Nursing Elites

1. A 20-year-old college student has presented to her campus medical clinic for a scheduled Pap smear. The clinician who will interpret the smear will examine cell samples for evidence of:

• A. Changes in cell shape, size, and organization
• B. Presence of unexpected cell types
• C. Ischemic changes in cell sample
• D. Abnormally high numbers of cells

Correct answer: A

Rationale: The correct answer is changes in cell shape, size, and organization (Choice A). Pap smears are performed to detect potential precancerous or cancerous conditions by examining the cells for any abnormalities in their shape, size, or organization. This helps in identifying early signs of cervical cancer. Choices B, C, and D are incorrect because Pap smears primarily focus on detecting cellular changes associated with cancer, not unexpected cell types, ischemic changes, or abnormally high numbers of cells.

2. A patient taking oral contraceptives reports breakthrough bleeding. What should the nurse assess in this patient?

• A. Adherence to the medication schedule
• B. The possibility of pregnancy
• C. The need for an increased dosage
• D. The effectiveness of the current oral contraceptive

Correct answer: A

Rationale: When a patient on oral contraceptives experiences breakthrough bleeding, the nurse should assess the patient's adherence to the medication schedule. Breakthrough bleeding can be a sign of missed doses or inconsistent timing, which can decrease the effectiveness of oral contraceptives. Assessing the patient's adherence helps in ensuring proper use of the medication. Choices B, C, and D are incorrect because breakthrough bleeding is more likely related to adherence issues rather than pregnancy, the need for increased dosage, or the effectiveness of the current oral contraceptive.

3. Which of the following findings is commonly associated with congestive heart failure?

• A. Decreased jugular venous pressure
• B. Pulmonary edema
• C. Hyperactive bowel sounds
• D. Weight loss

Correct answer: B

Rationale: Pulmonary edema is a common finding in congestive heart failure. In congestive heart failure, the heart is unable to pump effectively, leading to fluid buildup in the lungs, causing pulmonary edema. This results in symptoms like shortness of breath, coughing, and wheezing. Choices A, C, and D are not typically associated with congestive heart failure. Jugular venous pressure is often elevated, not decreased in heart failure. Hyperactive bowel sounds and weight loss are not specific findings for congestive heart failure.

4. When the body produces antibodies against its own tissue, the condition is called:

• A. Alloimmunity
• B. Opsonization
• C. Autoimmunity
• D. Hypersensitivity

Correct answer: C

Rationale: Autoimmunity is the correct term for a condition where the body's immune system mistakenly targets its own tissues. Alloimmunity (Choice A) refers to an immune response against foreign tissue. Opsonization (Choice B) is a process where pathogens are marked for destruction by immune cells. Hypersensitivity (Choice D) involves an exaggerated immune response against antigens.

5. 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.

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