A client with a history of chronic alcoholism presents to the emergency department with a complaint of double vision. Which cranial nerve is most likely involved?

• A. Cranial nerve I (Olfactory)
• B. Cranial nerve III (Oculomotor)
• C. Cranial nerve VI (Abducens)
• D. Cranial nerve VII (Facial)

Correct answer: C

Rationale: The correct answer is Cranial nerve VI (Abducens). Chronic alcoholism can lead to damage to the abducens nerve, which controls the lateral movement of the eye. This damage can result in symptoms like double vision. Cranial nerve I (Olfactory) is responsible for the sense of smell and is not related to eye movement. Cranial nerve III (Oculomotor) controls most of the eye movements but is less likely to be affected in chronic alcoholism than the abducens nerve. Cranial nerve VII (Facial) is responsible for facial movements and is not associated with double vision.

5. A patient has been prescribed mifepristone (RU-486) to terminate a pregnancy. How does this drug achieve its therapeutic effect?

• A. By inhibiting the action of progesterone, which is necessary to maintain pregnancy.
• B. By increasing estrogen levels, which induce uterine contractions.
• C. By altering the uterine lining, preventing implantation.
• D. By stimulating uterine contractions, which expel the embryo.

Correct answer: A

Rationale: Mifepristone (RU-486) functions by inhibiting the action of progesterone, a hormone crucial for maintaining pregnancy. By blocking progesterone, mifepristone disrupts the uterine environment necessary for pregnancy continuation, ultimately leading to termination. Choice B is incorrect because mifepristone does not increase estrogen levels; instead, it acts on progesterone. Choice C is incorrect as mifepristone's mechanism does not involve altering the uterine lining to prevent implantation. Choice D is incorrect because mifepristone does not directly stimulate uterine contractions; its primary action is through progesterone inhibition.

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