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 has been diagnosed with a fungal infection and is to be treated with itraconazole (Sporanox). Prior to administration, the nurse notes that the patient is taking carbamazepine (Tegretol) for a seizure disorder. Based on this medication regime, which of the following will be true regarding the medications?

• A. The serum level of carbamazepine will be increased.
• B. The patient's carbamazepine should be discontinued.
• C. The patient's antiseizure medication should be changed.
• D. The patient will require a higher dosage of itraconazole (Sporanox).

Correct answer: A

Rationale: When itraconazole is administered with carbamazepine, itraconazole may increase the serum levels of carbamazepine, potentially leading to toxicity. Therefore, choice A is correct. Discontinuing carbamazepine (choice B) or changing the antiseizure medication (choice C) is not necessary unless advised by a healthcare provider. Choice D, requiring a higher dosage of itraconazole, is not accurate in this scenario.

3. A 52-year-old has made an appointment with his primary care provider and has reluctantly admitted that his primary health concern is erectile dysfunction (ED). He describes the problem as increasing in severity and consequent distress. Which of the nurse's assessment questions is most likely to address a common cause of ED?

• A. “How would you describe your overall health status?”
• B. “Are you taking any medications for high blood pressure?”
• C. “How has this issue been impacting your relationship?”
• D. “Have you experienced any recent injuries?”

Correct answer: B

Rationale: In the context of erectile dysfunction (ED), medication use is a crucial factor to consider. Many medications, including those used for high blood pressure, can contribute to ED as a side effect. Asking about medication use, particularly for conditions like high blood pressure, can help identify a common cause of ED. Choices A, C, and D do not directly address potential causes related to medication use, making them less likely to reveal a common underlying issue for ED in this case.

4. The nurse knows which phenomenon listed below is an accurate statement about axonal transport?

• A. Anterograde and retrograde axonal transport allow for the communication of nerve impulses between a neuron and the central nervous system (CNS).
• B. Materials can be transported to the nerve terminal by either fast or slow components.
• C. The unidirectional nature of the axonal transport system protects the CNS against potential pathogens.
• D. Axonal transport facilitates the movement of electrical impulses but precludes the transport of molecular materials.

Correct answer: B

Rationale: The correct answer is B. Axonal transport involves the movement of materials to the nerve terminal by either fast or slow components, which is essential for cell survival. Choice A is incorrect because while anterograde and retrograde axonal transport are involved in the movement of materials, they do not specifically relate to the communication of nerve impulses between a neuron and the CNS. Choice C is incorrect because the unidirectional nature of axonal transport does not primarily function to protect the CNS against pathogens. Choice D is incorrect as axonal transport is responsible for the movement of various materials, not just electrical impulses.

5. A nurse is teaching a class about immune deficiencies, and a person from the audience asks which cells are affected by severe combined immune deficiency (SCID) syndrome, and the nurse answers:

• A. B cell deficits
• B. T cell deficits
• C. Complement deficits
• D. B and T cell deficits

Correct answer: D

Rationale: The correct answer is D: B and T cell deficits. Severe combined immune deficiency (SCID) syndrome affects both B and T cells, leading to a severe impairment in the immune system's ability to fight infections. Choice A (B cell deficits) is incorrect because SCID affects not only B cells but also T cells. Choice B (T cell deficits) is incorrect as SCID is characterized by deficits in both B and T cells. Choice C (Complement deficits) is incorrect as SCID primarily involves B and T cell deficiencies rather than complement deficiencies.

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