Nursing Elites

1. A 21-year-old male is brought to the ED following a night of partying in his fraternity. His friends found him 'asleep' and couldn't get him to respond. They cannot recall how many alcoholic beverages he drank the night before. While educating a student nurse and the man's friends, the nurse begins by explaining that alcohol is:

• A. A water-soluble compound that is easily absorbed by the gastric lining of the stomach.
• B. Very lipid-soluble and rapidly crosses the blood–brain barrier.
• C. Able to reverse the transport of some substances to remove them from the brain.
• D. Very likely to cause sedation and therefore the client just needs to sleep it off.

Correct answer: B

Rationale: The correct answer is B. Alcohol is very lipid-soluble and rapidly crosses the blood–brain barrier, leading to its effects on the central nervous system and causing symptoms like sedation and unconsciousness. Choice A is incorrect because alcohol is not water-soluble; it is lipid-soluble. Choice C is incorrect as alcohol does not reverse the transport of substances from the brain. Choice D is incorrect as sedation from alcohol is not a reason to just 'sleep it off' in cases of alcohol poisoning, which can be life-threatening and requires medical attention.

2. Women who have breast cancer due to a BRCA1 gene mutation are usually:

• A. positive for human epidermal growth factor receptor 1 and 2.
• B. negative for estrogen receptor.
• C. positive for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2.
• D. negative for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2.

Correct answer: D

Rationale: Women with breast cancer due to a BRCA1 gene mutation commonly have a triple-negative breast cancer subtype, which means they are negative for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 (HER2). This subtype tends to be more aggressive and harder to treat. Choice A is incorrect as they are typically negative for HER2. Choice B is incorrect because they are usually negative for estrogen receptor. Choice C is incorrect as they are usually negative for progesterone receptor and HER2.

3. Which of the following describes the etiology of a cerebrovascular accident (CVA)?

• A. A blow to the head from a hard object
• B. Lack of blood flow to part of the brain
• C. Excessive exercise, such as running
• D. A ruptured artery in the heart

Correct answer: B

Rationale: The correct answer is B. A cerebrovascular accident (CVA), or stroke, is often caused by a lack of blood flow to part of the brain. This leads to damage in the brain tissue due to the deprived oxygen and nutrients. Choices A, C, and D are incorrect. A blow to the head from a hard object can cause a traumatic brain injury but is not the etiology of a CVA. Excessive exercise like running does not typically lead to a stroke. A ruptured artery in the heart may result in a heart attack, not a cerebrovascular accident.

4. A patient's anemia is described as having erythrocytes that demonstrate anisocytosis. The nurse would recognize the erythrocytes as:

• A. Pale in color
• B. Present in various sizes
• C. Able to assume various shapes
• D. Live only a few days

Correct answer: B

Rationale: The correct answer is B: 'Present in various sizes.' Anisocytosis refers to erythrocytes that are present in various sizes, indicating an abnormality in the uniformity of red blood cell size. Choice A is incorrect because anisocytosis does not refer to the color of erythrocytes. Choice C is incorrect as anisocytosis does not involve the shape of erythrocytes. Choice D is incorrect as anisocytosis does not determine the lifespan of erythrocytes.

5. 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.

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