Nursing Elites

1. Which of the following are manifestations of Cushing syndrome?

• A. Truncal obesity with thin extremities.
• B. Enlargement of face, hands, and feet.
• C. Cachexia.
• D. Thick scalp hair.

Correct answer: A

Rationale: Truncal obesity with thin extremities is a classic manifestation of Cushing syndrome due to the redistribution of fat. Enlargement of face, hands, and feet is seen in conditions like acromegaly, not Cushing syndrome. Cachexia is a state of severe weight loss and muscle wasting, typically seen in conditions like cancer or advanced infections. Thick scalp hair is not typically associated with Cushing syndrome.

2. When educating a patient starting on oral contraceptives, what should the nurse include regarding the medication's effectiveness?

• A. Oral contraceptives are 100% effective when taken correctly.
• B. Oral contraceptives are effective immediately after starting.
• C. Oral contraceptives are less effective if taken with certain antibiotics.
• D. Oral contraceptives are less effective if taken with food.

Correct answer: C

Rationale: The correct answer is C. Oral contraceptives can be less effective when taken with certain antibiotics due to potential drug interactions. It is crucial for patients to be informed about this to consider additional contraceptive methods during antibiotic therapy. Choice A is incorrect because while oral contraceptives are highly effective, they are not 100% foolproof. Choice B is incorrect as it may give the impression that immediate protection is conferred, which is not the case. Choice D is incorrect as taking oral contraceptives with food does not significantly impact their effectiveness.

3. A 10-year-old male is stung by a bee while playing in the yard. He experiences a severe allergic reaction and has to go to the ER. The nurse providing care realizes this reaction is the result of:

• A. Toxoids
• B. IgA
• C. IgE
• D. IgM

Correct answer: C

Rationale: The correct answer is C: IgE. A severe allergic reaction, such as the one experienced by the 10-year-old male after being stung by a bee, is mediated by IgE. IgE is involved in common allergic responses, triggering the release of histamine and other chemicals that lead to allergy symptoms. Choice A, Toxoids, are inactivated toxins used in vaccines. Choice B, IgA, is mainly found in mucosal areas and secretions, playing a role in mucosal immunity. Choice D, IgM, is the first antibody produced in response to an infection.

4. When administering an immunization, which of the following medications should be available?

• A. Diphenhydramine (Benadryl)
• B. Hydroxyzine (Vistaril)
• C. Physostigmine
• D. Epinephrine

Correct answer: D

Rationale: When administering an immunization, it is essential to have epinephrine available in case of an allergic reaction such as anaphylaxis. Epinephrine is the medication of choice for treating severe allergic reactions due to its ability to reverse the symptoms rapidly. Diphenhydramine and hydroxyzine are antihistamines that can help manage mild allergic reactions but are not the primary medications for severe reactions like anaphylaxis. Physostigmine is not indicated for managing allergic reactions and is used for specific conditions such as anticholinergic toxicity.

5. In which disorder does a Staphylococcus aureus organism produce a toxin leading to exfoliation and large blister formation?

• A. Herpes simplex I virus
• B. Herpes simplex II virus
• C. Necrotizing fasciitis
• D. Cellulitis

Correct answer: B

Rationale: The correct answer is 'Herpes simplex I virus.' This disorder is known as Staphylococcal scalded skin syndrome (SSSS), where a Staphylococcus aureus organism produces an exfoliative toxin leading to skin exfoliation and large blister formation. Choices B, C, and D are incorrect. Herpes simplex viruses (I and II) cause different types of skin lesions and do not lead to exfoliation and blister formation. Necrotizing fasciitis is a severe soft tissue infection, while cellulitis is a bacterial skin infection that does not typically involve exfoliation and blister formation like in SSSS.

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