Nursing Elites

1. What is the etiology and most likely treatment for myasthenia gravis in a 22-year-old female college student?

• A. Autoimmune destruction of skeletal muscle cells; treatment with intensive physical therapy and anabolic steroids.
• B. A decline in functioning acetylcholine receptors; treatment with corticosteroids and intravenous immunoglobulins.
• C. Cerebellar lesions; surgical and immunosuppressive treatment.
• D. Excess acetylcholinesterase production; treatment with thymectomy.

Correct answer: B

Rationale: Myasthenia gravis is characterized by a decline in functioning acetylcholine receptors rather than autoimmune destruction of skeletal muscle cells (Choice A), cerebellar lesions (Choice C), or excess acetylcholinesterase production (Choice D). The most likely treatment for myasthenia gravis involves corticosteroids to reduce inflammation and intravenous immunoglobulins to block the antibodies attacking acetylcholine receptors. Intensive physical therapy and anabolic steroids are not primary treatments for myasthenia gravis.

2. After ingestion of cysts, how long does it take for the symptoms of giardiasis to develop?

• A. 12 to 24 hours
• B. 3 to 5 days
• C. 1 to 2 weeks
• D. 2 to 3 months

Correct answer: B

Rationale: Giardiasis symptoms typically develop 3 to 5 days after ingestion of the cysts. This timeframe aligns with the incubation period of the Giardia parasite. Choice A (12 to 24 hours) is too short for giardiasis to manifest. Choice C (1 to 2 weeks) and choice D (2 to 3 months) represent durations that are not consistent with the usual onset of symptoms in giardiasis.

3. A male patient receiving androgen therapy is concerned about side effects. What is the most serious adverse effect the nurse should monitor for during this therapy?

• A. Increased risk of cardiovascular events
• B. Increased risk of bone fractures
• C. Increased risk of venous thromboembolism
• D. Increased risk of mood changes

Correct answer: A

Rationale: The correct answer is A: Increased risk of cardiovascular events. Androgen therapy can significantly increase the risk of cardiovascular events, such as heart attack and stroke, especially in older patients. Monitoring for signs and symptoms of cardiovascular issues is crucial during this therapy. Choice B, increased risk of bone fractures, is not typically associated with androgen therapy. Choice C, increased risk of venous thromboembolism, is more commonly linked to estrogen therapy rather than androgen therapy. Choice D, increased risk of mood changes, can occur with androgen therapy but is not as serious or life-threatening as cardiovascular events.

4. How often should a patient be administered a tetanus toxoid?

• A. Every year
• B. Every 10 years
• C. Every 2 years
• D. Every 5 years

Correct answer: B

Rationale: Tetanus toxoid should be administered every 10 years to ensure continued protection against tetanus infection. The correct answer is 'Every 10 years.' Choice A ('Every year') is incorrect as the frequency is too frequent. Choice C ('Every 2 years') is incorrect as it is too frequent for tetanus toxoid administration. Choice D ('Every 5 years') is incorrect as it does not align with the recommended interval for tetanus toxoid booster doses.

5. Which of the following is a characteristic of the human immunodeficiency virus (HIV), which causes AIDS?

• A. HIV only infects B cells
• B. HIV is a retrovirus
• C. Infection does not require a host cell receptor
• D. After infection, cell death is immediate

Correct answer: B

Rationale: The correct answer is B. HIV is a retrovirus that infects T cells and leads to the gradual destruction of the immune system. Choice A is incorrect because HIV infects T cells primarily, not just B cells. Choice C is incorrect because HIV infection requires host cell receptors for entry. Choice D is incorrect because cell death after HIV infection is not immediate; instead, the virus gradually weakens the immune system over time.

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