Nursing Elites

1. A 25-year-old just had a colonoscopy and was diagnosed with Crohn disease. Which of the following is consistent with this diagnosis?

• A. Right lower quadrant cramping
• B. Severe bloody diarrhea
• C. Nausea and vomiting
• D. Mostly affects the rectum

Correct answer: A

Rationale: Crohn's disease is a type of inflammatory bowel disease that can affect any part of the digestive tract. Right lower quadrant cramping is consistent with Crohn's disease as it commonly involves the terminal ileum, which is located in the right lower quadrant of the abdomen. Severe bloody diarrhea is more characteristic of ulcerative colitis, another type of inflammatory bowel disease. Nausea and vomiting are not specific symptoms of Crohn's disease. Crohn's disease can affect any part of the digestive tract, not just the rectum, so it is not accurate to say it mostly affects the rectum.

2. A report comes back indicating that muscular atrophy has occurred. A nurse recalls that muscular atrophy involves a decrease in muscle cell size:

• A. Number
• B. Size
• C. Vacuoles
• D. Lipofuscin

Correct answer: B

Rationale: The correct answer is B: Size. Muscular atrophy is characterized by a reduction in the size of muscle cells. This decrease in size can be due to various factors such as disuse, aging, or disease. Choice A, Number, is incorrect because muscular atrophy does not involve a decrease in the number of muscle cells but rather their size. Choice C, Vacuoles, is incorrect as vacuoles are not directly related to the definition of muscular atrophy. Choice D, Lipofuscin, is incorrect as lipofuscin is a pigment associated with aging and has no direct connection to the decrease in muscle cell size seen in muscular atrophy.

3. A patient suffers from an autoimmune disorder. Which of the following represents a potential result of a viral infection in a patient with an autoimmune disorder?

• A. Lymphocytes recognize the host's tissue as foreign.
• B. Erythrocytes destroy the T cells of the host.
• C. The involution of the thymus gland increases the risk of infection.
• D. The differential decreases the sedimentation rate.

Correct answer: A

Rationale: In a patient with an autoimmune disorder, a viral infection can trigger an immune response where lymphocytes mistakenly recognize the host's tissue as foreign. This can lead to an exacerbation of the autoimmune condition. Choice B is incorrect because erythrocytes are not responsible for destroying T cells. Choice C is incorrect as thymus involution weakens the immune response, making the patient more susceptible to infections rather than increasing the infection risk. Choice D is unrelated to the potential effects of a viral infection in a patient with an autoimmune disorder.

4. A 30-year-old man has a history of heart transplant and is receiving long-term steroids to prevent rejection. The patient is due for routine vaccines. Attenuated vaccines are contraindicated in this patient because the antigen is:

• A. live and can cause infection.
• B. mutated and infectious.
• C. inactive but still infectious
• D. pathogenic

Correct answer: A

Rationale: The correct answer is A: live and can cause infection. Patients who are immunocompromised, like those receiving long-term steroids after an organ transplant, should not receive live vaccines because the live attenuated organisms in these vaccines can cause infections in individuals with weakened immune systems. Choice B is incorrect because attenuated vaccines are live but weakened, not mutated. Choice C is incorrect because while inactive, attenuated vaccines are not infectious. Choice D is incorrect because attenuated vaccines are not pathogenic; they are attenuated (weakened) forms of the pathogen.

5. How will taking an oral contraceptive affect the physiologically of an insulin-dependent diabetic patient?

• A. Increase risk of hypoglycemia
• B. Increase heart rate
• C. Increase blood glucose
• D. Increase risk of metabolic alkalosis

Correct answer: C

Rationale: Taking an oral contraceptive can lead to an increase in blood glucose levels in insulin-dependent diabetic patients. This occurs due to the hormonal changes induced by the contraceptive, which can impact insulin sensitivity. Therefore, diabetic patients need to closely monitor their blood glucose levels when starting an oral contraceptive to prevent complications. The other choices are incorrect as oral contraceptives do not typically lead to an increase in heart rate, risk of hypoglycemia, or risk of metabolic alkalosis in this context.

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