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 is found to have liver disease, resulting in the removal of a lobe of his liver. Adaptation to the reduced size of the liver leads to ___________ of the remaining liver cells.

• A. Metaplasia
• B. Organ atrophy
• C. Compensatory hyperplasia
• D. Physiologic hyperplasia

Correct answer: C

Rationale: Compensatory hyperplasia is the process by which the remaining cells increase in number to adapt to the reduced size of the liver. In this case, after the removal of a lobe of the liver, the remaining cells undergo compensatory hyperplasia to compensate for the lost tissue. Metaplasia refers to the reversible change of one cell type to another, not an increase in cell number. Organ atrophy is the decrease in organ size due to cell shrinkage or loss, which is opposite to an increase in cell number seen in compensatory hyperplasia. Physiologic hyperplasia is the increase in cell number in response to a normal physiological demand, not specifically due to the removal of a portion of the organ.

3. While planning care for an elderly patient, the nurse remembers that increased age is associated with:

• A. Increased T cell function
• B. Increased immune function
• C. Increased production of antibodies
• D. Increased levels of circulating autoantibodies

Correct answer: D

Rationale: As individuals age, their immune function tends to decrease, making them more susceptible to infections and diseases. Additionally, increased age is associated with higher levels of circulating autoantibodies, which can lead to autoimmune conditions. Choice A is incorrect as aging is not typically associated with increased T cell function. Choice C is also incorrect as aging does not necessarily result in increased production of antibodies. Therefore, the correct answers are B (Decreased immune function) and D (Increased levels of circulating autoantibodies).

4. A 23-year-old pregnant female visits her primary care provider for her final prenatal checkup. The primary care provider determines that the fetus has developed an infection in utero. Which of the following would be increased in the fetus at birth?

• A. IgG
• B. IgA
• C. IgM
• D. IgD

Correct answer: C

Rationale: The correct answer is IgM. IgM is the first antibody produced in response to an infection and is elevated in a fetus with an in utero infection. IgG is the primary antibody responsible for providing immunity to the fetus and is transferred across the placenta during the third trimester. IgA is mainly found in mucosal areas and colostrum but not significantly elevated in fetal infections. IgD is involved in the development and maturation of B cells but not typically increased in fetal infections.

5. Which of the following patients are at higher risk for developing oral cancer?

• A. A female who has taken oral contraceptives for the last 4 years
• B. Both an adult male with a history of alcoholism and a middle-aged male who smokes a pipe
• C. An adult female who eats spicy foods regularly
• D. An older adult female who chews gum frequently

Correct answer: B

Rationale: The correct answer is 'Both an adult male with a history of alcoholism and a middle-aged male who smokes a pipe.' Alcohol consumption and tobacco use, such as smoking a pipe, are well-known risk factors for developing oral cancer. These two factors significantly increase the likelihood of developing oral cancer compared to the other choices. Taking oral contraceptives, eating spicy foods regularly, and chewing gum frequently are not established risk factors for oral cancer, making them less likely to lead to the development of this type of cancer.

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